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idx int64 6 114	inputs stringlengths 3.88k 11.5k	target stringlengths 306 1.78k	user_instruction stringclasses 1 value	system_prompt stringclasses 1 value
69	[doctor] hi , ms. thompson . i'm dr. moore . how are you ? [patient] hi , dr. moore . [doctor] hi . [patient] i'm doing okay except for my knee . [doctor] all right , hey , dragon , ms. thompson is a 43 year old female here for right knee pain . so tell me what happened with your knee ? [patient] well , i was , um , tr...	PLAN At this point, I discussed the diagnosis and treatment options with the patient. I have recommended a knee brace. She will take Motrin 800 mg, every 6 hours with food, for two weeks. She will use crutches for the next couple of days. She will follow up with me in 1 week for a repeat evaluation. If she is not bett...	Summarize the patient/doctor dialogue into an assessment and plan.	You are a clinical expert and you are summarizing the patient/doctor dialogue into an assessment and plan. Focus on symptoms.
33	[doctor] so sophia i see that you you hurt your knee tell me about what happened [patient] yeah i was jumping on my kid's trampoline and i could just slipped out from under me [doctor] my gosh one of those big trampolines in your back yard [patient] yeah a pretty big one [doctor] okay which knee was it [patient] my rig...	ASSESSMENT AND PLAN 1. Right knee pain. - Medical Reasoning: I am concerned about a torn MCL due to pain on ambulation and trouble with weightbearing, as well as the pop she heard. - Patient Education and Counseling: We discussed treatment options today including bracing, anti-inflammatories, and icing. - Medical Tr...	Summarize the patient/doctor dialogue into an assessment and plan.	You are a clinical expert and you are summarizing the patient/doctor dialogue into an assessment and plan. Focus on symptoms.
80	[doctor] okay hi andrea well i [patient] hello [doctor] i understand you're you've come in with some right knee pain can you tell me about it what's going on [patient] it it's not the right knee it's the left knee [doctor] okay the left knee [patient] and it just happens occasionally less than once a day when i'm walki...	ASSESSMENT 1. Left knee pain. 2. Hypertension. 3. Diabetes mellitus type 2. PLAN After reviewing the patients x-rays, I believe there is some arthritis in the knee. I'm going to prescribe meloxicam 15 mg once daily. We can consider physical therapy to strengthen the muscles around the area to prevent any further i...	Summarize the patient/doctor dialogue into an assessment and plan.	You are a clinical expert and you are summarizing the patient/doctor dialogue into an assessment and plan. Focus on symptoms.
13	[doctor] hi , john , how are you doing ? [patient] hi , good to see you . [doctor] good to see you too . so i know the nurse told you about dax , i'd like to tell dax a little about you . [patient] sure . [doctor] so john is a 55-year-old male with a past medical history significant for anxiety and epilepsy who present...	ASSESSMENT AND PLAN John Brooks is a 55-year-old male with a past medical history significant for anxiety and epilepsy. He presents today with an abnormal lab finding. Newly diagnosed diabetes. • Medical Reasoning: His past hemoglobin A1c levels have been borderline high, but his most recent level was 8. His blood...	Summarize the patient/doctor dialogue into an assessment and plan.	You are a clinical expert and you are summarizing the patient/doctor dialogue into an assessment and plan. Focus on symptoms.
97	[doctor] elizabeth , how are you ? [patient] i'm doing okay . how are you ? [doctor] doing okay . so i know the nurse told you about dax . i'd like to tell dax a little bit about you , okay ? [patient] okay . [doctor] all right . elizabeth is a 66-year-old female with a past medical history of significant for depressio...	ASSESSMENT AND PLAN Elizabeth Peterson is a 66-year-old female with a past medical history significant for depression and hypertension. She presents today for her annual exam. Depression. • Medical Reasoning: She is doing well with weekly therapy. She also has a solid support system at home. • Medical Treatment: ...	Summarize the patient/doctor dialogue into an assessment and plan.	You are a clinical expert and you are summarizing the patient/doctor dialogue into an assessment and plan. Focus on symptoms.
