Dialogue:
Doctor: What race and gender do you identify with?
Patient: I'm white, and I identify as male. 
Doctor: Okay, and how old are you? 
Patient: I'm fifty years old. 
Doctor: How long have you had lower back pain? 
Patient: It's been continuous for about two years. I was in an accident. 
Doctor: Has there been another accident since this one two years ago? 
Patient: About two and a half days ago I threw out my back while I was unloading my buddy's motorcycle. I really felt it when it happened.  
Doctor: Has your pain gotten worse over the last couple days? 
Patient: Yeah, I rode up to Massachusetts and Maine to pick up some clients the day after, and I think that aggravated my chronic back pain too. 
Doctor: Have you ever had surgery in the past? 
Patient: I broke my pelvis before, and I have a screw in my right hip. 
Doctor: What kind of treatments have you had for your back pain?
Patient: Um, I have them written down, um, Ultram, Celebrex, gabapentin, and amitriptyline. 
Doctor: Who prescribed you those? 
Patient: My P C P. He doesn't give opiates for chronic back pain. 
Doctor: Have you seen another doctor? 
Patient: I went to another doctor for another opinion, and he recommended that I follow up at a pain clinic to talk about more treatment options, um, like medicine. I think that's what I need.  
Doctor: Did you seen the pain management specialist? 
Patient: No, I wasn't feeling well at that time, so I came to the E D and I saw Doctor X. 
Doctor: How did Doctor X treat you?
Patient: He gave me a prescription for twelve Vicodin and he gave me some more to take home when I left the E D last night. 
Doctor: Did you fill that prescription? 
Patient: No, not yet. I told the nurse too, but I don't think I'll have enough to last through the weekend. 
Doctor: Do you have any medicine at home?
Patient: I have, um, methadone and Darvocet from previous prescriptions, should I restart those? 
Doctor: Let me write down the medicines you are taking and attach it to the chart.

Clinical note section (GENHX):
Patient is a 50-year-old white male complaining of continued lower back pain.  Patient has a history of chronic back pain, dating back to an accident that he states he suffered two years ago.  He states he helped a friend unload a motorcycle from a vehicle two-and-a-half days ago, after which he "felt it" in his lower back.  The following day (two days ago), he states he rode to Massachusetts and Maine to pick up clients.  He feels that this aggravated his chronic back pain as well.  He also claims to have a screw in his right hip from a previous surgery to repair a pelvic fracture.  He is being prescribed Ultram, Celebrex, gabapentin, and amitriptyline by his PCP for his chronic back pain.  He states that his PCP has informed him that he does not prescribe opiate medications for chronic back pain. The patient did self-refer to another physician, who suggested that he follow up at a pain clinic for his chronic back pain to discuss other alternatives, particularly the medications that the patient feels that he needs.  Patient states he did not do this because he was feeling well at that time. The patient did present to our emergency room last night, at which time he saw Dr. X.  He was given a prescription for 12 Vicodin as well as some to take home last night.  The patient has not picked up his prescription as of yet and informed the triage nurse that he was concerned that he would not have enough to last through the weekend.  Patient states he also has methadone and Darvocet at home from previous prescription and is wondering if he should restart these medicines.  He is on several medications, the list of which is attached to the chart.