X7-qP2-mN9-v4/MTS_Dialogue-Clinical_Note huggingface dataset:
Doctor: When did your pain begin? 
Patient: I've had low back pain for about eight years now.
Doctor: Is there any injury? 
 Patient: Yeah, it started when I fell in an A B C store.
Doctor: How old are you now?
Patient: I'm twenty six.  
Doctor: What kind of treatments have you had for this low back pain? 
Patient: Yeah, I got referred to P T, and I went, but only once or twice, um, and if I remember right, they only did the electrical stimulation, and heat. 
Doctor: I see, how has your pain progressed over the last eight years? 
Patient: It's been pretty continuous, but it's been at varying degrees, sometimes are better than others. 
Doctor: Do you have any children? 
Patient: Yes, I had my son in August of two thousand eight, and I've had back pain since giving birth. 
Doctor: Have you had any falls since the initial one? 
Patient: Yes, I fell four or five days ago while I was mopping the floor. 
Doctor: Did you land on your lower back again?
Patient: Yes, right onto my tailbone. 
Doctor: Did that make the low back pain worse? 
Patient: Yes. 
Doctor: Have you seen any other doctors for this issue? 
Patient: Yes, I saw Doctor X on January tenth two thousand nine, and I have a follow up appointment scheduled for February tenth two thousand nine.

Clinical note:
Symptoms: Low back pain
Diagnosis: N/A
History of Complaint: Traumatic injury to low back eight years ago from a fall at an ABC Store, received physical therapy with modality treatment (electrical stimulation and heat) for one to two visits, continuous low back pain since initial fall, experienced increased symptoms after recent fall landing on tailbone, gave birth in August 2008 and has had low back pain since then, initial physician examination with Dr. X on 01/10/09 with follow-up appointment scheduled for 02/10/09
Plan of Action: N/A
Doctor: Hey, bud. What brings you in today? 
Patient: A rash on my upper arms and torso. 
Doctor: When did it start? 
Patient: Bout a day or two ago. 
Doctor: Any itchiness to the area? 
Patient: Yes, a lot actually. 
Doctor: Have you had episodes of shortness of breath or wheezing? 
Patient: No. 
Doctor: How about swelling to your lips, tongue, or throat? 
Patient: No. 
Doctor: And no nausea or headaches? 
Patient: No. 
Doctor: Have you applied anything to the rash? 
Patient: No, I thought it'd go away on its own.

Clinical note:
Symptoms: Rash on upper arms and torso, itchiness
Diagnosis: N/A
History of Complaint: Rash started about a day or two ago, accompanied by significant itchiness, denies shortness of breath, wheezing, swelling of lips, tongue, or throat, headache, or nausea
Plan of Action: N/A
Doctor: Has anything changed in your medical history since you last visit on April fifteenth two thousand five?
Patient: What do you mean by that?
Doctor: Have you been diagnosed with any new medical conditions, or are you experiencing any new symptoms?
Patient: Oh, no, nothing like that.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: Essentially unchanged medical history from visit on April 15, 2005
Plan of Action: N/A
Doctor: How've you been treating your acne? 
Patient: The dermatologist started me on Accutane.  
Doctor: How long have you been on Accutane? 
Patient: About three months now. 
Doctor: Have you noticed any improvements since starting it? 
Patient: Yeah, kinda.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: Treatment with Accutane for acne for about three months
Plan of Action: N/A
Doctor: Have you been experiencing any mental difficulties or confusion? 
Patient: No. Doctor: Any hallucinations? Are you seeing hearing thing that is not real? 
Patient: No.

Clinical note:
Symptoms: No mental difficulties or confusion, no hallucinations
Diagnosis: N/A
History of Complaint: N/A
Plan of Action: N/A
Doctor: How is his birth history? Was he born normal? Or was there any abnormality? 
Guest_family: He was born at thirty two weeks. He was my fourth pregnancy, and he was around four pounds and eleven ounces. 
Doctor: Was he placed in an incubator? 
Guest_family: Yes, he was there for three weeks. He had jaundice but they didn't give any treatment for it.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: Born at 32 weeks gestation, weighed 4 pounds 11 ounces, placed in incubator for 3 weeks due to jaundice without treatment
Plan of Action: N/A
Doctor: Have you had any surgeries in the past?
Patient: Nope I have not. 
Doctor: Anything?
Patient: No.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: No previous surgeries
Plan of Action: N/A
Doctor: Hello. How are you doing today? 
Patient: Not great. My back is killing me. 
Doctor: What happened?
Patient: I fell down on it. 
Doctor: I see. Let's do some tests to see if you damaged anything.