108	[doctor] hey gregory good to see you today so take a look at my notes and i see that you're here you've had a nonhealing foot ulcer so can you tell me how you're doing how long have you had it what's going on with it [patient] sure so i've had it for about two months now and it's recently become red and is draining so ...	ASSESSMENT Right diabetic foot ulcer. PLAN After reviewing the patient's examination and radiographic findings today, I have had a lengthy discussion with the patient in regards to his current symptoms. I have explained to him that his x-rays did not reveal any evidence of osteomyelitis. I have recommended that we o...	Summarize the patient/doctor dialogue into an assessment and plan.	You are a clinical expert and you are summarizing the patient/doctor dialogue into an assessment and plan. Focus on symptoms.
37	[doctor] hey dylan what's going on so i lift quite a bit of weights i try to stay in shape as much as i can i'm not like normal people i lift heavy weights and my elbow is extremely sore which elbow is it [patient] actually it's both my elbows but my right elbow is hurting me the most [doctor] okay and you said you lif...	ASSESSMENT Bilateral medial epicondylitis. PLAN After reviewing the patient's examination and radiographic findings today, we had a lengthy discussion in regards to his current symptoms. I want to get an MRI of the bilateral elbows for further evaluation. We discussed the possibility of performing a whole blood tran...	Summarize the patient/doctor dialogue into an assessment and plan.	You are a clinical expert and you are summarizing the patient/doctor dialogue into an assessment and plan. Focus on symptoms.
18	[doctor] hi miss russell . [patient] hi- [doctor] nice to meet you- [patient] doctor gutierrez . how are you ? [doctor] i'm well . [patient] good . [doctor] hey dragon . i'm seeing miss russell . she's a 39-year-old female here for , what are you here for ? [patient] it's my right upper arm . it hurts really , really b...	PLAN At this point, I discussed the diagnosis and treatment options with the patient. I have recommended we place her into a long arm cast and sling. She will follow up in 2 weeks for repeat imaging. At that point, we may need to discuss surigical options. I will prescribe Lortab, 5 mg, #20 (twenty) to take every 6 ho...	Summarize the patient/doctor dialogue into an assessment and plan.	You are a clinical expert and you are summarizing the patient/doctor dialogue into an assessment and plan. Focus on symptoms.
65	[doctor] hey anna good to see you today so i'm looking here in my notes says you have you're coming in today for some right ankle pain after a fall so can you tell me what happened how did you fall [patient] yeah so i was taking out the trash last night and i ended up slipping on a patch of ice like and then when i fel...	ASSESSMENT Right ankle sprain. PLAN After reviewing the patient's examination and radiographic findings today, I have had a lengthy discussion with the patient in regards to her current symptoms. I have explained to her that her symptoms are consistent with a right ankle sprain. I have recommended that we treat the ...	Summarize the patient/doctor dialogue into an assessment and plan.	You are a clinical expert and you are summarizing the patient/doctor dialogue into an assessment and plan. Focus on symptoms.
28	[doctor] patrick allen . date of birth : 7/7/1977 . new patient visit . past medical history includes gerd , anxiety , depression . here for chronic abdominal pain . he had an abdominal ct on 1/23/2020 . impression is a normal ct of the ab- abdomen . [doctor] hello , are you mr. allen ? [patient] yes , i am . [doctor] ...	ASSESSMENT • Constipation • Mild hepatomegaly PLAN Patrick Allen is a 42-year-old male who presents for a new patient visit for chronic abdominal pain, constipation, and diarrhea. The most likely etiology of his abdominal pain is constipation given his history, exam with increased stool burden, and normal abdominal...	Summarize the patient/doctor dialogue into an assessment and plan.	You are a clinical expert and you are summarizing the patient/doctor dialogue into an assessment and plan. Focus on symptoms.
