In this episode of The Good GP, host Dr Tim Koh welcomes distinguished guest Professor Chan Cheah, a clinical and laboratory-based haematologist with a special interest in lymphoma. Professor Cheah, who practises at Sir Charles Gairdner Hospital and works with Western Diagnostic Pathology, explores the challenges and considerations of managing thrombocytopenia in general practice.

Professor Cheah begins by explaining what thrombocytopenia is and discusses its prevalence. He addresses common causes and sheds light on the pitfalls like pseudothrombocytopenia—where an artificial drop in platelet counts occurs due to platelet clumping in EDTA-treated tubes. Important advice is shared on how a different anticoagulant, such as citrate, can be used to overcome this issue.

He also explains the various age-related factors that should guide a GP's differential diagnosis process and details how different conditions might mimic or contribute to thrombocytopenia. He discusses important associated conditions such as Immune Thrombocytopenic Purpura (ITP), medication-induced reductions, and other infections that can manipulate platelet counts.

They then pivot to the necessary diagnostic steps and laboratory investigations that are vital in assessing a patient with low platelets. Professor Cheah rounds off the discussion by covering urgent conditions like thrombotic microangiopathies and other haematological abnormalities, stressing the importance of urgent and precise diagnosis in severe scenarios.

Join Professor Chan Cheah in uncovering the critical aspects of diagnosing and managing low platelet counts, a commonly encountered yet complex issue in general practice.

If you have any questions or would like to contact The Good GP, send an email to [email protected]

The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialisation. Learn more at www.talkinghealthtech.com/podcast/network

Mentioned in this episode:

Proudly supported by Medtech Global:

The Good GP Podcast is sponsored by Medtech Global, they help GPs be GPs by working with clinicians in Australia and New Zealand to develop Patient Management Systems and healthcare technology. Visit the link for more information:

Medtech Global

In this episode, host Dr Sean Stevens welcomes Dr Michael Clements and Dr Kaylene Girgenti to discuss the practicalities and benefits of rural GP outreach. Dr Girgenti is a GP obstetrician with a unique practice split between Townsville and remote Karoombara Health Centre, which she commutes to by plane. Dr Clements is not only a pilot but also the Vice President of the RACGP, Chair of the Rural Faculty, and a practice owner of Clements Medical in Townsville and Magnetic Island.

Dr Girgenti shares her motivations behind taking on rural work, emphasising the diversity and fulfilment it adds to her practice, alongside the notable appreciation from the communities she serves. She encourages early career GPs to seek diversity and engage with diverse work environments that rural practice presents.

Dr Clements discusses the journey of integrating remote services into his practice, explaining the initial challenges and the rewards that result from providing critical services to underserved areas. He outlines the strategic approach to adopting a rural clinic from the perspective of an urban practice and the role of funding and clinical governance.

They also touched upon the dynamics of GP service in rural areas, including the importance of continuity of care and the value it brings to both the community and the healthcare provider.

Concluding with advice for urban GPs looking to extend their services to rural communities, highlighting the potential of such a model for adding excitement, scope, and a sense of mission to their practice.

The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialisation. Learn more at www.talkinghealthtech.com/podcast/network

If you have any questions or would like to contact The Good GP, send an email to [email protected]

Mentioned in this episode:

Proudly supported by Medtech Global:

The Good GP Podcast is sponsored by Medtech Global, they help GPs be GPs by working with clinicians in Australia and New Zealand to develop Patient Management Systems and healthcare technology. Visit the link for more information:

Medtech Global

In this episode of The Good GP, host Dr Sean Stevens along with Dr Rebecca Goadby interview Dr Alison Creagh, renowned for her expertise in intimate partner violence and contraceptive management. Alison addresses managing the side effects of long-acting reversible contraceptives (LARCs), focusing on contraceptive implants and intrauterine devices (IUDs).

