The Medical Republic

If Caitlin Delaney hadn't pushed for genomic testing and off-label therapies, she might not have been around to share her insights on The Medical Podcast this week. As a health professional she also had the benefit of health literacy and a personal assertiveness that may have well also helped her be at her daughter's 10th birthday. “There were lots of ‘sliding door' moments. If I hadn't asked a certain question or pushed for a different answer or gotten a second or third opinion, then the outcome would be very different,” she says. The epicentre of Ms Delaney's survival is genetic testing. She says it's critical because it opens the doorway to emerging new treatments, personalized medicine and clinical trials. “These are critical for all cancer patients, but especially for rare cancer patients whose treatment options may be limited,” Ms Delaney said Ms Delaney was diagnosed with stage 4 clear cell ovarian cancer nearly seven years ago. She is enthusiastic about PROSPECT a new cancer treatment pathway that provides genomic testing to Australians with rare or incurable cancers, and then provides access to any clinical trials and off-label therapies that might make a difference. PROSPECT cancer screening program is a clever collaboration between University of New South Wales, NSW government and a whole range of players in the Australian medical research sector. [ACAST LINK] Professor David Thomas leads Omico, the not-for-profit which runs PROSPECT's cancer screening program. He is optimistic about PROSPECT bringing a bit more equity to cancer treatment for those with rare cancers who often miss out on trials or are and also for remote patients. “Regional and rural Australia is very important to us and we're specifically trying to promote the program and work with our clinical colleagues in regional cancer centers. “That specifically applies also to Aboriginal and Torres Strait Islander cancer patients. Rural and regional patients, as well as Indigenous cancer patients, have demonstrably worse outcomes. We don't want them to be left behind,” he says. For the 150 people diagnosed each day with a rare cancer, it's a new pathway that can make the difference and not just in the future. Professor Thomas says the program is not a philanthropic exercise with no connection with patient interests. “The pace of research progress is so great that it's now creating options for patients in real time rather than for some future benefit. “I would encourage us to think about research as just another part of the way of our armamentarium when we try to treat diseases like cancer,” he says. Hosted on Acast. See acast.com/privacy for more information.

The number of spinal fusions performed in Australia has skyrocketed over the past few decades, with the number of privately funded procedures far outstripping those done in the public system. Spinal fusions, which help stabilise the spine by surgically joining two or more vertebrae together, can be used following traumatic injury, or to help correct scoliosis in children. But the most common use for spinal fusions is in degenerative conditions of the spine. This episode of The Medical Republic Podcast explores when this procedure should be considered, and why we are seeing such a large increase in the number of these procedures being performed. Dr Ashish Diwan, director of the Spine Service at St George Hospital in New South Wales, says there are several considerations to be weighed before undertaking a spinal fusion, including the duration, intensity and frequency of back pain; whether other treatment options have been tried; and what the patient wants. Dr Diwan has sympathy for GPs with patients who are considering undergoing a spinal fusion, which is far from a straightforward decision: “It's like trying to get married. If you're in doubt, don't do it.” The decision not to do surgery can be equally challenging, according to Dr Diwan. “There is also an incredible lack of evidence as to what you do for a person who continues to suffer. The alternatives [drugs, spinal cord stimulators or radiofrequency ablations] are not very clear … none of them stack up when you start dealing with people who have pain of a chronic nature.” There are many reasons for the spike in the number of spinal fusions being performed, according to Professor Ian Harris, an orthopaedic surgeon and researcher from the University of NSW. “There is an aging of the population, but [now] there are more so called ‘indications' for spine surgery,” he tells the podcast. “The techniques of doing them have developed in a way that there's now lots of different ways you can do spine fusions.” Several reasons also exist for why more privately, rather than publicly, funded procedures are being done. But Professor Harris feels the inclusion of MRI scans on the MBS is glaringly obvious one. This presents a fine line to walk between using imaging to rule out potential pathologies and jumping at shadows and operating unnecessarily on age-related changes. This reinforces the need for clear discussions with patients about any imaging findings. “Just having a scan doesn't hurt anyone. It's what you do with the results that can harm people.” Hosted on Acast. See acast.com/privacy for more information.

