In this special episode of The Good GP, recorded live at GP24 in Perth, host Dr Sean Stevens engages in a conversation with Associate Professor Ramesh Balasubramaniam and Dr Francesco Piccolo on the management of obstructive sleep apnea (OSA).

Associate Professor Ramesh Balasubramaniam, an Oral Medicine Specialist and Discipline Lead in Oral Medicine at UWA, and Dr Francesco Piccolo, a respiratory and sleep specialist at Midland, share various approaches to diagnosing and treating obstructive sleep apnea. Discussing patient-specific factors that influence the choice of therapy, including the use of CPAP (Continuous Positive Airway Pressure) and mandibular advancement devices.

Dr Piccolo emphasises the importance of thorough clinical evaluation and insights into the sleep study reports, the severity of obstructive sleep apnea, and the associated symptoms and comorbidities that influence treatment decisions. Prof. Balasubramaniam discusses the role of patient preference in treatment adherence and the importance of follow-up and monitoring.

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 thegoodgp@gmail.com. Visit www.thegoodgp.com.au for previous episodes and more information.

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In this episode of The Good GP, Dr Krystyna de Lange engages in a conversation with Dr Nick Hummel, a respected and experienced GP from the Sunshine Coast in Queensland, on his experience of becoming a patient following his prostate cancer diagnosis.

Dr Hummel shares his journey, the process leading up to his diagnosis, and the various medical procedures and challenges he has faced since. He explores the importance of being up to date with preventative health and screening measures and taking into consideration full personal and family history in conjunction with a GP.

He highlights the importance of comprehensive, multidisciplinary care and underlines the necessity of not neglecting one's own health as a medical professional. Emphasising the value of being proactive about health insurance, planning for unexpected medical leave, and consulting with one's own GP regularly.

Through his experiences, Dr Hummel aims to raise awareness among GPs about the critical importance of self-care, regular health screenings, and managing their health risks responsibly. Providing practical advice for other doctors who may be navigating similar health challenges.

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 thegoodgp@gmail.com. Visit www.thegoodgp.com.au for previous episodes and more information.

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In this episode of The Good GP, host Dr Sean Stevens is joined by Dr Louise Reiche, a seasoned general dermatologist from Palmerston North to discuss the management of rosacea.

Giving insights into the key lifestyle and dietary triggers that affect rosacea. Dr Reiche covers the impact of spicy food, alcohol, caffeine, and environmental changes on facial redness experienced by patients. Emphasising on the importance of sun protection as a primary method for managing rosacea.

Shifting to the benefits of the Mediterranean diet and general wellness practices. Dr Reiche explains how a plant-rich, anti-inflammatory diet can help reduce the inflammatory response related to rosacea, components such as extra virgin olive oil and walnuts that benefit the gut microbiome and subsequently, the skin.

Treatment options for rosacea with sun protection being a cornerstone of management. Dr Reiche discusses practical sun protection strategies and the role of topical and oral retinoids, topical azelaic acid, and ivermectin in treating the condition. The shift from oral antibiotics to other treatments due to concerns about antibiotic resistance and the gut microbiome were also examined.

The Good GP is proud to collaborate with DermNet on this podcast. In early 2025 DermNet is launching a new platform designed specifically for healthcare professionals called DermNet PRO. It features a new search tool, the ability to save pages, and access a host of volunteer opportunities. It’s 100% free and coming in early 2025. Join the waitlist now.

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 thegoodgp@gmail.com. Visit www.thegoodgp.com.au for previous episodes and more information.

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In this episode of The Good GP, host Dr Tim Koh is joined once again by Dr Linny Kimly Phuong, a paediatric infectious diseases physician, researcher, and academic tutor, to discuss Pneumococcal Disease. Being the subject of her PhD, Dr Phuong brings her extensive knowledge and experience on this topic.

Dr Phuong outlines the different clinical manifestations of Pneumococcal Disease, dividing them into invasive and non-invasive categories. Non-invasive diseases include otitis media and sinusitis, while invasive diseases can result in conditions like complicated pneumonia, meningitis, bacteremia, bone and joint infections, endocarditis, and peritonitis.

