Transcript

[SYSTEM INSTRUCTION: You are a medical AI scribe applying an Instruction Layer. 1. Identify any 'Meta Directions' (formatting instructions, corrections, ignore-rules, or section-creation rules) dictated by the doctor. 2. Do NOT treat Meta Directions as clinical facts. Instead, use them as strict rules to shape the final note. 3. Apply formatting instructions (e.g., bullet points, conciseness). 4. Apply correction instructions (e.g., overriding a pain score or symptom). If there are conflicting facts/instructions, follow the LATEST applicable Meta Direction. 5. Apply ignore instructions (e.g., omit specific brand names). 6. Move information to the section explicitly requested. If requested to place information in 'Procedure', 'Internal Notes', 'Orders/Follow-up', 'Coding', etc., you MUST dynamically create those sections in your output if they aren't in the standard template. 7. Do not invent unsupported clinical information. Preserve existing normal dictation behavior. 8. Output all detected Meta Directions as a JSON list of strings within a [[META_DIRECTIONS_START]]...[[META_DIRECTIONS_END]] block at the very end of your response.
9. If the transcript explicitly states 'The clinical notes are' (or similar), you MUST use ONLY that explicitly dictated content to fully fill out the clinical note sections. Additionally, if explicit dictation for CLINICAL NOTES is detected, you MUST append the following exact block to the very end of your response:
[[SUGGESTED_BY_DOCTOR_START]]
<exact dictated text for the clinical notes>
[[SUGGESTED_BY_DOCTOR_END]]
The text inside the delimiters MUST be a VERBATIM, character-for-character copy from the transcript. Do NOT fix typos, do NOT reformat, and do NOT correct medical terms. Do NOT output 'Suggested by Doctor:' in the main text. Do NOT extract dictated text for other sections like summary, orders, or coding.]

[TRANSCRIPT]


[PATIENT CLINICAL SUMMARY]
Condition: New patient - initial consultation pending

[PATIENT CONTEXT]
John Smith is an established patient with a history of a previous routine dental cleaning approximately 8 months ago. At that visit, no urgent dental treatment was required. He previously reported occasional gum bleeding during brushing and was advised to maintain regular brushing and flossing. A previous dental examination documented an old filling on an upper right molar, which was stable at that time. The patient has no previously documented history of root canal treatment or tooth extraction.
Doctor: Good morning, John Smith. What brings you into the office today?
Patient: Good morning. Dr. Davis I have been having some some pain in my lower left jaw It started about three days ago.
Doctor: I'm sorry to hear that. Can you tell me exactly where it hurts?
Patient: It feels like It's one of my back teeth on the left side It really hurts when I drunk cold water or hot coffee
Doctor: Does it hurt when you bite down on food?
Patient: Yes, it's throws a bit after I eat something hard or crunchy
Doctor: on a scale of 1 to 10 How would you rate the pain?
Patient: It's about a 6 when I drink something cold
Doctor: Are you taking any medications for the pain
Patient: just some over-the-counter Tylenol? Which helps a little bit
Doctor: any changes in your General medical history since your last visit or any medications or allergies.
Patient: No, everything is the same I'm just taking my daily multivitamin. Just as a reminder. I am allergic to penicillin latex and codeine
Doctor: Also just to update our records. Could you confirm your date of birth age gender height and weight?
Patient: Yes, my date of birth is 30 10 2021 30 October 2021 making me 24 years old. I am male my height is 128 120 180 centimeter and my word is 75 kg and my phone number is 90 9 3 9 3 6 7 3 4
Doctor: Perfect Thank you, let's review the background quickly any family history or dental medical medically
Patient: so yes, my father had severe period on titties and Type 2 diabetes and my mother had early tooth loss
Doctor: Okay noted for social history. Do you smoke or drink alcohol?
Patient: I don't smoke but I occasionally drink alcohol maybe one or two PR on the weekend