Clinical note:
Symptoms: Back pain
Diagnosis: N/A
History of Complaint: Back pain after falling
Plan of Action: N/A
Doctor: When are you planning to quit your I V and inhalation drugs Mister X Y Z?
Patient: I am on treatment now. They are following me up for depression issues too.
Doctor: Okay yes, you are on methadone maintenance. 
Patient: Yes.
Doctor: Who lives with you?
Patient: I have a roommate.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: History of inhalation and intravenous drug abuse, currently on methadone maintenance, followed for depression and substance abuse in Psychiatry, lives with a roommate
Plan of Action: N/A
Doctor: Good afternoon, ma'am. 
Patient: Good afternoon, doctor. 
Doctor: Before we begin, how old are you?
Patient: I'm fifty seven years old. 
Doctor: Very well, and what seems to be the problem today? 
Patient: So, I had surgery on these feet, um, like thirteen years ago to remove bunions, but they're back now. 
Doctor: I see, are these bunions present on both feet? 
Patient: Yeah, they are. 
Doctor: Is one foot worse than the other? 
Patient: Yeah, my right foot is worse than the left. 
Doctor: Is the pain getting worse?
Patient: Yes, and I'm so uncomfortable. 
Doctor: On the right foot, do you have any other pain? Or is it just because of the bunion? 
Patient: Well, I have some pain here, and here. 
Doctor: Okay, just so you know, these are the second toe, and M T P joint. This is where you're feeling the pain, right?
Patient: Yes, it hurts so bad there. 
Doctor: There's some deformity here at the second toe as well. 
Patient: Yes, I see what you're talking about. 
Doctor: Going back to that surgery thirteen years ago, did you heal up well?
Patient: Since that surgery this bunion has slowly been coming back. 
Doctor: I see. 
Patient: Please, look at my left foot, do those toes look strange to you?
Doctor: Yes, you have that deformity in the second and third toes of the left foot as well. 
Patient: What does that mean?
Doctor: It means you have some arthritis in these toes. What do you do for a living?
Patient: I see. I work in the hospital.
Doctor: Can I assume you're on your feet all day for work?
Patient: Yes, I have to stand all day every day. 
Doctor: Do you wear supports, or any kind of orthotics? 
Patient: Yes, I wear orthotics. 
Doctor: Do those provide any relief? 
Patient: They definitely give me some relief, but I'm still in so much pain.

Clinical note:
Symptoms: Recurrent bunion deformity in bilateral feet, increasing pain and discomfort, pain localized to second toe and MTP joint of right foot, deformity in second and third toes of left foot
Diagnosis: N/A
History of Complaint: Prior surgery performed approximately 13 years ago for bunions, recurrence of deformity since surgery, progressive deformity in lesser toes of left foot, employed as a hospital employee requiring standing all day, wears functional orthotic for relief of forefoot pain
Plan of Action: N/A
Doctor: Hi, I will ask about some birth related questions about your baby, okay?
Guest_family: Yeah, sure.  
Doctor: Was she born normal or cesarian? 
Guest_family: No cesarian, there was normal delivery. It was spontaneous too. 
Doctor: Where was she born?
Guest_family: At the Women's. 
Doctor: What was her weight at birth?
Guest_family: She weighed seven pounds three ounces.
Doctor: Any complications?
Guest_family: No.
Doctor: Was there any hearing test?
Guest_family: Yeah, she cleared her all her screening tests.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: Normal spontaneous vaginal delivery at Women's, birth weight 7 pounds 3 ounces, no complications, passed hearing screening at birth
Plan of Action: N/A
Doctor: So, where do you work? 
Patient: Oh, I am a data operator for an I T company. 
Doctor: Okay.
Doctor: Do you smoke or drink?
Patient: No, I don't!

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: Denies tobacco or alcohol use, works as a data operator for an IT company
Plan of Action: N/A
Doctor: Who are going to stay with? 
Patient: I am going home with my son. I will stay with him.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: N/A
Plan of Action: Going home with his son
Doctor: When did you move here from Philippines, sir?
Patient: I think somewhere around nineteen eighty four.
Doctor: Oh wow, it's been a while, do you have a green card?
Patient: Yes I do have G C. My apartment is not too far from there.
Doctor: Do you live by yourself? Or you married?
Patient: No, I live by myself. Never been married or widowed or kids.
Doctor: Okay what have you studied?
Patient: I finished high school. But I do work.
Doctor: Okay. Do you drink alcohol or smoke?
Patient: I do smoke but no alcohol.
Doctor: How about drugs?
Patient: I used to but not anymore.
Doctor: Which one?
Patient: Meth.
Doctor: Okay. Do you have a P C P?
Patient: No. But I have a case manager, Mister X Y Z. He is making me go to counselling
Doctor: Okay. Can I get the notes?
Patient: Yes, I can ask them to send you.
Doctor: Okay that will be good.
Patient: Awesome!

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: Immigrated to the country in 1984, has a green card, lives alone, single with no history of marriage or children, completed high school education, history of past methamphetamine use (denied at present), current smoker, denies alcohol use, receiving counseling with case manager named XYZ
Plan of Action: N/A
Doctor: How old are you, sir? 
Patient: I am sixty two year old African American. 
Doctor: Do you have any relevant past medical history? 
Patient: I do have diabetes, high blood pressure and I had a stroke in the year two thousand and two. I do have weakness on my right side after that. I also had two heart attacks. Ah. 
Doctor: Any history of surgery? 
Patient: I have a pacemaker. 
Doctor: It shows here that you came to us in two thousand and one for weakness and numbness in your legs. How is that now? 
Patient: Oh, it was never gone. Instead, it has also moved to my hands and areas above my knees. 
Doctor: What are your symptoms now? 
Patient: It's mostly like something is burning and numbness is still there. 
Doctor: Is that your main concern? 
Patient: Yeah, it is. That is my main problem. I do have pain, but it is not that much of a concern. 
Patient: For the last six months, I cannot feel anything hot in my hands. Things slip out of my hand. I don't have any weakness as such, but it's just like that feeling of clumsiness and it's just lots of sensation. 
Patient: Sometimes I feel, like, these jerks in my body, mainly my shoulders and both hands. 
Doctor: Has it been for some time? 
Patient: It has been like forever but now I am noticing it more than before. 
Doctor: Do you get any kind of tremors? 
Patient: No. 
Doctor: Any neck pain? 
Patient: No, but as you might have noticed I am using this walker because I do not feel safe walking. 
Doctor: Have you used anything for your pain? 
Patient: Yeah, they tried different medicines but only oxycodone helped a little. It does give me sometimes around three hours of relief. Gabapentin did not work at all. 
Doctor: How is your sleep?
Patient: I cannot sleep properly because of the pain. It has been for many years. I haven't had a proper sleep. 
Doctor: When did you get your pacemaker? 
Patient: It was around six months ago after the heart attack and pacemaker I was transferred to a nursing home. There they stopped my insulin and since then, I'm taking tablets for that. 
Doctor: Do you have any back pain?
Patient: Nope. 
Doctor: Any change in bathroom routine? 
Patient: No. 
Doctor: Did you ever have any accidents or any injury before all this started? 
Patient: No, nothing like that.