Discussing the significance of the strep pneumoniae bacteria, which is commonly found in the nasopharynx of healthy individuals. Dr Phuong explains the switch from carriage to disease manifestation and highlights the risk factors for invasive Pneumococcal Disease, including extremes of age, immunocompromise, chronic health conditions, and certain lifestyle factors.

They then turn to pneumococcal vaccines, and the differences between conjugate and polysaccharide vaccines, their valencies, and their impact on clinical practice. Dr Phuong emphasises the importance of vaccination in reducing morbidity and mortality related to Pneumococcal Disease, particularly in young children and older adults.

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 thegoodgp@gmail.com

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In this episode of The Good GP, Dr Tim Koh is joined by Dr Linny Kimly Phuong, a paediatric infectious diseases physician, researcher, and academic tutor, to discuss Kawasaki disease.

They began by explaining Kawasaki disease as an inflammatory vasculitis with potential long-term cardiac consequences. Dr Phuong notes that one child is diagnosed with Kawasaki disease every day. While the disease is more common in children under the age of five, it can present at any age and across all ethnic groups, with a higher incidence in children of Asian ethnicity.

They discussed the clinical picture of Kawasaki disease, commonly remembered by the mnemonic "CRASH and burn." This includes Conjunctivitis, Rash, Adenopathy, Strawberry tongue, and Hand/feet changes—all accompanying a prolonged fever. Dr Phuong emphasises the importance of recognising these symptoms even if they do not manifest simultaneously.

They move onto diagnosis, highlighting the absence of diagnostic tests and the reliance on clinical evaluation supported by laboratory tests such as full blood count, inflammatory markers, and liver function tests. Dr Phuong also elaborates on differential diagnoses, including both infectious (e.g., scarlet fever, adenovirus) and non-infectious conditions (e.g., drug hypersensitivity, systemic juvenile idiopathic arthritis).

Finally, outlining the long-term clinical impact of Kawasaki disease, emphasising the importance of treatment with intravenous immunoglobulin and low-dose aspirin to reduce the risk of coronary artery aneurysms. Highlighting the necessity for long-term cardiology follow-up due to the potential for severe complications like coronary artery stenosis and myocardial infarction.

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 Talking HealthTech.

If you have any questions or would like to contact The Good GP, send an email to thegoodgp@gmail.com

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In this episode, Dr Krystyna de Lange hosts Associate Professor Dr Alireza Ahmadvand, a practising GP with a special interest in gastroenterology at the Princess Alexandra Hospital in Brisbane, to discuss disorders of gut-brain interaction (DGBI).

Dr Ahmadvand elaborates on what DGBIs are and provides the latest insights into the pathophysiology, mentioning conditions such as irritable bowel syndrome and functional dyspepsia. He explains the diagnostic criteria and the importance of recognising these conditions in general practice, and highlights the role of GPs in identifying and ruling out structural abnormalities before considering a DGBI diagnosis.

They also covered the multifactorial nature of these disorders, including the impact of psychological and psychosocial factors, such as stress, anxiety, and depression, and the interactions between gut microbiome and gut function. Dr Ahmadvand outlines when GPs should consider DGBIs and what red flags to watch for, emphasising the importance of comprehensive evaluations and specialist collaboration.

For management, Dr Ahmadvand advocates for a multidisciplinary approach involving dietitians, psychologists, exercise physiologists, and gastroenterologists to provide holistic care. Pharmacological treatments, diet modifications, and psychological interventions, such as Cognitive Behaviour Therapy, are also mentioned as part of a comprehensive management plan.

Lastly, Dr Ahmadvand points GPs towards the Rome Foundation's criteria, the Gastroenterological Society of Australia, and patient-focused platforms like Gut Foundation Australia and the IBS Network. He also encourages keeping alongside of the latest research through journals like Neurogastroenterology and Motility.