Future overlords or really helpful assistants? Hosted on Acast. See acast.com/privacy for more information.

Does an app a day keep the doctor away or make them worried? Hosted on Acast. See acast.com/privacy for more information.

Voluntourism is an enticing form of travel: exotic locales, cultural immersion, serving needy populations with your skills – all wrapped up in your four weeks' annual leave. Not so fast. Before packing your passport and mosquito net tune in to The Medical Republic podcast to hear from two guests who might make you reconsider. Dr Andrew Browning has been doing fistula surgery in Africa through the Barbara May Foundation for around 25 years. He says its life changing for patients who start to live normal lives again after the deeply distressing injury caused by obstructed labour. However, Dr Browning says a donation that funds local health workers may better support outcomes than a short-term volunteering stint. “When you're there for a short term the people don't know you, you don't know them. You don't know the culture, you don't know the way things work or don't work. “The people there are very polite, very long suffering and will put up with you for the time that you're there. Then as soon as you leave, they just go back to their normal ways,” Dr Browning says. But if you're still keen Dr. Browning said there are some spaces for shorter term volunteers if you have specialised in obstetrics, gynecology or midwifery. “Around 40% of these girls have been suicidal or attempted suicide with this injury, a hundred percent of them are depressed. And when you treat them they just turn back to be normal, happy citizens,” Dr Browning said. It's the kind of heroic work that many doctors dream of, says rheumatologist Dr Rob Baume. After a bout of professional burn out, Dr Baume considered medical voluntourism but ended up not buying a plane ticket after all. “When I did a bit of more research, I found that unless you have a specific specialties such as anesthetist or an obstetrician, you need to sign up for nine months. The other part of the equation is that I don't speak the language. Then there's also the cost, the health risks and the risk to your life,” he said. Instead of volunteering himself, Dr. Baume has just raised $1 million for healthcare in developing nations through his charity, Twice the Doctor. Dr Baume said that research by Dr Greg Lewis shows that if a doctor wants to make maximum impact on the world, it doesn't matter which specialisation they do. “What matters is that you give a fair bit of your income to third world causes,” Dr Baume said. Hosted on Acast. See acast.com/privacy for more information.

The latest episode of The Medical Republic podcast is a special insight into female parts across the age spectrum.We speak first with Associate Professor Melissa Kang who was, for 23 years, the iconic Dolly Doctor in Dolly magazine – the Australian teen-girl's bible for many decades.Professor Kang said that teenagers want to know how to navigate the health system and that young women are keen to talk about sexual health but need the GP to raise the topic first.“Research has also told us that young women want GPs to bring up the difficult topics. They want GPs to introduce the topic of sexual health or sex or intimacy,” she said.Professor Kang said that creates a bit of a mismatch because GPs often feel that those topics are too personal and sensitive.“They are waiting for patients to bring it up themselves, whereas young women are saying, “No, we want GPs to do it!”. So, as doctors, we do need to create that space,” Professor Kang said.We also talk about whether young women's health concerns have changed over the last few decades. Professor Kang said that young women have more health knowledge these days but that some concerns are enduring.“The stigmatization of their bodies and their sexuality. I don't think that has changed an awful lot over the decades that I've been working with young people as a doctor,” she said.Dr Talat Uppal, our second guest, also that even midlife women experience taboo and shame about their bodies and that their health concerns are often minimised. She said that if a woman says she's having pain, even from a point of view of ischemic heart disease, they are more likely to be “fobbed off” by doctors than men.“It never sees this to amaze me how much women put up with prior to seeking care or sometimes they've sought care but they have not been proactively managed as well as we would hope,” Dr Uppal says.As a gynacologist and obstetrician, Dr Uppal opened her a multidisciplinary team based care clinic, in Sydney. The team draws on a range of expertise including a GP, colorectal specialist, nurse practitioners and physiotherapists.Women's Health Road cares for women health across their lifespan; from teenage girls with menstrual problems right through to older women with prolapse.“It genuinely gives me joy when I see the difference in quality of care that the woman has access to, which has not been from what just I could do personally, rather, it has been the contribution of all the other tenanted clinicians in our team,” she says. Hosted on Acast. See acast.com/privacy for more information.