Clinical note:
Symptoms: Progressive numbness and weakness in lower extremities since 2001, now involving legs above knees and hands, burning sensation and numbness, difficulty feeling hot objects in hands, objects slipping out of hands, muscle jerks in hands and shoulders, unsteadiness with gait, pain (primary concern), difficulty sleeping due to pain
Diagnosis: Diabetes, hypertension, previous stroke in 2002 with residual right-sided weakness, two myocardial infarctions, status post pacemaker insertion
History of Complaint: Symptoms initially presented in 2001, progressively worsening, recent exacerbation of symptoms including difficulty feeling hot objects, objects slipping out of hands, muscle jerks, and pain
Plan of Action: Tried gabapentin with no effect, oxycodone provides partial relief, insulin stopped after pacemaker insertion, currently only on oral medication for diabetes
Doctor: Hi, how can I help?
Patient: No, I just came in for follow up.
Doctor: Okay so just a follow up today. No complaints?
Patient: Nope. Nothing.
Doctor: That's great.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: N/A
Plan of Action: N/A
Doctor: Just to go over few things let me ask, any aches and pains?
Patient: Currently I just have left hip pain and shoulder pain. 
Doctor: Oh, how bad is it?
Patient: Pretty bad.
Doctor: What else is going on?
Patient: I have this leg swelling from last couple weeks. 
Doctor: Any new skin lesions on your legs from the swelling?
Patient: No. 
Doctor: How about problems with urination and abdominal pain?
Patient: No problems with urination.
Doctor: How about chest pain or shortness of breath or hormonal imbalances?
Patient: No I don't have any such problems, except I have vision and hearing problems.
Doctor: You have chronic depression right?
Patient: Yes that is correct.
Doctor: Any sort of headaches?
Patient: No. 
Doctor: What about thyroid dysfunction?

Clinical note:
Symptoms: Left hip pain, shoulder pain, leg swelling, vision problems, hearing problems, chronic depression
Diagnosis: N/A
History of Complaint: Denies urinary problems, abdominal pain, chest pain, shortness of breath, headache syndrome, thyroid dysfunction; presents with swelling in lower extremities
Plan of Action: N/A
Doctor: Hi there! I am Doctor Frankland. 
Patient: Hi. It is nice to meet you.
Doctor: How are you today?
Patient: I'm good. 
Doctor: Do you live at home with both of your parents? 
Patient: Yes. 
Doctor: What grade are you in? 
Patient: Firth grade.
Doctor: Mom, is he in public school? 
Guest_family: Yes. 
Doctor: Is he enrolled in any special education classes?
Guest_family: No. He is in all the regular mainstream classes. 
Doctor: Great!

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: Lives with both parents, attends mainstream 5th grade classes
Plan of Action: N/A
Doctor: What brings you here today, sir?
Patient: I'm feeling a lot of lightheadedness and I just cannot keep stable. I'm losing my balance all the time.
Doctor: Do you have any spinning sensation?
Patient: No, but I had it before when I had vertigo. I'm just feeling lightheaded.
Doctor: Is it happening after anything special you are doing? What symptoms are you witnessing?
Patient:  Whenever I'm trying to change my positions like standing from sitting or getting up from the bed it is happening. Normally sitting back down helps. But it is not completely gone for like fifteen to thirty minutes. I feel very shaky and weak.
Doctor: Are you taking any medications for that?
Patient: Ah yes, I was taking lorazepam, but it did not help with the sensation.
Doctor: Anything else going on?
Patient: Um, my blood pressure was up so they increased my dose of metoprolol for it. They think all these symptoms are because of the increased dose. I just wanted to check in with you as well.

Clinical note:
Symptoms: Lightheadedness, difficulty maintaining balance, weakness, shakiness, worsens with position changes (standing from sitting or lying down), does not fully resolve for 15 to 30 minutes
Diagnosis: N/A
History of Complaint: Previously had vertigo with spinning sensation, currently experiencing lightheadedness without spinning sensation, lorazepam was ineffective, symptoms worsened after increase in metoprolol dosage
Plan of Action: N/A
Doctor: Are you taking any medication?
Guest_family: Yes, I am taking that antibiotic.
Doctor: Oh yes!
Guest_family: Yeah.
Doctor: Yes, you are taking amoxicillin.
Guest_family: That's right.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: No medications other than recent amoxicillin
Plan of Action: N/A
Guest_clinician: I see that the patient was in yesterday. 
Doctor: Yes, she's a frequent flyer. 
Guest_clinician: What's her medical history? 
Doctor: She suffers from bipolar disorder and anxiety. She's also anemic and not on any iron supplements. As for surgeries, she's had her tubes ligated.