Links & Resources:

Rome Iv Diagnostic Criteria For Fgids

• https://theromefoundation.org/rome-iv/rome-iv-criteria/
• https://theromefoundation.org/resources/rome-iv-criteria-booklet/ (downloadable booklet in PDF)

Patient Education Material

Irritable Bowel Syndrome (IBS)

• https://dietitiansaustralia.org.au/health-advice/irritable-bowel-syndrome-ibs
• https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/irritable-bowel-syndrome-ibs
• https://www.healthdirect.gov.au/irritable-bowel-syndrome-ibs

Resources From The Australian Journal Of General Practice

The lived experience of irritable bowel syndrome: A focus on dietary management

• https://www1.racgp.org.au/ajgp/2022/june/the-lived-experience-of-irritable-bowel-syndrome

Research Instruments/Projects

Valid Instrument for Evaluating Symptoms in the Clinical Setting - Structured Assessment of Gastrointestinal Symptoms Scale (SAGIS)

In this episode, Dr Sean Stevens hosts a discussion on the topic of public hospital virtual clinics with three distinguished guests: Dr Morgan Rayner, a new fellow GP, Associate Professor Joanna Lawrence, a paediatrician at the Royal Children's Hospital in Melbourne and Director of the Victorian Virtual Specialist Clinic (VVSC), and Dr Dominic Mallon, an immunologist at Fiona Stanley in Perth and founder of the Virtual Immunology Clinic.

They explore the origins, purposes, and operational models of the Victorian Virtual Specialist Clinic and the Virtual Immunology Clinic. Associate Professor Joanna Lawrence discusses how the VVSC was established to enable GPs to access specialist expertise more swiftly, to reduce wait times for patients and enhance the ability of community physicians to manage patient care efficiently. Dr Dominic Mallon shares insights into the Virtual Immunology Clinic, how it has successfully reduced patient wait times and facilitated timely access to specialist care, especially in rural areas.

Dr Morgan Rayner also provides a first-hand account of using virtual consult services as a junior registrar, discussing the benefits of building relationships with specialists and improving patient care through timely consultations.

The VVSC is available to any GP working in Victoria. The collab-consult model is a free 20-minute case conference with a specialist (with or without the patient). The collab-consult enables GPs to access timely expert advice to support managing their patients in the community. CPD can be claimed for participating in a case conference. Booking is easy through https://vvsc.org.au/ or email VVSC@nh.org.au.

The Virtual Immunology Clinic is available to any GP in WA who is in or very near the Fiona Stanley Hospital Catchment area for public hospital outpatients services (South Metro, South West, Great Southern)

The link to register, log in and refer is: South Metropolitan Health Service - SMHS Online Services Portal https://smhs.health.wa.gov.au/Our-services/SMHS-Online-Services-Portal

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 thegoodgp@gmail.com

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In this episode of The Good GP, Karin Sekhon speaks with Professor Jayashri Kulkarni, a renowned psychiatrist, about premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD).

Professor Kulkarni explains the distinctions between PMS and PMDD, emphasising that PMS is more prevalent and generally involves physical symptoms like bloating and headaches, while PMDD affects a smaller percentage of women and includes severe psychological symptoms such as major depression, anxiety, and brain fog. She talks about the genetic and environmental factors contributing to PMDD, highlighting a specific gene complex that may be activated by trauma.

Discussing the primary pharmacological treatments for PMDD, Professor Kulkarni advises starting with hormonal treatments like the combined oral contraceptive pill; she recommends the pill "Zoely" for its balanced hormone levels. She also elaborates on the use of SSRIs like sertraline for additional support and gives a stepped approach to treatment, including the possible need for hormone replacement therapy (HRT) or menstrual suppression in complex cases.

They also touched on the potential role of complementary therapies and the importance of holistic care, involving psychological support and lifestyle modifications. Professor Kulkarni provides guidance on when GPs should consider referring patients to specialists and emphasises the collaborative role of GPs in managing PMDD effectively.

If you want to learn more about this topic, consider the HER Centre Australia's online short course on Women's Mental Health: https://www.monash.edu/medicine/translational/psychiatry/short-courses/womens-mental-health

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 thegoodgp@gmail.com

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Get 10% Off Lyrebird Health

Unlock a 10% discount on Lyrebird Health by using the code GOODGP and discover how this AI scribe can transform your practice by saving you time and ensuring your documentation sounds just like you: www.thegoodgp.com.au/lyrebird

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