The GP Show

Welcome to the first of a new segment I am trying out every now and then.  I review the theory and science behind controversial topics and rate it - confirmed, busted or plausible. I have had a lot of requests to cover medicinal cannabis, so here it is.  There is some really interesting science here, but it is still early days.  In this episode we cover: What is medicinal cannabis? How does it wor...

I really enjoyed this online conversation with Professor Felice Jacka from the Deakin University School of Medicine and Food and Mood Centre about how food effects our mental health and what clinicians and patients can do about it.  We reviewed the SMILES trial, a randomised control trial showing healthy food choices like the Mediterranean diet can produce remission in people with major depression...

After making a fool of myself in the first 30 seconds, Dr Tony and I have a good yarn about prostate cancer history, examination, investigations and treatments with the last 10 minutes covering the evidence for PSA testing for screening.  For more on PSA screening guidelines and types of PSA testing, DRE in screening and lifestyle medicine interventions in early prostate cancer - check out my earl...

I caught up with my old friend and GP registrar Dr Nadim Cody in Central QLD and we talked about his experiences with Medicins San Frontieres (Doctors Without Borders) in PNG and various regions of Sudan.  Informative, touching, hopefully helpful are three ways to describe the talk.  Humble, wise and an inspiration are three words I would use to describe Nadim.   I apologise for some mic bumping n...

On December 1 2017 the cervical screening program changes from the current pap smears to HPV testing with a change in frequency and follow up.  Join gynaecologist Dr Kelvin Larwood and I having a casual yarn over the new guidelines.  

A/Prof Bittoun gave one of the most useful workshops I have ever done at the recent Australasian Society of Lifestyle Medicine conference on smoking cessation. I had to interview her to share some of the principles with you.  With 15% of Australians still smoking and 21% in disadvantaged areas - this is still a major disease determinant - but were the people who have already quit the low hanging f...

Today we are joined by Dr Hans Seltenreich Gastroenterologist and Hepatologist and founder of the Coastal Digestive Health clinic on the Sunshine Coast, QLD.  We have a yarn about the gut microbiome/microbiota and the role of faecal transplants.  In particular: 1.  What is the microbiome? 2. What is it impacted by? 3. What are its roles in the human body? 4. What is its role in disease? 5. What is...

Today we have a chat with dietitian and health coach extraordinaire Shivaun Conn.  We discuss some principles around how to more effectively change patient behaviour for the better.  It is a topic that requires years of study, application and improvement, but we have had some laughs covering a few basics, including tips from our experience, motivational interviewing, setting 'SMART' goals, the tru...

Today we are joined by Dr Joanna McMillan PhD Dietitian at the Australasian Society of Lifestyle Medicine conference. I have heard conflicting stories over the years about which oils are safe to cook with and in particular olive oil. Joanna talks us through new Australian research comparing common cooking oils: extra virgin olive oil, olive oil (a refined blend), canola oil, rice bran oil, grapese...

Today we are joined by ophthalmologist and all round nice guy Dr Russell Phillips to discuss red eye in GP - differentials, causes, approach to history, exam and management. Approach to the red eye in GP Conjunctivitis (bacterial, viral, allergic) Subconjunctival haemorrhage Herpetic keratitis + dendritic ulcer Herpes zoster ophthalmicus Anterior uveitis (iritis) Scleritis Episcleritis Acute close...

In this episode we will cover history and examination in eye disorders.  This is a review episode to help give us the foundations to assessing any eye disorder which we will cover more in future episodes. - History - Examination - visual acuity, visual fields, eye movements, pupils and swing torch test, torch examination and fluoroscein staining, slit lamp exam, intraocular pressure testing, ophth...

1.Key points of medicare 2.What medicare covers and doesn't cover 3.Detail of certain item numbers: During hours, after hours, emergency, women's health, procedures, GPMP/TCA, MHCP, health assessments, cycle of care and more, 4.PIP/SIPs and GPRIPs 5.Auditing and 80/20 rule 6.Medicare Safety Net

This episode we will cover clinical lifestyle evidence based medicine in cardiovascular disease.  We will cover: - What is Lifestyle Medicine (LM)? - Why do we need it? - Chronic disease burden  - What are the myths and facts about changing peoples lifestyles? - LM in hypertension, size of effect and details - including DASH diet, reduction by weight loss, smoking cessation, diet changes, physical...

Today we will cover opioid prescribing guidelines for chronic non-cancer non-palliative care pain in adults.  Enjoy!   Contents: •New codeine laws 2018 •Opioids prescription facts and harms •Evidence for opioids •Types of opioids and equivalence dosing •Side effects – short and long term •Initiating and ongoing presciprtion •Break through pain management •Discontinuing •Aberrant behaviour manageme...

PSA and DRE screening – to do or not to do, where is the evidence?  And intensive lifestyle changes in early prostate cancer.  1. Digital rectal examination - recommendations  2. PSA test– what is it, the benefits and risks, medicare implications, the review of guidelines for screening for average to high risk and follow up, what to do with a + result, age related reference ranges  and the PSA var...

Today we will cover a case on weight with question and answers.  Questions include:     Question 1  What further history do you want to obtain for weight loss? Question 2  What examination do you want to perform? Question 3  Are there any investigations to perform? Question 4  How does this change your management when prescribing the pill? Question 5  She asks you – "what about the low carb high f...

In this episode we will review acute and chronic low back pain.    •Overview of assessment of back pain •Quick review of some red flags and yellow flags •Review differential diagnosis in LBP •Review of the evidence for some back imaging •Review of radiation risk of some common imaging •Screening tools for assessing risk of chronicity •Review of management principles •What is self management •Acute...