Clinical note:
Symptoms: N/A
Diagnosis: Bipolar disorder, iron deficiency anemia, anxiety disorder, history of tubal ligation
History of Complaint: N/A
Plan of Action: N/A
Doctor: Do you smoke? 
Patient: No, I do not.
Doctor: How about alcohol.
Patient: No, I don't drink alcohol as well. 
Doctor: Okay let me ask you, do you have any children or are you married?
Patient: No, I am single, thus no kids.
Doctor: Okay, where do you work?
Patient: I work as a payroll representative. I used to do a lot of work in jewelry business, with chemical. 
Doctor: interesting.
Patient: Yeah.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: Non-cigarette smoker, non-alcohol user, single with no children, works as a payroll representative, previously worked in jewelry business involving chemicals
Plan of Action: N/A
Doctor: I looked over your report from urgent care. 
Patient: They didn't do much other than tell me to follow up with you.  
Doctor: Given that you're sensitive to light and feel nauseated, I believe a migraine is highly likely. 
Patient: Can I take anything for it? 
Doctor: I'm going to prescribe you Tylenol with codeine to help your pain. 
Patient: Can I get a doctor's note, too? 
Doctor: Yes. In fact, I'd like you to take a day off from school and rest until you start to feel better. 
Patient: Okay. Thank you.

Clinical note:
Symptoms: Sensitivity to light, nausea
Diagnosis: Migraine
History of Complaint: Seen in urgent care, prescribed Tylenol with codeine for pain relief, advised to take a day off from school and rest until feeling better
Plan of Action: N/A
Doctor: Let me write you a prescription for Cipro and Flagyl.
Patient: Okay.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: N/A
Plan of Action: Prescribed Cipro and Flagyl
Doctor: Hello, ma'am. How are you doing today? 
Patient: My right hand hurts. 
Doctor: Is that your dominant hand? 
Patient: It is. 
Doctor: I see. What seems to be the problem? 
Patient: I feel like my right thumb just locks up, and I can't move it anymore. 
Doctor: Does it stay locked? 
Patient: No, it doesn't. It just moves out of nowhere. Like right now! 
Doctor: I can see that. Have you seen someone about your thumb before? 
Patient: I have. These are the notes from that visit. Here you go. 
Doctor: Thank you. It looks liked you were diagnoses with stenosing tendinosis, which is trigger finger. 
Patient: Is that common for a fifty one year old woman like me? 
Doctor: Yeah, it is. We can proceed by releasing the A one pulley? 
Patient: Could you describe what that means? Could you also go over the risks and benefits of the surgery?
Doctor: Of course. I'll explain it and give it to you in writing. 
Patient: Thank you. I'll most likely agree to it. I need to fix this thumb.

Clinical note:
Symptoms: Pain and locking sensation in the right thumb
Diagnosis: Stenosing tendinosis (trigger finger)
History of Complaint: Patient has a longstanding history of pain and locking sensation in the right thumb, diagnosed with stenosing tendinosis
Plan of Action: Proceed with release of A1 pulley, risks and benefits of the surgery discussed and agreed upon by the patient
Doctor: Are you keeping up with your food journal? 
Patient: Yes, and I have it with me today. 
Doctor: Good, and you're using calorie points, correct? 
Patient: Yes, I range from twenty six to thirty. 
Doctor: Good, are you exercising regularly?
Patient: Yes, I am. I'm also going to Overeaters Anonymous. 
Doctor: How is that going? 
Patient: Good, my sponsor is helping me, and told me to think about snacks that can help with my high blood sugar. That was what we talked about last. 
Doctor: Good, all of that is good to hear. 
Patient: I'm feeling a lot better, and I've lost weight, but do you have any information on diabetic exchanges, doctor?

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: Patient is keeping a food journal, counting calorie points (26 to 30 per day), exercising regularly, attending Overeaters Anonymous, receiving support from sponsor to plan snacks for high blood sugar, feeling better and has lost weight
Plan of Action: Patient requests information on diabetic exchanges
Guest_clinician: Any significant family history of disease? 
Doctor: None according to my records.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint:  No significant family history of disease according to doctor's records
Plan of Action: N/A
Doctor: Have you ever had surgery?  
Patient: One too many times. 
Doctor: Which ones? 
Patient: I had my appendix taken out and glaucoma surgery fairly recently. I also had my gallbladder taken out ten years ago and a partial colon resection due to colon cancer in nineteen sixty one. 
Doctor: Any recurring episodes of colon cancer? 
Patient: No, thankfully.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: Partial colon resection due to colon cancer in 1961 with no recurrence, cholecystectomy 10 years ago, appendectomy, glaucoma surgery
Plan of Action: N/A
Doctor: What is your surgical history? 
Patient: I had cataract surgery on both eyes. I also had knee replacement surgery on my left knee.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: Left knee arthroplasty, bilateral cataract surgery
Plan of Action: N/A
Doctor: Hi, there. How are you doing? 
Patient: I think I have some sort of condition.
Doctor: Why do you say that? 
Patient: My body has been feeling weird lately. 
Doctor: I see. Is there anything that runs in your family?
Patient: I know a lot of my family has some sort of heart problem. We have high blood pressure and blood sugar. There's one more thing. It starts with a C. Something to do with the brain. Do you know?
Doctor: Is it cerebrovascular disease?
Patient: There you go. How'd you get that so fast?
Doctor: I guess I know my stuff.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: Family history of heart disease, cerebrovascular disease, diabetes, and hypertension
Plan of Action: N/A
Doctor: Hi mister Jones.  Do you remember me from the last time you were here? How old are you now?
Patient: I am fifty two. Yes doc. I remember you. 
Doctor: What have you been using most recently? I need to know what kind of drugs we are dealing with. 
Patient: I gotta kick the heroin. It's going to kill me this time. Please help me. My whole body hurts. I am so cold. 
Doctor: Okay. Is there anything else that you been using recently? Alcohol? Pills? 
Patient: I did some coke. It's this heroin that is going to get me. I used to abuse alcohol, but now I have switched to drugs.