Do you struggle to keep your practice running like a well-oiled machine?   Our line-up of experts today share insights on how to earn more profit, retain staff, cover your risk and level up your practice management. Guests include an accountant, lawyer and cybersecurity guru. We also hear from a health economist and a GP who has scaled their clinic to good financial and patient reward. Their advice includes how to optimise billing, hours of operation, and the value of a monthly review meeting with your team. Our guests also delve into technology solutions to cover your biggest cybersecurity risk and using social media to recruit staff that are a perfect match. Can a general practice prioritise clinical excellence and still make money? Listen to The Medical Republic podcast and find out what the experts say. [ACAST EMBED CODE]  Resources: Guide to health privacy, Office of the Australian Information Commissioner.   You can listen and subscribe to the show by searching for “The Medical Republic” in your favourite podcast player.  Hosted on Acast. See acast.com/privacy for more information.

When the choice is between writing a script for pain killers and a 45 consultation about weight management, which one do you choose?According to Associate Professor Kade Paterson, University of Melbourne, scripts for pain killers and referrals to orthopaedic surgeons are unnecessarily common for patients with osteoarthritis (OA).Professor Paterson says everyone who has osteoarthritis should be offered some sort of therapeutic exercise that suits them, and his fitness focus is backed by evidence.“We see very positive outcomes from the three approaches - exercise, weight management and education. All have been shown to be clinically effective at reducing both pain and function,” Professor Paterson says.Professor Kim Bennell is director of the Centre for Health, Exercise and Sports Medicine at University of Melbourne. She says that the kind of language clinicians use with OA patients is important. Focusing on the person, rather than the joint, is shown to be clinically effective in improving a patient's willingness to take up exercise, she says.Resources: OA treatment resources from the Centre for Health, Exercise and Sports Medicine.“Using language that talks with optimism about the effective, different treatments out there,” is a small change that is relatively easy to make says Professor Bennell.General practitioner Dr David King also advocates for non-drug and non-surgical treatments to be prescribed first. He's on the RACGP's project team for the Handbook of Non-Drug Interventions (HANDI).“HANDI is designed to be a similar resource as a pharmacopia for drugs - just like when we look up, say Australian Medicine Handbook, we can get an idea of the indication and the dose of the non-drug intervention and any contraindications and size of benefits,” he said.Guests also discuss when ACL surgery is best, why young girls are at risk and what gets in the way of a doctor trying non-drug treatments first. Hosted on Acast. See acast.com/privacy for more information.

There's been a swell of advocacy lately around breast density, which increases cancer risk while reducing the sensitivity of mammograms. The FDA in the US has recently mandated that women be notified by mammogram providers if they have dense breasts, giving them the opportunity to arrange supplemental testing. But BreastScreen Australia's 2020 position statement does not recommend the routine recording of breast density or the provision of supplemental testing for women with dense breasts. Professor Vivienne Milch, the government's medical advisor on screening policy, and Professor Bruce Mann, a breast surgeon and researcher, are two of our guests today in the Tea Room – the last Tea Room before we become The Medical Republic Podcast and go from weekly to fortnightly episodes. We also talk to two patients about their experiences with breast density and cancer, who find the lack of notification baffling – and a little bit 1950s. Dr Sandy Minck, a GP by training and a breast cancer survivor, said she was “dumbfounded” by the BSA position statement. “As a consumer I'm outraged. As a health professional, I'm dumbfounded. I just don't understand it.” Professor Milch says the program will conduct an evidence review on supplemental screening for women with dense breasts some time this year, although there is no guarantee of a policy change. “We're aware of the growing momentum of advocacy and of also some women's desire to know their breast density,” Professor Milch says, adding that different states have different policies. “Western Australia has been telling women about their breast density for some time, and then there are pilots in some services in [Queensland and South Australia]. “We may or may not have a policy change. But we'll be looking at the evidence.” Professor Bruce Mann, who works with the Roadmap to Optimising Screening in Australia (ROSA) project, says there is enough evidence to justify a change to BSA's screening regimen. “As women and the community becomes more informed, there is a danger that what is offered by BreastScreen will be seen as insufficient,” he said, which will lead to women opting out of BreastScreen and going private. “What we don't want in this country is a two-tiered system where those who know and can get the best, do, and everyone else gets what's offered to them. That's what we are working to avoid. “If you can show that by doing something different you are finding more cancers, fewer cancers are being diagnosed between screening rounds, and the stage, the size and the nodal status of cancers that are diagnosed is moving in a favourable direction, I believe that's sufficient to encourage implementation with a planned review in 10 years when the mortality information's there.” Hosted on Acast. See acast.com/privacy for more information.

