Dialogue:
Doctor: Hello, miss. What brings you into our clinic today? Also, before we start, it looks like you forgot to fill out your ethnicity on the new patient paperwork. Do you mind telling me what you identify as?
 Patient: Hello, doctor. I am white and I am a young sixty two years old. I have a list of issues I would like to talk about. 
Doctor: Let's begin. I know that you have been dealing with hypertension and lipometabolism disorder. Doctor X Y Z and I follow you on the hypertension. What else do we have going on?
Patient: First off I have a history of diabetes in my family. My father had it and my brother has it currently. I am afraid because I know I have gained some weight. My knee also has been hurting for a long time. The left knee. 
Doctor: Can you locate where the pain is?
Patient: I think it is everywhere in the knee. It hurts to kneel. I had imaging done on it a while ago. Can you check to see the results?  
Doctor: Ah, yes. We have on file that you had an X Ray done in nineteen ninety nine. I see that a joint is narrowing. We can talk about possible surgery. 
Patient: Can I have it x rayed again? I don't want any surgery, but I want to know what is going on. I am afraid of surgery. 
Doctor: Let's see what else I can do. Any other issues?
Patient: Yes. I am very concerned because my poop is baby yellow and I have some rectal bleeding occasionally. It is always bright red and drips into the toilet. My last colonoscopy was in nineteen ninety nine. 
Doctor: Do you have any history of colon cancer?
Patient: I do not, but I think my mother did. She is gone now, so I cannot check. Do you think my poop is baby yellow because of my stomach pain? I have some stomach pain and have been laying off the fast food and soda, but it doesn't seem to work. Sometimes my poop is hard or runny. It is always random. 
Doctor: Do you bleed when the stool is hard?
Patient: Not really. Oh, and lastly, I had cold symptoms. Like a sore throat and I was sneezing a lot. I think it was a cold or flu because Claritin did not work. I think the body aches were also from this illness. I feel okay today, but I wanted to bring this up just in case it had to do with my stool being discolored. During this sick period I also am wondering if I have sleep apnea because I wake up in the middle of the night randomly. 
Doctor: Do you snore? That is a sign of sleep apnea. Smoking also can contribute to restlessness.
Patient: No I do not snore and I do not smoke.

Clinical note section (GENHX):
The patient is a 62-year-old white female with multiple chronic problems including hypertension and a lipometabolism disorder.  She follows with Dr. XYZ on her hypertension, as well as myself.  She continues to gain weight.  Diabetes is therefore a major concern.  In fact, her dad had diabetes and she has a brother who has diabetes.  The patient also has several additional concerns she brings up today.  One is that her left knee continues to bother her and it hurts.  She cannot really isolate where the pain is, it just seems to hurt through her knee.  She has had this for some time now and in fact as we reviewed her records, her left knee has been x-rayed in 1999.  There was some minimal narrowing of the weightbearing joint with some minor hypertrophic spurring medially.  She would like to have this x-rayed again today.  She is certainly not interested in any surgery.  She has noted that it particularly hurts to kneel.  In addition, she complains of her stools being a baby-yellow.  She has rectal bleeding off and on.  It is bright red.  She had a colonoscopy done in 1999.  She does have a family history of colon cancer questionable in her mother, who is deceased.  She complains of some diffuse abdominal pain off and on.  She has given up fast foods and her pop and this has not seemed to help.  She does admit however, that she is not eating right.  Sometimes her stools are hard.  Sometimes they are runny.  The blood does not really seem to be related to necessarily a hard stool.  It is always bright red and will sometimes drip into the toilet.  Over the last couple of days, she had also been sneezing and has had an itchy throat.  She tried some Claritin and this did not help.  She has had some body aches.  She is finally feeling better today with this.  She also is questioning whether she has some sleep apnea.  She will awaken suddenly in the middle of the night.  She was told that she does snore.  She does not smoke.  As stated, she has gained significant weight.