Clinical note:
Symptoms: Whole body hurts, feeling cold
Diagnosis: N/A
History of Complaint: 52-year-old gentleman with history of heroin abuse and recent use, history of cocaine use, history of alcohol abuse
Plan of Action: N/A
Doctor: Anyone sick in your family?
Patient: No one.
Doctor: Okay.
Patient: Everyone is healthy.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: Noncontributory
Plan of Action: N/A
Doctor: Tell me a little more about your family. Are there any significant conditions that your parents or siblings had that you know of?
Patient: Um, my dad died a few years back. He had color cancer and thyroid cancer. 
Doctor: I'm so sorry to hear that, sir. How old was he? 
Patient: Thank you, he was only fifty two. 
Doctor: That's tragic, I'm sorry. What about your siblings?
Patient: I have seven total. One of my brothers died from stomach cancer when he was fifty three and another brother committed suicide. 
Doctor: I'm so sorry to hear that. Can I assume your other siblings are healthy?
Patient: Yes sir, they're all doing very well. 
Doctor: That's good. Do you have any other conditions, like heart disease, high blood pressure, diabetes, or kidney disease? 
Patient: Nope, I keep pretty healthy.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: Family history of colon cancer, thyroid cancer, stomach cancer, and suicide, father died at age 52 from colon and thyroid cancers, one brother died at age 53 from stomach cancer, one brother committed suicide, five other siblings are healthy, negative for coronary heart disease, hypertension, diabetes, or kidney disease
Plan of Action: N/A
Doctor: I have sent over your referral for physical therapy, occupational therapy and speech therapy. The patient coordinator at Siskin Rehab Hospital will give you a call within two days to see up your appointments. It is important to take your medications regularly. You need to continue the Cipro for an additional two days only. That will take care of the U T I. Do you have any questions? 
Patient: No.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: N/A
Plan of Action: Take medications regularly, PT, OT, and speech therapy evaluation and treatment at Siskin Rehab Hospital, continue Cipro for additional two days for UTI
Doctor: Can you tell me about cancer in your family?
Patient: Yes, my mom had stomach cancer and she died at fifty nine.
Doctor: And father?
Patient: My dad died at ninety one years of age.
Doctor: Okay.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: Mother died at age 59 from stomach cancer, father died at age 91
Plan of Action: N/A
Doctor: Does she have any past medical history or health problems? 
Guest_family: No. She is a healthy child.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: Generally very healthy
Plan of Action: N/A
Doctor: I looked at your labs. Everything looks normal for the most part. You do have abnormal levels for Sodium and Creatinine which are related to your kidneys. Then your thyroid levels are not normal as well. 
Patient: How about my E K G? I had a negative pregnancy test.
Doctor: Oh yes that. Your E K G showed a higher heart rate of one twenty two per minute. We will evaluate everything further.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: Labs show abnormal levels for Sodium (133), Creatinine (0.2), TSH (0.004), Free T4 (19.3), EKG showed sinus tachycardia with a rate of 122, negative urine pregnancy test
Plan of Action: Further evaluation of abnormal lab results and EKG findings
Doctor: I'd like to know more about your family's medical history. 
Patient: Buckle up. This is a long one. My son is fifty eight and he suffers from glaucoma, high cholesterol, high blood pressure, and R A. My eldest brother passed away at ninety two due to old age and my two younger brothers followed in their seventies after a long battle with Parkinson disease. 
Doctor: I'm incredibly sorry to hear that. 
Patient: It's alright. Both my mom and dad died in their mid eighties from old age. I think my dad was eighty five and my mom eighty nine.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: Family history includes son with glaucoma, high cholesterol, high blood pressure, and rheumatoid arthritis at age 58, eldest brother died at age 92 from old age, two younger brothers died in their seventies from Parkinson's disease, father died at age 85 and mother at age 89, both from "old age"
Plan of Action: N/A
Doctor: How are you related to the patient?
Guest_family: I am his friend; I work with him in a coffee shop. He works as a cook there.
Doctor: Can you tell me your age? 
Patient: I'm forty one. 
Doctor: Can you tell me what exactly happened? 
Guest_family: He was cooking, and the hot oil splashed onto his arm. 
Doctor: Did this happen in the coffee shop kitchen?
Patient: Yes. I don't know how the oil splashed but burned my hand. I tried to let it cool down, but the pain was unbearable. I asked my friend to take me to the emergency department here. 
Doctor: So, this will be the workers' compensation for injury. 
Patient: I guess, yeah. 
Doctor: OK, let me see your hand. 
Patient: OK. 
Doctor: The burn is from the elbow to the wrist. It is mainly on the medial aspect. 
Doctor: OK, don't worry. We will take care of you.

Clinical note:
Symptoms: Burn on the arm from elbow to wrist, mainly on the medial aspect
Diagnosis: N/A
History of Complaint: Workers' Compensation injury, hot oil splashed onto arm while cooking in coffee shop kitchen
Plan of Action: Provide care for burn injury
Doctor: Are you ready for home?
Patient: Yes.
Doctor: Who will help at home?
Patient: Just my family.
Doctor: That is great.
Patient: Thanks.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: N/A
Plan of Action: Discharge to home with assistance from family
Doctor: It looks like your white blood cell count is normal according to your most recent labs. But, I do want to keep an eye on it given your history of high white blood cells. 
Patient: That's good to hear. I'm glad that it's back to normal. 
Patient: However, I must say that I've been having a lot of pain over the past several days. 
Doctor: Where's the pain located? 
Patient: It's mainly my left shoulder and lower back. 
Doctor: Oh, I see. Have you been taking anything for the pain? I remember you were having problems with your lower back the last time you were here. Did you get a chance to see the orthopedist? I believe the left shoulder pain could be due to impingement syndrome. 
Patient: No, I haven't taken anything for it yet and I forgot to make an appointment with the doc you recommended. I've been smoking cigs to help with the pain. 
Doctor: I'd advise that you try to wean off smoking for now and consider looking into nicotine patches. Let me see what I can do for the pain and if we can schedule you to see an orthopedist. 
Patient: Thanks, doc. I've had a lot of trouble weaning off cigs for a while now. I've also been eating pretty bad, too. I got to do better.
Doctor: It'll take time, but with the right diet and regimen, you'll be on better track towards attaining a healthy weight and lifestyle. 
Patient: Oh, and before I forget-
Doctor: Yes? 
Patient: I seem to be peeing a lot more these days. 
Doctor: Are you experiencing any other urinary symptoms? 
Patient: No, nothing else. 
Doctor: I'll order a urine sample for today's visit to see if you have an infection.
Patient: Thank you, doc. And before you write the order, do you know why my one leg is more swollen than the other? 
Doctor: Let me take a look.