South Australia's long covid clinic loves GPs and keeps them close.Dr Angela Molga is a clinical pharmacologist and geriatrician at the long covid clinic at Royal Adelaide Hospital.“We engage the GPs very early on, from the moment we receive the referrals. The patients are kept updated on the length of the waitlist and we also send them out resources specifically around self-rehabilitation,” she says.Dr Molga says the average age of the patients who were seen in the South Australian clinic last year was 47 years old.“These were previously healthy people. Little contact with the healthcare system, but now have multiple chronic issues. They have to change their lifestyle significantly, and then this also impacts their mental health,” she says.Also on The Tea Room medical reporter Cate Swannell shares the nitty gritty details of the long covid parliamentary inquiry report.Although long covid fails to get a mention in the federal budget Cate says the long covid parliamentary inquiry is pushing for $50 million. She says the RACGP has welcomed the recognition of GPs in the report.“They also have pointed out that many recommendations reflect what the RACGP has been calling for, for a long time. Particularly around data collection and research,” Cate says.Cate says the report seemed to hinge on the establishment of a national Centre for Disease Control which we saw confirmed in this week's federal budget.“They're also talking about expanding the list of eligibility for antivirals and there is a call for the establishment of a multidisciplinary advisory body to oversee the impact of poor air quality and ventilation on the economy,” Cate says.Join The Medical Republic at an interactive live webinar that will equip you with the knowledge and tools to treat long covid patients.Ask questions about including diagnostics and assessment, guidelines, billing and item numbers, and how to create a long covid clinic in a community practice.The expert panel include doctors treating long covid in family practices, leaders of tertiary care teams, clinical researchers and public health specialists. Hosted on Acast. See acast.com/privacy for more information.

What do you get when you cross advice from a health economist with that from a leading physiotherapist? Increased revenue and a better patient experience, say our guests on today's episode of The Tea Room.Scott Willis is president of the Australian Physiotherapists Association and a proud Palawa man. He says better results come from general practices who genuinely embrace allied health as part of the team.“If you have social events, invite them. Let them be part of your strategy of the practice. They might sometimes see things from a different angle and add value to where practice is heading,” he says.Mr Willis also says the business relationship amplifies when it wraps around the needs of the patients.“The number one thing is that both parties – GPs and allied health - believe that it's a partnership to make the patient journey better. I know it's a business transaction in terms of hiring a space or having some type of input within general practice, but it has to be viewed as more than that,” he saysTracey Johnson, health economist and CEO of Inala Primary Care, also favours multidisciplinary team care for patients. She also has a robust economic rationale for engaging allied health within a general practice.“Given the rents that people are now paying in this sector, it will be incredibly hard for you to survive if you don't have onsite allied health or pathology or pharmacy that you are subleasing to,” she said.Ms Johnson says that many doctors work part time and that hot-desking their rooms makes perfect economic sense.“Some doctors might work from 8:00am in the morning until 2:30pm and pick their children up from school. So, bring in some allied health who might to use those rooms from 3:00pm until 7:00pm. You get more utilization around those rooms, more marginal return, and generally things come together better for the patients as well,” she says.For more tips on how to optimise your allied health arrangements listen to the full episode. Hosted on Acast. See acast.com/privacy for more information.

