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: - Pain in lower left jaw intensified by cold beverages
- Discomfort when biting on hard foods
- Allergies to penicillin, latex, and codeine
- Pain in lower left jaw, possibly dental in origin
- No changes in general medical history
- Allergies to penicillin, latex, and codeine
Medications: Tylenol
Allergies: Penicillin, Latex, Codeine
Social History: Non-smoker, Occasional alcohol consumption (1-2 drinks on weekends)
Family History: Severe periodontitis, Type 2 diabetes (Father), Early tooth loss (Mother)

[PATIENT CONTEXT]
Past 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 pain in my lower left jaw. It started about two 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 right side It really hurts when I drink cold water or hot coffee
Doctor: Does it hurt when you bite down on feet?
Patient: Yes, it throws After I eat something crunchy
Doctor: On a scale of 1 to 10. How would you rate your pain?
Patient: It's all about 7 when I drink something cold
Doctor: Are you taking any medications or ibuprofen?
Patient: Just some over-the-counter Tylenol Which helps 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 and I am just taking my daily multivitamin Just a reminder. I am allergic to penicillin latex and codeine