Clinical note:
Symptoms: Left shoulder and lower back pain, increased urination frequency, left leg swelling
Diagnosis: Impingement syndrome (left shoulder pain), chronic low back pain, obesity, tobacco abuse
History of Complaint: History of leukocytosis, chronic low back pain, obesity, tobacco abuse
Plan of Action: Consideration for orthopedist referral for impingement syndrome, encourage weaning off smoking and consideration of nicotine patches, evaluation of urine for possible infection, assessment of leg swelling
Doctor: How are you feeling? 
Patient: I feel good. I feel like I am getting stronger every day.
Doctor: Great! I would like you to continue your exercises at home but please take it slow. Try to stick to the diet we discussed for the next month. Do you have any questions? 
Patient: No.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: N/A
Plan of Action: Activity as tolerated, diet as tolerated
Doctor: Hello, sir. What brought you in today? 
Patient: Do you not see the swelling on my right hand and arm? I'm white. The swelling should be noticeable!
Doctor: Oh, wow! How did this happen? 
Patient: I got stung by this huge Yellow Jacket Wasp yesterday. I usually see Doctor X Y Z, but he wasn't available. 
Doctor: I see. Have you ever been stung by a wasp before? 
Patient: Oh, yeah. Plenty of times. I'm twenty nine right now. I've been getting stung since I was in my early twenties. I usually just swell up like I am right now. 
Doctor: That's good. You never had any severe reactions before? 
Patient: I did one time before, which is why I came here early to get it checked out. 
Doctor: I see. Just a lot of swelling, correct? What about any anaphylaxis type reactions? 
Patient: What type of reaction? I don't know what that means, but you're right about the swelling. 
Doctor: It's a reaction that occurs that makes your body go into shock and lowers your blood pressure. 
Patient: Oh, I get you. No, I've never experienced that before. 
Doctor: Great. Have you ever felt a shortness of breath or your throat closing up before?
Patient: Nope. That would be really scary though. 
Doctor: Sounds good. Have you ever felt anxious or a fast heart beat after you've been stung? 
Patient: No, I haven't. I've only had swelling in the areas I've been stung.

Clinical note:
Symptoms: Swelling in right hand and arm
Diagnosis: N/A
History of Complaint: 29-year-old white male with history of wasp stings resulting in localized swelling, no history of anaphylaxis-type reactions, shortness of breath, throat closure, racing heart beat, or anxiety
Plan of Action: N/A
Doctor: Are you in pain?
Patient: Yes, I want something strong for this. 
Doctor: We can give you a shot.
Patient: Yes please.
Doctor: Okay nurse, give her Dilaudid of 4 M G I M.
Patient: Thank you.
Doctor: How are you now? Any bad side effects?
Patient: No I feel much better.

Clinical note:
Symptoms: Pain
Diagnosis: N/A
History of Complaint: N/A
Plan of Action: Patient received Dilaudid 4 mg IM for pain without adverse reaction
Doctor: Do you smoke cigarettes? 
Patient: No. No cigarettes. 
Doctor: Do you drink alcohol or use recreational drugs? 
Patient: I drink alcohol and I smoke weed from time to time.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: Denies smoking cigarettes, admits to alcohol consumption and occasional marijuana use
Plan of Action: N/A
Doctor: Are you a smoker? 
Patient: Yes. I do not drink if that is any constellation. 
Doctor: How much do you smoke per day? 
Patient: I just started taking Chantix and now I am down to a half a pack a day.
Doctor: How much did you smoke per day prior to starting Chantix? 
Patient: I was smoking about two to three packs a day. I have been smoker since I was ten years old.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: Smoker since age 10, previously smoked 2-3 packs per day, currently smoking half a pack per day after starting Chantix, denies alcohol abuse
Plan of Action: N/A
Doctor: Let me add Flagyl intra venously. It will be five hundred M G every eight hours and I would also like to add Levaquin five hundred M G daily. 
Patient: Okay.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: N/A
Plan of Action: IV Flagyl 500 mg every 8 hours, Levaquin 500 mg daily
Doctor: Any difficulty in hearing? 
Patient: No.
Doctor: Difficulty swallowing?
Patient: Um no.
Doctor: Any double vision or blurred vision or difficulty seeing things properly?
Patient: No, no problem at all.
Doctor: Okay.
Doctor: How about headaches or migraine?
Patient: No headache. 
Doctor: Did you notice any change in your bowel moment? 
Patient: No, it is the same.
Doctor: Any pain while urinating or change in frequency? 
Patient: No.
Doctor: Okay.

