> "clin_narrative_fk_encounter_key" unique, btree (fk_encounter, narrative, 
> soap_cat)
> 
> this constraint would block someone entering a health issue with an 
> identically autogenerated narrative,
Which would be a good thing.

> or say  dealing with hypertension and diabetes in one
> encounter with   "script; routine checkup"  for both.
But this is not. So, yes, indeed, 

> would it be better as (fk_encounter, fk_episode, narrative, soap_cat) ?
you are entirely correct. Thanks.

The top case (autogenerated narrative) is acceptable.

Fixed.

Karsten
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