Professor Rob Moodie describes himself as “an eternal optimist”. He needs to be. A long and distinguished career in public health has seen Professor Moodie tackle the “big four” industries – alcohol, tobacco, junk food, and fossil fuel – and these days he's added a fifth to the list, gambling. Those industries and corporate multinationals make up a large slice, but by no means all, of the commercial determinants of health – defined by Professor Moodie and his colleagues as “the products and practices of some commercial actors—notably the largest transnational corporations—[that are] responsible for escalating rates of avoidable ill health, planetary damage, and social and health inequity”. In a recent series in the Lancet, Professor Moodie, Professor Anna Gilmore from the University of Bath in the UK and other colleagues set out to define, conceptualise and frame an argument for paying attention to the commercial determinants of health and rebalancing the distribution of the profits of capitalism. Are Professor Moodie and his colleagues talking about the overthrow of capitalism? “We're talking about a much more responsible form of capitalism,” he tells TMR. “[At the moment] these corporations, don't pay the costs of their production and their consumption. Individuals and states pay the costs. And that means that money can't be spent on other things like education or other forms of healthcare. “They can completely externalise all the negatives, and they leave it for the rest of the society to pick up, literally what they've left behind. And that makes them more powerful.” Doing nothing to correct the balance of power between corporations and society could be catastrophic, says Professor Moodie. “We've grown up with an expectation, literally, that life expectancy will continue to increase, that our lives will get longer and better as we go grow older and that we'll have a happier society,” he said. “That notion of a fair go was built into our ethos, but it's been disappearing over the last 15 to 20 years. “We've watched all these indexes that are going the wrong way, whether it's around childhood education, childhood development, sustainability, biodiversity, press freedom, peace index, quality of life index, quality of death index – in Australia we used to be really up there. “This has been worn away.” We need a shift in our mindset and where we look for inspiration, says Professor Moodie. “We could go to the wrong place,” he said. “The US is not a place to go for overall policy inspiration. We need to look to northern Europe or Scandinavia, where there's a commitment to the society as a whole, and what that produces. “The greater the equality, the better the health, and there's a dictum that says if you want to live the American dream, go to Denmark.” Hosted on Acast. See acast.com/privacy for more information.

With so much to learn in so little time, managing LGBTQI+ patients isn't yet high on the priority list at medical schools. Dr Asiel Adan Sanchez is a GP and clinical tutor at the university of Melbourne. He knows first-hand that clinical environments can be off putting for people who are queer, trans and gender diverse. He's also created a solution for that called Wavelength: a learning tool that builds clinician skills and makes general practices safer for LGBTQI+ folk. Dr Sanchez gives a quick masterclass on the simple and practical ways to take away the awkward interactions that occur in many medical environments. They say a very common example is when taking a sensitive history and asking about gender affirmation procedures. “A lot of clinicians really struggle with asking those questions and often the language that they use is quite inappropriate. ‘Have you had the operation?' for example. A patient might get this question all the time outside, in the real world, and if you don't explain to the patient what the rationale behind asking those questions is, it can be really distressing for them,” says Dr Sanchez. Dr Sanchez provides a graduated approach to inquiring about gender affirmation surgery, after building rapport through simple ways such as using correct pronouns. “I often tell medical students to fall back on the skills that they already have around cultural competency to build that rapport with the person. For example, you might be talking about work and family and what the patient does at home. Then you can ask ‘By the way, are there any pronouns that you'd like me to use?' And that's an organic and simple approach,” they say. Wavelength training module is now managed by the Australian Medical Student Association (AMSA), which is advocating to incorporate the content into Australian medical school curricula. Medical student Sophia Nicolades has researched the LGBTQI+ health curriculum gap. They found that, on average, there were between zero and two hours across the whole medical degree dedicated to LGBTQI+ health. “We also found that the groups with the poorest healthcare outcomes were also the least present in our curricula – those being trans people, intersex people, bisexual people, and those with intersectional experiences such as First Nations people and folks with disability,” Mx Nicolades said. Dineli Kalansuriya, medical student and chair of AMSA Queer, is also working to improve the medical curricula at Australian universities. “We would also love for some practising doctors to take part in the Wavelength module and let us know if they feel that it's relevant, if it's representative of the presentations that they've been seeing as well,” she said. Hosted on Acast. See acast.com/privacy for more information.