Clinical note:
Symptoms: N/A
Diagnosis: No headaches, no visual, hearing, or swallowing difficulties, no changes in bowel or urinary habits
History of Complaint: N/A
Plan of Action: N/A
Guest_clinician: I did a review of her systems, and everything looks normal other than what was mentioned earlier.
Doctor: Okay, thanks for your help. 
Guest_clinician: No problem.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: N/A
Plan of Action: N/A
Doctor: Okay, so let's go over the plan again. I'd like you to apply Acticoat dressing daily and make sure you're spending at least eight hours out of the chair for pressure relief. Any questions? 
Patient: That sounds doable. I'll try my best. No questions about the plan.
Doctor: I'd also like you to come back in a week for a reevaluation. 
Patient: Can I make that appointment today? 
Doctor: Yes, the receptionist will be able to get you on the schedule for next week. 
Patient: Great.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: N/A
Plan of Action: Daily application of Acticoat dressing, pressure relief by spending at least 8 hours out of the chair, follow-up appointment in one week
Doctor: When are you planning to quit? 
Patient: I always plan to do it.
Doctor: Okay let me refer you to a substance abuse clinic because you need it.
Patient: Okay, I will look at it.
Doctor: Sure. But please try to stop your substance abuse. It is a bad habit.
Patient: Yes.

Clinical note:
Symptoms: N/A
Diagnosis: Substance abuse
History of Complaint: N/A
Plan of Action: Referral to substance abuse clinic, encouragement to stop substance abuse
Doctor: Do you have a history of tobacco, alcohol or recreational drug use? 
Patient: No.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: Denies history of tobacco, alcohol, or recreational drug use
Plan of Action: N/A
Doctor: How are you Miss G? 
Patient: I am good doctor, thank you for asking. 
Doctor: So, tell me what is going on?
Patient: I have this ear pain and headache for some time. It's better than before but I still want to get it checked. 
Doctor: Okay, when exactly did it start?
Patient: Um, almost three weeks ago. I am having difficulty hearing. I also feel this pressure on the left side of my sinus causing tooth pain. I went to my dentist yesterday, but my teeth are fine. 
Doctor: Okay, do you have headache now?
Patient: No, just ear pain and this jaw pain on the left side. 
Doctor: Any fever, cough, sore throat, or any cold like symptoms? 
Patient: No, but I have a sinus problem and I suffer from chronic left sided headache.
Doctor: How old are you?
Patient: Oh, I am forty nine.
Doctor: Hm, so are you taking any medications for your pain?
Patient: No, currently I am just using Cutivate for my eczema. It has helped me a lot, I do need a refill for it. 
Doctor: Okay I will send a prescription for it to your pharmacy.

Clinical note:
Symptoms: Ear pain, headache, difficulty hearing, left-sided sinus pressure, tooth pain on left side, left-sided jaw pain
Diagnosis: N/A
History of Complaint: Symptoms started approximately three weeks ago, difficulty hearing has improved, chronic left-sided headache, history of atopic dermatitis, sinusitis
Plan of Action: Refill prescription for Cutivate cream, further evaluation and treatment for ear pain and headache
Doctor: So, I have the evaluation report from your psychiatrist.
Patient: Ah, okay and what does it says?
Doctor: Well, he thinks you are doing really good. 
Patient: Nice!

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: N/A
Plan of Action: Refer to psychiatric evaluation report
Doctor: How are you today? 
Patient: I am doing okay. 
Doctor: Just to confirm, you are fifty seven years old? 
Patient: Yes. 
Doctor: What brings you to see me today? 
Patient: I have been having these headaches every day for the last six months. 
Doctor: That is a long time. I am sorry that you have been experiencing that. 
Patient: Well, I am hoping you can make them stop. 
Doctor: I will do my very best to help.

Clinical note:
Symptoms: Daily headaches for the last six months
Diagnosis: N/A
History of Complaint: N/A
Plan of Action: Further evaluation and treatment for daily headaches
Doctor: Welcome to the office, Miss A. I am Doctor Luna. 
Patient: Thank you. It is nice to meet you. 
Doctor: What is your family medical history? 
Patient: My mother died about three or maybe it is four years ago? 
Doctor: I am so sorry to hear that. How did she pass? 
Patient: She had lung cancer. My mom didn't talk much about her own health problems. 
Doctor: What about your father? Does he have any health conditions? 
Patient: My dad has gout. I think he also had blood clots. That is all that I can remember my dad talking about. 
Doctor: Do you have siblings? 
Patient: Yes. My brother has asthma and uses an inhaler. My sister had some sort of tumors removed from her stomach or something.  Oh, I think I remember my mom talking about some of her family having issues with high blood pressure, high cholesterol and someone had a stroke. I am not sure though. 
Doctor: Okay.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: Difficulty providing familial medical history, mother deceased from lung cancer, father has gout and blood clots, siblings treated for asthma and GI tumors, uncertain about other familial medical conditions
Plan of Action: N/A
Doctor: Are you taking any medications? 
Patient: No.
Doctor: Any over the counter drugs or anything?
Patient: None.
Doctor: Okay.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: N/A
Plan of Action: N/A
Doctor: Do you know any familiar diseases in your family? 
Patient: Do you mean like B P, high sugar? 
Doctor: Yes.
Patient: No, no one in my family has anything like that.
Doctor: Great.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: Non-contributory family medical history
Plan of Action: N/A
Doctor: Hi sir, let me start by getting your age.
Guest_family: He is fifty three!
Doctor: So, tell me what's going on?
Guest_family: He is complaining of so many things but-
Patient: But I have a lot of pain from my hernia. That's the number one complaint, but I am also having pain in my lower legs.
Guest_family: He has so many issues going on with him, that is why I got him to emergency.
Patient: My wife freaks out easily. 
Doctor: Don't worry, let me take a look. So, any nausea and or vomiting? 
Patient: Yes both. And I am not sure, but I think I noticed some blood in my stool.
Doctor: Oh, but you are not sure?
Patient: It is questionable!
Doctor: I see. And on the scale of one to ten, ten being severe, how will you rate your lower extremity pain?
Patient: Actually, my leg pain has improved considerably. I did have more significant tingling and numbness in the past but now it has improved a great deal.
Doctor: Hm.
Guest_family: He has so many medical issues. Here, I have gotten his reports. You can look at them Doctor. 
Doctor: Oh, that's great, thank you for getting these, let me go through them quickly. So, I see you have a history of multiple-
Guest_family: Strokes?
Doctor: Yeah, also called as C V A. Peripheral vascular disease. Oh, and heart failure too. 
Guest_family: Yes.
Patient: Yeah.
Doctor: And you also have a history of multiple bowel ischemia. 
Patient: Well, yeah.
Doctor: There is a reason why your wife is worried. So, are you taking any medicines currently?
Guest_family: He is taking Coumadin for his atrial fibrillation. Also, they mentioned it's not optimal for his condition but-
Doctor: Oh, I see its subtherapeutic. 
Patient: Yeah, but I am still taking it.