Alison discusses the common issue of unpredictable bleeding with contraceptive implants, providing detailed insights into identifying potential causes, assessing the pattern of bleeding, and discussing management options with patients. She highlights the significance of ruling out abnormal causes and offers a range of strategies, including reassurance, combined pill usage, anti-inflammatory and hormonal options, and considering alternative contraceptives, if necessary. Additionally, she provides guidance on addressing weight gain, headaches, loss of libido, and concerns around fertility associated with long-acting contraceptives, dispelling myths and offering practical advice to reassure patients.

Their discussion then delves into challenges related to IUD insertions, addressing potential pain, bleeding, and cramping post-insertion. Alison outlines strategies for pain management during insertion, discusses the normality of bleeding patterns post-insertion, and shares management options for heavier bleeding or cramping. 

The conversation concludes with Alison demystifying fertility concerns associated with LARCs, providing clarity on the rapid return to normal fertility post-discontinuation of contraceptive methods.

The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialization. Learn more at www.talkinghealthtech.com/podcast/network

If you have any questions or would like to contact The Good GP, send an email to [email protected]

Mentioned in this episode:

Proudly supported by Medtech Global:

The Good GP Podcast is sponsored by Medtech Global, they help GPs be GPs by working with clinicians in Australia and New Zealand to develop Patient Management Systems and healthcare technology. Visit the link for more information:

Medtech Global

In this episode of The Good GP, Dr Sean Stevens and Dr Rebecca Goadby welcome Dr Alison Creagh to discuss the differences between older progesterone-only pills - such as levonorgestrel and norethisterone - and the newer drospirenone ones. Alison outlines how the older pills primarily work through cervical mucus and, to some extent, blocking ovulation, while the newer drospirenone pills are more effective at blocking ovulation and have a wider window of time for pill intake. The impact on bleeding is also highlighted, with the drospirenone pills leading to more regular bleeding during the withdrawal section.

Discussing the cost and payment options for the different pills, with the older pills being more cost-effective for those with healthcare cards, while the newer ones are more forgiving in terms of timing. Additionally, contraindications and missed pill windows for the two types of pills are explored, with specific attention to potassium levels in relation to the newer drospirenone pills.

Alison further delves into the advice for the missed pill window and the potential side effects for both types of progesterone-only pills. The variability in individual responses to these pills is highlighted, as well as the potential need to try different types if hormonal side effects arise.

The episode concludes with Sean Stevens thanking Alison Creagh for her valuable insights and highlighting the important takeaways from the discussion.

The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialization. Learn more at Talking HealthTech.

If you have any questions or would like to contact The Good GP, send an email to [email protected]

Mentioned in this episode:

Proudly supported by Medtech Global:

The Good GP Podcast is sponsored by Medtech Global, they help GPs be GPs by working with clinicians in Australia and New Zealand to develop Patient Management Systems and healthcare technology. Visit the link for more information:

Medtech Global

In this episode of The Good GP, host Dr Sean Stevens is joined by Dr Alison Creagh, a GP specialising in women's health and sexual and reproductive health, with over 20 years of experience in this field. Alison sheds light on the issue of intimate partner violence and its impact on the health of those affected, particularly women. She discusses how intimate partner violence differs from domestic violence and emphasises the importance of GPs in addressing this prevalent issue.

Delving into why patients may be reluctant to discuss intimate partner violence with their GPs and offers insights into how GPs can effectively broach this sensitive topic with their patients. Alison provides practical guidance on identifying potential signs of intimate partner violence and outlines gentle and effective approaches for GPs to initiate conversations with their patients.

Furthermore, Alison shares valuable resources and support services available to GPs and patients dealing with intimate partner violence, emphasising the need for confidentiality and sensitivity in handling such cases. Concluding with the discussion on additional learning opportunities and resources for GPs to further their understanding and approach in addressing intimate partner violence.

Resources for Getting Help on Intimate Partner Violence across Australia:

National

1800 RESPECT

Counselling, information and referral for people experiencing abuse, friends and family and health

professionals.

1800 737 732

MensLine Australia

For men with concerns about abuse, including those who are abusive.

