The physician enters the room, greets Rob and asks him what brought him in. Rob mentions that he notices a shortness of breath when climbing ladders and he tires easily. He thought he needed to exercise more, but after several months, it has only gotten worse. He has also noticed that he is always coughing and is sometimes producing pinkish phlegm. The physician then asks Rob a series of questions concerning his lifestyle and records the answers on his Electronic Health Record (EHR). The first question involves his smoking history. Rob informs the physician that he has been smoking for 24 years – typically smoking about ten packs a week. When he is stressed he finds himself taking more smoke breaks. The physician shakes his head discouragingly.
The physician reviews Rob’s vital signs, taken by the nurse on his arrival. Then he begins the physical exam by listening to Rob’s heart and asking him to cough, an easy task for him. Rob sounds congested and coughs several more times, no longer on command.
While in the physician’s office, Rob has a regular chest x-ray to check his respiratory system.