75	[doctor] next is betty hill , uh , date of birth is 2/21/1968 . she has a past medical history of uterine fibroids and anemia . she's a new patient with a referral from the er of esophagitis . um , i reviewed our records from the er , including the normal cardiac workup , and we're about to go in and see her now . good...	ASSESSMENT The patient presents today following a visit to the emergency department in early 10/2020 for 4-days of sharp chest pain, made worse by eating, and dysphagia. Notably, the patient was experiencing higher levels of stress than normal for her at that time due to a job transition. Her cardiac evaluation in the...	Summarize the patient/doctor dialogue into an assessment and plan.	You are a clinical expert and you are summarizing the patient/doctor dialogue into an assessment and plan. Focus on symptoms.
46	[doctor] okay so we are recording okay so okay so i understand you've so you've got a past medical history of type two diabetes and you're coming in and for evaluation of a newly diagnosed ovarian cancer so how are you doing today [patient] i do n't hear the question but i'm assuming that you when you say batcher so wh...	ASSESSMENT AND PLAN 1. Ovarian cancer. - Medical Reasoning: Looking at her abdominal CT results, it appears to be stage IIIA disease based on the lymph node involvement. - Patient Education and Counseling: I explained to the patient that the typical approach to treating this stage of cancer is surgical intervention ...	Summarize the patient/doctor dialogue into an assessment and plan.	You are a clinical expert and you are summarizing the patient/doctor dialogue into an assessment and plan. Focus on symptoms.
62	[doctor] okay raymond it looks like you've been having some difficulty swallowing over for a period of time could you tell me like what's going on [patient] well i've been better for the last several weeks i've been noticing that it's been hard for me to swallow certain foods and i also have pain when i swallow down in...	ASSESSMENT Acute esophagitis. PLAN After reviewing the patient's examination and barium swallow findings today, I have had a lengthy discussion with the patient in regards to his current symptoms. I have prescribed the patient Protonix 40 mg first thing in the morning to treat his acute esophagitis. I have also pres...	Summarize the patient/doctor dialogue into an assessment and plan.	You are a clinical expert and you are summarizing the patient/doctor dialogue into an assessment and plan. Focus on symptoms.
39	[doctor] hi virginia how are you today what brings you in [patient] i'm doing alright i started seeing this new pcp last year and you know she has been doing a lot of changes to my medication and making sure everything is up to date and she my noticed that my blood pressure has been quite high so she added to medicatio...	ASSESSMENT AND PLAN 1. Hypertension, uncontrolled. - Medical Reasoning: The patient's elevated blood pressure is consistent with uncontrolled hypertension. - Patient Education and Counseling: We discussed the nature of the diagnosis and that this is typically multifactorial. I advised the patient that further testin...	Summarize the patient/doctor dialogue into an assessment and plan.	You are a clinical expert and you are summarizing the patient/doctor dialogue into an assessment and plan. Focus on symptoms.
107	[doctor] so bryan it's nice to see you again in the office today what's going on [patient] i was in my yard yesterday and i was raking leaves and i felt fine and then when i got into my house about two hours later my back started tightening up and i started getting pins and needles in my right foot [doctor] alright hav...	ASSESSMENT Low back sprain. PLAN The examination findings and x-ray results were discussed with the patient and his partner today. I recommend we treat this conservatively with rest, meloxicam, and formal physical therapy. If he fails to improve, we can consider obtaining an MRI for further evaluation.	Summarize the patient/doctor dialogue into an assessment and plan.	You are a clinical expert and you are summarizing the patient/doctor dialogue into an assessment and plan. Focus on symptoms.