1300 789 978

White Ribbon

Lists national helplines available according to needs.

whiteribbon.org.au/helplines

ACT

Domestic Violence Crisis Service

02 6280 0900

NSW

NSW Domestic Violence Line

Counselling and referrals for women experiencing DV

1800 656 463

NSW Department Communities and Justice

Online information source, with quick exit buttons

https://dcj.nsw.gov.au/children-and-families/family-domestic-and-sexual-violence.html

Women’s Domestic Violence Court Advocacy Services

Provide information, advocacy and referrals for women and children, and support accessing restraining orders

legalaid.nsw.gov.au/about-us/our-partners/womens-domestic-violence-court-advocacy-program

NT

Domestic, family and sexual violence page from NT government

Lists local support services according to region

nt.gov.au/law/crime/domestic-family-and-sexual-violence/get-help-for-domestic-family-and-sexual-violence

QLD

DVConnect Womensline

Support, accommodation, counselling and referrals for women experiencing family or domestic violence

1800 811 811

DVConnect Mensline

Support, counselling and referrals for men affected

1800 600 636

Government Domestic & Family Violence page

Information about services available

qld.gov.au/community/getting-support-health-social-issue/support-victims-abuse/domestic-family-violence

Domestic Violence Prevention Centre

Counselling, practical support, safety planning and referrals

07 5532 9000

SA

Domestic and family violence & sexual assault support services

Listings of supports available for specific issues

sa.gov.au/topics/family-and-community/safety-and-health/domestic-violence-and-sexual-assault/support-services

Domestic Violence Crisis Line

Crisis counselling, support and accommodation referrals

1800 800 098

TAS

Family Violence Counselling and Support Service

Information, support, safety planning, assistance with police, referrals

1800 608 122

health.tas.gov.au/health-topics/family-violence/family-violence-counselling-and-support-service-fvcss

VIC

Family Violence Statewide Support Services

Lists the relevant support services available

vic.gov.au/family-violence-statewide-support-services

Safe Steps

Crisis support, information and accommodation

1800 015 188

WA

Crisis Care

Information and counselling for people in crisis

1800 199 008

Women’s Domestic Violence help

Information, referral, support, police liaison

1800 007 339

Men’s Domestic Violence help

For men who have experienced abuse themselves, or are concerned about their own abusive behaviour,

or been served with a restraining order

1800 000 599

Centre for Women’s Safety and Wellbeing

Searchable information about who can provide help:

cwsw.org.au/directory

Women’s Legal Service WA

Useful resources on legal issues

Wlswa.org.au

The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialization. Learn more at Talking HealthTech

If you have any questions or would like to contact The Good GP, send an email to [email protected]

Mentioned in this episode:

Proudly supported by Medtech Global:

The Good GP Podcast is sponsored by Medtech Global, they help GPs be GPs by working with clinicians in Australia and New Zealand to develop Patient Management Systems and healthcare technology. Visit the link for more information:

Medtech Global

In this episode, host Tim Koh is joined by Dr Michael Wright, Chief Medical Officer for Avant Mutual and Chair of RACGP Expert Committee on Funding and Health System Reform, to discuss the do's and don'ts of telehealth consulting. They delve into the guidelines set by the Medical Board of Australia, the legislative requirements for Medicare billing, and the considerations for conducting telehealth consultations effectively. 

Michael emphasises the importance of maintaining the standard of care, patient identification, consent, and privacy protection in telehealth consultations. He also addresses the challenges and limitations of telehealth, including the need to transition to face-to-face consultations when necessary, staying compliant with Medicare billing requirements, and protecting oneself from potential issues and complaints related to telehealth consultations. 

Discussing the implications of patients accessing medical advice from outside of Australia and the responsibilities of GPs practising telehealth while travelling abroad. Exploring the use of other forms of communication, such as SMS, electronic messaging, and email, in patient consultation and information provision.