Clinical note:
Symptoms: Pain from hernia, lower leg pain, nausea, vomiting, questionable blood in stool
Diagnosis: N/A
History of Complaint: 53-year-old man presenting with multiple complaints including pain from hernia, some question of blood in stool, nausea, vomiting, left lower extremity pain. Left lower extremity pain has improved considerably, with past significant paresthesias now improved. History of multiple medical problems including atrial fibrillation, on subtherapeutic Coumadin, multiple CVAs in the past, peripheral vascular disease, congestive heart failure, multiple previous ischemia of large bowel.
Plan of Action: N/A
Doctor: Do you have any prior history of surgeries? 
Patient: I had surgery on my back and shoulder after a bad skiing accident.  
Doctor: How long ago did you have those surgeries? 
Patient: About three to four years ago. Oh, I had my appendix removed when I was a teenager.

Clinical note:
Symptoms: N/A
Diagnosis: N/A
History of Complaint: Back surgery and shoulder surgery performed approximately three to four years ago, appendicectomy during teenage years
Plan of Action: N/A
Doctor: So, ma'am, what brings you in for a visit today? 
Patient: Well, a few things, I have hay fever, um, eczema, sinus problems, and hives. 
Doctor: Wow, that's quite a lot. Do you have any history of melanoma, or skin cancer? 
Patient: No, just the eczema. 
Doctor: How about psoriasis? 
Patient: No, that doesn't ring any bells. 
Doctor: Do you have any family history of cancer? 
Patient: Um, yes, my mother had mouth cancer. 
Doctor: I see, do you smoke tobacco? 
Patient: Um, no, that never appealed to me, especially with the history of cancer. 
Doctor: Can I safely assume that you've been sunburned before? 
Patient: Sure, it happens when I go to the beach all the time. 
Doctor: What medicines are you taking right now? 
Patient: Um, I'm taking benzoyl peroxide and Daypro. Sorry I forgot to bring the blood test today.

Clinical note:
Symptoms: Hay fever, eczema, sinus problems, hives
Diagnosis: N/A
History of Complaint: No history of melanoma or skin cancer, no psoriasis, family history of oral cancer (mother), nonsmoker, had sunburn in the past
Plan of Action: On benzoyl peroxide and Daypro, no blood tests brought today
Doctor: Hello, this is my assistant, and she will be working with me today for your care. Can you please represent the patients case? 
Guest_clinician: This is Miss A B C. She's here for her follow up regarding her cervical spinal stenosis. She was seen by you on nineteenth June. She had an incident on fourth of June, when she lifted many objects and experienced exacerbated symptoms. She is experiencing paresthesia, weakness, and pain in her upper extremities on the right side more than the left since then. She was referred for a cervical spine M R I. 
Doctor: So, how are you feeling today? 
Patient: I'm still having all those things like pain and weakness, and I believe that everything is coming down from my neck.
Doctor: Did you get some physical therapy? Did it help? 
Patient: I did some. It was helping me with my neck pain. But this right hand is still feeling weak. I feel it is difficult at times to open jars and open doors. Many times, I drop items. 
Doctor: Is it happening with both hands or one is more than the other? 
Patient: Right side is giving me more problems than the left. 
Doctor: Anything else that you noticed? 
Patient: Yeah, one more thing I noticed is that sometimes when I am sleeping in the night, I feel this sharp shooting pain and weakness. It goes down my left side of upper, I mean, whole hand and I feel scared after that. 
Doctor: Are you seeing anyone for that? 
Patient: Yeah, Doctor X is trying to help me, uh, with that without surgery. His methods are good it and it is helping me with my neck pain, but not hand. 
Doctor: Are you having any issues with your bowel movements? 
Patient: Nope. 
Doctor: Any pain in the lower side of your back or in your legs? 
Patient: Nope. 
Doctor: Any problem with walking or stability? 
Patient: Nope.

Clinical note:
Symptoms: Right greater than left upper extremity pain, weakness, paresthesias, sharp shooting radicular pain and weakness down left upper extremity
Diagnosis: Cervical spinal stenosis
History of Complaint: Incident on 06/04/07 exacerbating symptoms, ongoing right upper extremity pain, paresthesias, weakness believed to radiate from neck, physical therapy helping with neck pain but not hand weakness, difficulty opening jars and doors, often drops items from right upper extremity, nonoperative management by Dr. X for neck pain but not upper extremity symptoms, no bowel or bladder dysfunction, no lower back pain, no lower extremity pain, no instability with ambulation
Plan of Action: N/A