101	[doctor] patient is julia jones , date of birth 5/16/1996 . she is a new breast reduction consult . hello , how are you doing today ? i'm dr. gonzalez . it's nice to meet you . [patient] nice to meet you , ma'am . how are you ? [doctor] i'm doing good , thank you . so you're here to discuss a breast reduction , correct...	ASSESSMENT • Macromastia. Julia Jones is a 25-year-old female with symptomatic macromastia presenting for evaluation of breast reduction. The patient has attempted non-surgical treatments with minimal relief and is an ideal candidate for bilateral reduction mammoplasty. Her minimum required resection based on a BSA...	Summarize the patient/doctor dialogue into an assessment and plan.	You are a clinical expert and you are summarizing the patient/doctor dialogue into an assessment and plan. Focus on symptoms.
52	[doctor] so anna good to see you today so reading here in your appointment notes you were you were diagnosed with kidney stones from your your pcp and you currently have one and so they they had you come in so can you tell me what happened how's all that going for you [patient] sure i've been having some back pain on m...	ASSESSMENT Kidney stone, right side. PLAN After reviewing the patient's examination and CT results, I discussed the findings with the patient. The CT scan revealed a 0.5 cm kidney stone in the proximal right ureter. I advised her to drink plenty of fluids, as much as possible, to help facilitate passing of the stone...	Summarize the patient/doctor dialogue into an assessment and plan.	You are a clinical expert and you are summarizing the patient/doctor dialogue into an assessment and plan. Focus on symptoms.
63	[doctor] so gloria is a 46 -year-old female today with past medical history of diabetes and back pain and today here for shortness of breath with chf and copd also so gloria tell me what's going on [patient] i i i'm having a lot of trouble sleeping [doctor] okay and and how long has this been going on for [patient] rea...	ASSESSMENT AND PLAN 1. Shortness of breath. - Medical Reasoning: I believe this is an exacerbation of her congestive heart failure. - Patient Education and Counseling: I advised the patient to monitor her weight daily. - Medical Treatment: She will increase her dose of Lasix from 20 mg to 60 mg for the next 4 days....	Summarize the patient/doctor dialogue into an assessment and plan.	You are a clinical expert and you are summarizing the patient/doctor dialogue into an assessment and plan. Focus on symptoms.
66	[doctor] hey gabriel i'm doctor scott good to see you today i know you've heard about dax is it okay if i tell dax a little bit about you [patient] sure [doctor] okay so gabriel is a 43 -year-old male today here for back pain evaluation and also has a past medical history of diabetes high blood pressure and high choles...	ASSESSMENT AND PLAN 1. Lower back pain. - Medical Reasoning: I believe this is more of a muscular sprain. - Patient Education and Counseling: We discussed treatment options today. - Medical Treatment: I am going to start him on Naprosyn 500 mg twice a day and Flexeril 10 mg twice a day. I will refer him for physica...	Summarize the patient/doctor dialogue into an assessment and plan.	You are a clinical expert and you are summarizing the patient/doctor dialogue into an assessment and plan. Focus on symptoms.
34	[doctor] alright you can go ahead [patient] hey alan i good to see you today so i looked here my appointment notes and i see that you're coming in you had some shoulder pain left shoulder pain for the last three weeks so [doctor] how you doing is it is it gotten any better [patient] yeah yeah i've been having a lot of ...	ASSESSMENT Left shoulder pain, likely rotator cuff tendinopathy. PLAN After reviewing the patient's examination and radiographic findings today, I have had a lengthy discussion with him regarding his current symptoms. I have explained that his x-rays did not reveal any signs of a fracture. I have recommended that we...	Summarize the patient/doctor dialogue into an assessment and plan.	You are a clinical expert and you are summarizing the patient/doctor dialogue into an assessment and plan. Focus on symptoms.
6	[doctor] hi , anna . how are you ? [patient] i'm doing okay . how are you ? [doctor] i'm doing okay . so i know the nurse told you about dax . i'd like to tell dax a little bit about you . [patient] all right . [doctor] so , anna is a 44-year-old female with a past medical history significant for arthritis , gout , and...	ASSESSMENT AND PLAN Anna Mitchell is a 44-year-old female with a past medical history significant for arthritis, gout, and reflux, who presents today for follow-up of her chronic problems. Acid reflux with nausea and vomiting. • Medical Reasoning: She reports episodes of vomiting in the morning, as well as abdomin...	Summarize the patient/doctor dialogue into an assessment and plan.	You are a clinical expert and you are summarizing the patient/doctor dialogue into an assessment and plan. Focus on symptoms.