Resources & Links:

• Telehealth - Telehealth – what you need to know - Avant by doctors for doctors
• Guidelines - https://www.medicalboard.gov.au/Codes-Guidelines-Policies/Telehealth-consultations-with-patients.aspx

For Medical Practitioners in General Practice

Stay updated on the latest in healthcare, delivery, and digital health by visiting Talking HealthTech, the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialization. If you have any questions or would like to contact The Good GP, send an email to [email protected]

Mentioned in this episode:

Proudly supported by Medtech Global:

The Good GP Podcast is sponsored by Medtech Global, they help GPs be GPs by working with clinicians in Australia and New Zealand to develop Patient Management Systems and healthcare technology. Visit the link for more information:

Medtech Global

In this episode of The Good GP, Dr Sean Stevens welcomes Dr Paul Effler, Medical Coordinator of the Communicable Disease Control Directorate in WA, to discuss the new RSV immunisation, Nirsevimab. They explore the differences between traditional vaccines and Nirsevimab, its effectiveness, safety, target group, and the likelihood of a national rollout. They also dive into the seasonal patterns of RSV and the co-administration of Nirsevimab with other vaccines. Providing valuable insights into the development and potential impact of this new immunisation.

The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialization. Learn more at www.talkinghealthtech.com/podcast/network

If you have any questions or would like to contact The Good GP, send an email to [email protected]

Mentioned in this episode:

Proudly supported by Medtech Global:

The Good GP Podcast is sponsored by Medtech Global, they help GPs be GPs by working with clinicians in Australia and New Zealand to develop Patient Management Systems and healthcare technology. Visit the link for more information:

Medtech Global

In this episode of The Good GP, Dr Sean Stevens welcomes Dr Sarah Heynemann, a Melbourne-based early career medical oncologist and PhD candidate with Sydney Health Ethics, The University of Sydney. Dr Heynemann brings valuable insights into the changes in cancer care and cancer survivorship over the years. She discusses the impact of advances in cancer therapies, such as immunotherapy and targeted therapies, on the prognosis and quality of life for patients with cancer, particularly those with historically poor prognoses. She emphasises the need for GPs to be aware of the ongoing supportive care needs of patients, even if the tumour appears stable, and highlights the importance of effective communication across multidisciplinary teams for comprehensive cancer survivorship care.

Additionally, Sarah sheds light on upcoming cancer therapies and emphasises the evolving role of GPs in navigating the complexities of cancer care.

Recommending two key resources – the Victorian Comprehensive Cancer Centre’s online course for primary care practitioners and the Australian Cancer Survivorship Centre based out of Peter MacCallum Cancer Centre. She also mentions an recent article in the Journal of Clinical Oncology which provides an overview of the future of survivorship for patients living with metastatic cancer.

Resources & Links:

• 'Cancer Survivorship for Primary Care Practitioners' VCCC course starts 25th March 2024. Weblink here: https://www.futurelearn.com/courses/cancer-survivorship
• Australian Cancer Survivorship Centre based at Peter MacCallum Cancer Centre https://www.petermac.org/patients-and-carers/support-and-wellbeing/life-after-treatment

• The article Sarah referenced was published last year in the Journal of Clinical Oncology https://ascopubs.org/doi/10.1200/JCO.22.02212?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed

The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialization. Learn more at Talking HealthTech

If you have any questions or would like to contact The Good GP, send an email to [email protected]

Mentioned in this episode:

Proudly supported by Medtech Global:

The Good GP Podcast is sponsored by Medtech Global, they help GPs be GPs by working with clinicians in Australia and New Zealand to develop Patient Management Systems and healthcare technology. Visit the link for more information:

Medtech Global

In this episode of The Good GP, Dr. Krystyna de Lange is joined by Professor Lin Fritschi, an epidemiologist with expertise in occupational causes of cancer, to discuss the increasingly topical area of silicosis. They delve into the nature of silica dust, its harmful effects, and the occupational risks associated with it. Lin provides insights into the occupational screening needed for at-risk individuals, warning signs for symptomatic patients, and the counselling and preventative health points crucial for impacted patients.

Lin also sheds light on the mental health implications of silicosis, available compensation and support avenues, and essential resources for GPs to gather more information on the topic. Their discussion addressed the significance and urgency of acknowledging and addressing silicosis in the workplace and provides valuable guidance for healthcare professionals in dealing with affected patients.