Struggling to hang on to doctor staff? This episode offers more than a few gems of wisdom from the most unlikely location. Today, The Tea Room travels to Crystal Brook, a rural town 200 kilometres north of Adelaide. There we meet Dr Richard McKinnon co- owner of Crystal Brook Medical Practice – a small-town clinic that is anything but small. After 35 years in this farming community, he knows the hacks to running a thriving practice that allows plenty of time to play golf. The secret, it appears, is knowing how to retain registrars. “The current generation, quite rightly and no criticism at all, won't go to single-doctor practices, they won't go to two doctor practices and they probably won't go to three doctor practices. Because it's all about work life, balance and lifestyle,” Dr McKinnon says. At Crystal Brook Medical Practice registrars are “really looked after”, says Dr McKinnon. “They don't do any more on-call than I do. They're very well supported. And if they want to go and play netball in winter and they're on call, I'll cover them and they'll cover me when I want to go sailing. And the ones we like and who like us tend to stay,” he said. Providing great training is another major drawcard for registrars. At Crystal Brook they get hands-on experience assessing and treating conditions, like gout and polymyalgia rheumatica, which in a city clinic would be normally referred to another specialist. “I think rural GPs will do more procedures perhaps than our city colleagues because you don't want the patient have to travel 200 kilometres for treatment. And if you're not kind of putting patients at increased risk then we will do those treatments and try to encourage and teach the registrars coming through,” he said. Dr McKinnon sees an over reliance on “sophisticated investigations” in current training approaches in large hospitals. He believes this can compromise clinical acumen and the confidence to diagnose and treat some patients. “You go to Medical School, in my case for six years of medicine, then four years post-graduate. Basically you've done 10 years training. If you then don't use your clinical acumen, well, it just breaks my heart,” Dr McKinnon said. Hosted on Acast. See acast.com/privacy for more information.

The recent shake-up in asthma management and what that might mean for GPs.

An award-winning Australian trial has changed how we treat pneumothorax.

It sounds like common-sense that immunity declines with age. But new research suggests that some GP's aren't convinced.

We may never really know how many excess deaths the pandemic has caused, but it is well worth trying to find out.

Transvaginal ultrasounds are among the most invasive procedures women will undergo in their lives - but, surprisingly, the healthcare practitioners performing these procedures are almost entirely self-regulated. Now, the peak bodies representing sonographers are calling on AHPRA to regulate the profession. Our reporter, Sonia Kohlbacher, has the full story...

As Australia's first ever wellness officer, rheumatologist Dr Bethan Richards has focused on meeting the basic needs of hospital staff – offering protected lunch breaks, access to water, functioning rest areas and moments of human connection. It all sounds tragically obvious but has required deep changes in governance and culture.

The story of thalidomide is etched into the minds of every doctor and drug manufacturer. It serves as a warning of what can go wrong. The thalidomide mistake is why drugs are now so rigorously tested for safety.Decades after thalidomide was banned from being given to pregnant women, survivors are a living cohort still fighting to be seen and acknowledged.They've recently secured a major win with the federal government announcing to compensate them for the disabilities and difficulties they have endured – the culmination of years of advocacy.Sonia Kohlbacher, a reporter at TMR, has been following the story.

In this episode, Dr Megan Prictor from Melbourne Law School discusses the legal considerations of recording medical consults, how the files should be stored, and strategies to decline being recorded by a patient.

Subtle seizures can involve people zoning out from the conversation, experiencing unusual sensations, odd emotions, an intense feeling of déjà vu, or just not remember what they were doing and then coming back into the room like nothing has happened.The seizures may seem innocuous, but they can be quite dangerous if the patient happens to be driving a car, holding a cigarette or making a cup of tea.

Breaking down the stoicism that often prevents GPs from looking after their mental health is more important than ever during COVID-19.Doctors are notoriously bad at being patients. This podcast contains a few tips… “We should share the secret code with everyone,” says Dr Kathryn Hutt, a GP and the Medical Director at the Doctors Health Advisory Service in NSW.“You don't need to have a diagnosis to see your GP. You don't need to have anything wrong with you.“Just come in and say, ‘I'm just here for a check-up'. That's what members of the public do.“Then you're in the door and you can then sit down and talk about what is going on with your life.”

People with intellectual disabilities often feel like the passive subject of scientific studies. And it turns out we can render much more valuable results about individuals experiences when they are part of the research team, rather than just a participant.

Very few AMA presidents spend their two-year tenure first dealing with extreme summer bushfires, and then a majorly disruptive pandemic. This was the reality for immediate past president of the AMA, Dr Tony Bartone. He joins the show to talk about his time as leader of the AMA and the events which have defined the AMA's work over the last eight months.