54	[doctor] hey elijah how are you [patient] i'm doing okay [doctor] so i see here that your primary care provider sent you over it looks like you were doing some yard work yesterday and dropped a landscape brick on your foot can what so what's going on with your right foot today [patient] it's a little sore today but you...	ASSESSMENT Right foot pain, due to a Lisfranc fracture. PLAN After reviewing the patient's examination and radiographic findings today, I have had a lengthy discussion with him regarding his current symptoms. We discussed treatment options and I have recommended that we proceed with a right foot ORIF and all indicat...	Summarize the patient/doctor dialogue into an assessment and plan.	You are a clinical expert and you are summarizing the patient/doctor dialogue into an assessment and plan. Focus on symptoms.
114	[doctor] alright [patient] good morning Julie how are you doing today [doctor] i'm doing okay i'm just a little nervous about what's been going on with my headaches [patient] okay so i know you were sent here by your your pcp what was your understanding of why you were sent here [doctor] yeah so i actually have been so...	ASSESSMENT Headaches, concern for idiopathic intracranial hypertension. PLAN After reviewing the patient's examination today, I have had a lengthy discussion with the patient in regard to her current symptoms. I have recommended that we obtain an urgent MRI of the brain to evaluate for any other condition that could...	Summarize the patient/doctor dialogue into an assessment and plan.	You are a clinical expert and you are summarizing the patient/doctor dialogue into an assessment and plan. Focus on symptoms.
98	[doctor] all right . today i am seeing jose james . uh , date of birth 9/29/1957 . mr . james is a new patient who's having pain in his left shoulder and elbow . he fell five months ago going up a stairs , and the pain has been present since . [doctor] hi mr . james , i'm doctor isabella . how are you doing ? [patient]...	ASSESSMENT • Impingement syndrome of left shoulder Jose is a 64-year-old male who was seen today for impingement syndrome of his left shoulder, likely related to a fall he incurred 5 months ago. PLAN Today I discussed conservative options for left shoulder impingement with the patient, who opted to try physical t...	Summarize the patient/doctor dialogue into an assessment and plan.	You are a clinical expert and you are summarizing the patient/doctor dialogue into an assessment and plan. Focus on symptoms.
50	[doctor] hey mason good to see you today so let's see you here in my notes for evaluation of kidney stones your your pcp said you had some kidney stones so you got a referral over so can you tell me a little bit about that you know what happened when did you first notice them [patient] yeah it was about you know about ...	ASSESSMENT Right kidney stone. PLAN We reviewed the patient's CT results in detail today. I have recommended that we treat the patient conservatively. I have prescribed the patient oxycodone 5 mg every 6 to 8 hours for pain. He may continue to take Tylenol between the oxycodone doses for any breakthrough pain. The p...	Summarize the patient/doctor dialogue into an assessment and plan.	You are a clinical expert and you are summarizing the patient/doctor dialogue into an assessment and plan. Focus on symptoms.
109	[doctor] so stephanie morales is a 36 -year-old female today complaining of her ankle pain and she also has a history of diabetes and high blood pressure so stephanie tell me what's going on with your ankle [patient] well we had a long spring and the other day we got some snow and ice i was walking to my car and i slip...	ASSESSMENT AND PLAN 1. Left ankle pain. - Medical Reasoning: Given the nature of her injury, I believe this is an ankle sprain. - Patient Education and Counseling: I advised the patient that I will contact her with the results of her x-ray, and that if these reveal a fracture, we will put in a referral to orthopedic...	Summarize the patient/doctor dialogue into an assessment and plan.	You are a clinical expert and you are summarizing the patient/doctor dialogue into an assessment and plan. Focus on symptoms.