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]
Doctor: Good morning John Smith, what brings you into the office today?
Patient: Good morning Doctor Davis, I have been having 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 why it hurts?
Patient: It feels like it's one of my back teeth on the left side. It really hurts when I drink cold water or hot coffee.
Doctor: Is it hard when you bite down on food?
Patient: Yes, it strokes 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, but normally it's just a dull ache. Maybe a 3.
Doctor: Okay, are you taking any medications for the pain?
Patient: Just some over-the-counter Tylenol which helps me a little bit.
Doctor: Any changes in your general medical history since your last visit? Any new medications or allergies?
Patient: No, everything is the same. I am just taking my daily multivitamins just as a reminder. I am allergic to penicillin, latex, and codeine.
Doctor: Also, I just want to update our records. Could you confirm your date of birth, age, gender, height, and weight?
Patient: Sure, my date of birth is January 1st, 1999, making me 27 years old. I am male. My height is 180 centimeters and I weigh about 75 kg. My phone number is 555-867-5309.
Doctor: Perfect, thank you. Let's review your background quickly. Any family history or dental or medical issue?
Patient: Yes, my father had severe periodontitis and type 2 diabetes and my mother had early tooth loss.
Doctor: Okay, noted. And for social history, do you smoke or drink alcohol?
Patient: I don't smoke but I occasionally drink alcohol, maybe one or two beers on the weekend.
Doctor: How about past medical history? Have you had any strategies or major illness?
Patient: I had an appendectomy when I was 15 and I have mild hypertension that is managed by diet.
Doctor: Understood. Let me also confirm your insurance. We have you under Delta Dental PPO with pre-authorization already approved for potential restorative work today. Authorization number is AUTH12345.