The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialization. Learn more at Talking HealthTech

If you have any questions or would like to contact The Good GP, send an email to [email protected]

Mentioned in this episode:

Proudly supported by Medtech Global:

The Good GP Podcast is sponsored by Medtech Global, they help GPs be GPs by working with clinicians in Australia and New Zealand to develop Patient Management Systems and healthcare technology. Visit the link for more information:

Medtech Global

In this episode of The Good GP Podcast, host Dr Krystyna de Lange engages in a discussion with guest Deborah Hawthorne, a rural-based clinical pharmacist from Northeast Victoria, about the complexities of polypharmacy and the crucial need to reduce unnecessary medications.

Deborah emphasises the integral role of GPs in coordinating patient care and the importance of regularly reviewing medications to align with patient care goals.

The discussion centres on the challenges of polypharmacy, the need for medication review and deprescribing, and practical strategies for GPs to consider in patient care.

Deborah delves into the importance of medication review and deprescribing, emphasising the need to assess current therapeutic impact, potential side effects, and patient satisfaction with medications. She highlights the challenges of deprescribing certain medications and the need to taper them off gradually.

Delving into the rewarding aspect of simplifying medication regimens and the act of deprescribing, encompassing the reduction of medication strength, changing dosing intervals, and identifying prescribing cascades.

Additionally, Deborah mentions the availability of tools and guidelines, such as the:

- Drugs Burden Index Calculator (DBI)

- Beers Criteria

- CEASE

- ERASE

You can find links to deprescribing guidelines at the Australian Deprescribing Network ( https://www.australiandeprescribingnetwork.com.au/) and the Primary Health Network in Tasmania (https://www.primaryhealthtas.com.au/resources/deprescribing-resources/)

Exploring home medication reviews, their benefits, and reasons for referral, such as polypharmacy and cognitive issues. Hawthorne emphasises the value of conducting medication reviews in a patient's home to assess medication use, storage, and techniques and to provide education and confidence in managing medications.

The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialization.

Learn more at: Talking HealthTech

If you have any questions or would like to contact The Good GP, send an email to [email protected]

Mentioned in this episode:

Proudly supported by Medtech Global:

The Good GP Podcast is sponsored by Medtech Global, they help GPs be GPs by working with clinicians in Australia and New Zealand to develop Patient Management Systems and healthcare technology. Visit the link for more information:

Medtech Global

In this special episode of The Good GP, Dr Krystyna de Lange is joined by a number of doctors from current GPs in training through to experienced GPs and GP supervisors to share their top tips for having a successful placement in General Practice. Whether you are a GP in training just starting out, a GP supervisor or practice owner who supports trainees or even a GP just wanting a refresh, there is something in this episode for everyone.

Dr Bruce Willett, immediate past Vice President of the RACGP, emphasises the importance of considering the patient in front of you as your responsibility.

Dr Rebecca Loveridge, recently appointed chair of the RACGP GPs in training faculty, recommends creating templates for study notes and exam preparation.

Dr Emmon Mubbashir, a new fellow and international medical graduate, provides insights on the right time to write fellowship exams.

Dr Clay Rowe, an RVTS registrar, shares the importance of preparing for exams from day one and treating each patient consult like an exam question.

Dr Michael Clements, current vice president of the RACGP, stresses the significance of using time as a diagnostic and therapeutic tool in general practice.

Dr Karen Savery, a GP and medical educator, encourages curiosity and asking questions as a key way to learn as a GP.

The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialisation. Learn more at www.talkinghealthtech.com/podcast/network

If you have any questions or would like to contact The Good GP, send an email to [email protected]

Mentioned in this episode:

Proudly supported by Medtech Global:

The Good GP Podcast is sponsored by Medtech Global, they help GPs be GPs by working with clinicians in Australia and New Zealand to develop Patient Management Systems and healthcare technology. Visit the link for more information:

Medtech Global