It's no wonder that some look at COVID-19 and ask: could you ask for a better result if you wanted to sow massive disruption and chaos? Fortunately, the evidence suggests that this latest coronavirus occurred naturally. But it is worth asking, how at risk are we of a bioterrorist attack?

There might be five RACGP candidates, but only one can be your next president.This episode features Associate Professor Ayman Shenouda, a GP from Wagga Wagga NSW and the RACGP vice president.

We are inviting all candidates onto the podcast to answer questions about telehealth, GP advocacy and what needs to change for the college to keep its members now, and into the future. This episode features Dr John Buckley, a Queensland-based GP and director of GP training at GPTQ.

We are inviting all candidates onto the podcast to answer questions about telehealth, GP advocacy and what needs to change for the college to keep its members now, and into the future. This episode features Dr Chris Irwin, a Victorian GP, and practice owner of two clinics, in Diamond Creek and Ivanhoe.

We are inviting all candidates onto the podcast to answer questions about telehealth, GP advocacy and what needs to change for the college to keep its members now, and into the future. This episode features Dr Karen Price, a Melbourne GP and co-founder of GPDU.

Who wants to be the next college president? We've invited all the doctors vying for the position onto our podcast to find out. This episode features Melbourne-based GP Dr Magdalena Simonis.

Need to catch up on the current COVID situation? Bianca Nogrady shares the latest on Melbourne's new mountain of cases, new restrictions and what we know so far from the ASCOT trial about the use of corticosteroids as a potential treatment.Follow Bianca's COVID Catchup blog here: medicalrepublic.com.au/tag/live-blog

There might be five RACGP candidates, but only one can be your next president.This episode features Associate Professor Charlotte Hespe, a Sydney-based GP, practice owner, and chair of the NSW and ACT RACGP faculties. You can read more about her campaign here: https://www.drcharlottehespe.com/

There's a tendency to talk about COVID as a binary outcome – either you die or you're fine, says epidemiologist Gid Meyerowitz-Katz.But the first studies of people who have “recovered” from COVID show that about a third of patients with less severe disease (and around 80% of patients who were hospitalised) still have nasty symptoms three or four months later.Fatigue, chest discomfort, shortness of breath and loss of smell are common in patients with less severe COVID infections, while people who were hospitalised with COVID can suffer kidney injury or severe psychiatric issues.In this episode of The Medical Republic, Gid gives us a rundown of the latest evidence and TMR reporter Felicity Nelson ends on a lighter note by sharing some of the weirdest government responses to COVID.Here's Gid's piece in The Guardian, Felicity's listicle and Melissa Davey's exclusive in The Guardian about the St Vincent's Adapt study.

The theory that scientists actually designed the pandemic-causing virus isn't just bouncing around in the fringes of the web, it's been endorsed by political leaders in multiple countries and even a former intelligence chief. So how can virologists be so sure that it's false?TMR reporter Ruby Prosser Scully gives us some detailed and fascinating answers based on her interviews with genetic engineering and virus experts.Read Ruby's story here: http://medicalrepublic.com.au/how-we-know-covid-didnt-come-from-a-lab/31440

Need a COVID Catchup? Bianca Nogrady shares the latest on the Crossroads Hotel cluster in Sydney's southwest and Melbourne's new mountain of cases, while not forgetting the more amusing tales coming out of this pandemic.Follow Bianca's COVID Catchup blog here: medicalrepublic.com.au/tag/live-blog

It's been another interesting week full of COVID-19 stories, we catch up with Bianca Nogrady, our live blogger, to find out what's been happening.

A lot has been happening in the COVID-19 space as community transmission in Victoria continues to rise. Our COVID-19 blogger takes us through the highlights from the week - including the long-awaited results from the dexamethasone study.

It's been another interesting week full of COVID-19 stories, we catch up with Bianca Nogrady, our live blogger, to find out what's been happening.

We've had a few interesting COVID-19 stories crop up this week - and we've got Bianca Nogrady, our live blogger, here to tell us all about it.

COVID-19 has put a spanner in the works for medical conference organisers, but the RACGP is not letting the virus put a stop to its major education and networking event.GP20 will be going ahead this year using a new ‘hybrid' model, incorporating both digital and face to face elements.Social distancing guidelines permitting, the plan is for GPs to gather in capital cities and regional centres around the country on the same day and connect up via video link for the plenary sessions.RACGP president Dr Harry Nespolon says a ‘silver lining' coming out of the pandemic is that hybrid models make events accessible to more people.As this year's GP20 is region specific, it may allow more GPs to attend as they will not have to leave their practices for days at a time, he says.

Say the word 'coronavirus', and we first think of a respiratory disease. So why are scientists tracking what happens to patients' moods and minds in the years after they have recovered?It turns out that coronavirus illnesses like SARS, MERS - and possibly even COVID - appear to have a range of neurological and mental health effects too.Everything from delirium during hospitalisation, and depression, anxiety, PTSD and fatigue have been found in patients who recovered from the previous outbreaks. Which means that we should be on high alert for these problems in the coming months and years, even after the world starts moving on from COVID-19.Many mysteries still remain though. What is causing these neurological and mental health symptoms? Is it the disease itself? Is it the treatment? Or is it just the experience of being on death's door?In this episode of The Medical Republic podcast, Dr Jonathan Rogers, a neuropsychiatry expert at the University College London, shares the latest data.

COVID-19 research is flooding the news every day – and we are all finding it hard to keep up. We've invited Bianca Nogrady back on the show to give us a rundown of what's new and important. Bianca is our resident expert on all things pandemic-related; she updates The Medical Republic's COVID-19 live blog daily.

Last week, we were lucky enough to be joined by two leading business advisors in general practice on our live JobKeeper Q&A.We had so much engagement from our live audience that we've decided to invite our two panellists back.They're coming on the show today to answer some of your questions that they didn't manage to get to during the live event - even though we went massively overtime…!In this bonus episode, TMR webinar producer Talia Meyerowitz-Katz interviews David Dahm and Nick Tsoulakis, business advisors at Health & Life, an Adelaide-based consulting business.

In COVID-19 news this week... The Lancet has published an editorial asking voters not to elect Trump in November. Two studies try to answer the question of the true seroprevalence of COVID-19 in different populations. Australian researchers have estimated that the overall rate of asymptomatic COVID-19 presentations is around 16%. And Sweden's approach of relying on herd immunity may have shortened life expectancy of its citizens by 2-3 years. That - and more! - in this episode of The Medical Republic podcast.

Men can sometimes seem like an afterthought when trying to find out why couples are having trouble conceiving. But now the technology industry has caught on and is starting to pay attention to this lucrative, untapped market.Already, one in six couples are unable to conceive on their own, and in around half of those cases, there is a problem with the man.But what's causing these declining sperm rates? And what can we do to fix it?

Feeling out of the loop on COVID-19? Here's a news round up from the past week, brought to you by science freelancer Bianca Nogrady, podcast hosts Felicity Nelson and Francine Crimmins and TMR reporter Penny Durham, who's got an interesting and disturbing tale about children getting strange complications from COVID-19...

As you probably all know by now, we've been running a live blog on our website to bring you breaking news about the pandemic. Every news outlet is doing this now, but no one else is running a blog specifically for GPs! For this episode of The Medical Republic podcast, we're joined by Bianca Nogrady, a science and medical freelancer who has been working full-time on the blog.

It's a little shocking to suddenly get a letter from your commercial tenant asking for a 50% rent reduction – but COVID-19 is increasingly making this a reality for GPs. Many GPs are unsure about how to respond to these requests. So, we thought it would be helpful to share some of the conversations we've been having with business experts and lawyers on this topic. In this episode, we interview three experts: Brooke Glastonbury, a principal lawyer at Macpherson Kelley in Sydney; Stephanie McGrath, a senior associate at Robert James Lawyers in Victoria; and Graham Lawrence, the National Head of Business Services at Health Project Services, a company that mentors GPs on business matters.

Gazing into the crystal ball seems like a pretty foolish pastime right now – but what we can do is collect data.Epidemiologist and friend of the podcast Gideon Meyerowitz-Katz talks us through what variables we can and should be tracking to make more accurate predictions about the future of this pandemic.