The Good GP

In this episode of The Good GP, host Dr Krystyna de Lange is joined by Dr Tegan Allin, rural generalist and GP obstetrician from Thursday Island live from the GP25 Conference, to discuss the topic of foetal rhesus screening and recent changes in Australian guidelines.

They began with an overview of anti-D prophylaxis and its importance for women who are rhesus negative. Dr Tegan Allin explains the pathophysiology of rhesus disease, risks associated with sensitisation during pregnancy, and the traditional approach of universal prophylaxis with anti-D immunoglobulin.

They then shift to the new availability of non-invasive prenatal screening (NIPS) for foetal rhesus status. Dr Tegan Allin describes how this serum-based test examines cell-free foetal DNA in maternal blood from 11 weeks gestation. With sensitivity and specificity over 99%, it allows for more targeted administration of anti-D only to those carrying a rhesus positive fetus.

Covering key practicalities of ordering foetal rhesus screening, including the appropriate gestational window (after 11 weeks and before 29 weeks), the importance of lab-specific request forms, and consideration of slight lab-to-lab differences in recommended timing.

Highlighting the ongoing changes in first trimester antenatal management and the need for GPs to remain up to date with evolving testing protocols. Reinforcing the necessity of confirming neonatal rhesus status at birth via cord blood testing, even when negative results are obtained antenatally.

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

Mentioned in this episode:

Build the Career and Lifestyle You’ve Been Looking For, in the Vines.

Tired of traffic, long commutes, and feeling stuck in the grind? The Mudgee Region is calling. The Doctors 4 Mudgee Region initiative is working to attract and support GPs and registrars looking to build rewarding, sustainable careers in one of NSW’s most sought after regional destinations, just 3 hours from Sydney. With financial incentives of up to $45,000 for fellowed doctors and lifestyle concierge support for all relocating practitioners, there’s never been a better time to make the move. Learn more at www.doctors4mudgee.com.au

In this episode of The Good GP, host Dr Sean Stevens is joined by Dr Terri-Lynne South live from the GP25 Conference, to deliver an overview of obesity management, with a specific focus on the use of GLP-1 and GIP dual incretin therapies in general practice.

Dr Terri-Lynne South outlines the current Therapeutic Goods Administration (TGA)-approved indications for these treatments in Australia. These include use in patients with type 2 diabetes, overweight with complications, chronic kidney disease and type 2 diabetes, obesity with obstructive sleep apnoea, and secondary prevention of cardiovascular disease. Noting that this field is rapidly evolving, with recent changes in indications and ongoing international developments.

Addressing the importance of setting realistic patient expectations regarding weight loss outcomes and the duration of treatment, emphasising that clinical obesity is a chronic, complex condition requiring long-term management. Evidence shows that weight loss achieved with GLP-1 therapies can be maintained over four years if the patient remains adherent, while early discontinuation often leads to significant weight regain.

Practical strategies for managing common side effects, mainly gastrointestinal symptoms like nausea and constipation, are described in detail. Dr Terri-Lynne South provides useful tips for patients, including hydration, dietary modifications, and mindfulness around portion size and satiety cues. 

The importance of a multidisciplinary approach is reinforced, including psychological assessment (screening for eating disorders, depression, anxiety, and complications like sleep apnoea), dietitian involvement, and possible referral to exercise physiology and psychology services where also clinically indicated.

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

Mentioned in this episode:

Build the Career and Lifestyle You’ve Been Looking For, in the Vines.

Tired of traffic, long commutes, and feeling stuck in the grind? The Mudgee Region is calling. The Doctors 4 Mudgee Region initiative is working to attract and support GPs and registrars looking to build rewarding, sustainable careers in one of NSW’s most sought after regional destinations, just 3 hours from Sydney. With financial incentives of up to $45,000 for fellowed doctors and lifestyle concierge support for all relocating practitioners, there’s never been a better time to make the move. Learn more at www.doctors4mudgee.com.au

In this episode of This Could Save Your Life Podcast, hosts Dr Anna Mullins and Dr Catherine Bourke provide a comprehensive overview of cervical cancer screening and prevention.

They start with the epidemiology of cervical cancer, outlining that it affects approximately 1 in 175 women or people with a cervix. Explaining the anatomy of the cervix and discussing the primary cause of cervical cancer: human papillomavirus (HPV) infection. They clarify that while HPV is very common and transmitted through sexual contact, most strains are cleared by the body and only a subset are associated with cancer development. 

Covering common patient questions regarding HPV transmission, family history, and the relevance of these factors to individual risk. They emphasise that unlike many other cancers, a family history does not increase risk for cervical cancer.

Practical advice is presented around recognising possible symptoms of cervical cancer, such as abnormal vaginal bleeding, pelvic pain, and changes in vaginal discharge.

Exploring the details of cervical screening in Australia, which has shifted from Pap smears to HPV-based testing. Outlining the process and options for HPV testing, including both clinician-collected and self-collected swabs. 

Screening start age (25) and end age (74) are clarified, as well as earlier screening for those sexually active before age 14, and the importance of starting screening upon sexual activity.

They also discussed cervical cancer prevention through vaccination. Referencing the development of the Gardasil vaccine in Australia, its almost 100% effectiveness against several HPV strains, and its routine administration to both girls and boys under the National Immunisation Program. 

This Could Save Your Life Podcast is under The Good GP podcast, 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:

Build the Career and Lifestyle You’ve Been Looking For, in the Vines.

Tired of traffic, long commutes, and feeling stuck in the grind? The Mudgee Region is calling. The Doctors 4 Mudgee Region initiative is working to attract and support GPs and registrars looking to build rewarding, sustainable careers in one of NSW’s most sought after regional destinations, just 3 hours from Sydney. With financial incentives of up to $45,000 for fellowed doctors and lifestyle concierge support for all relocating practitioners, there’s never been a better time to make the move. Learn more at www.doctors4mudgee.com.au

In this episode of the Good GP, host Dr Maria Li welcomes back Dr Katherine Wyld, endocrinologist, for the third and final part of the series on hormone pseudoscience. Focusing on adrenal hormone-related misinformation, commonly encountered both in general practice and on social media.

Dr Wyld tackles the adrenal hormone-related prevalent misinformations, including:

• The widespread misinformation about adrenal hormones, especially related to cortisol, circulating on social media and online platforms. Cortisol testing requires careful consideration of context and timing, as cortisol levels fluctuate significantly throughout the day.
• Dr Wyld clarifies that single-point cortisol measurements are rarely clinically meaningful, and that salivary and urine cortisol tests should only be used in specific, evidence-based situations.
• Dutch testing (dried urine testing for hormones) is not supported by endocrine societies due to lack of evidence, questionable logic, and high cost.
• “Adrenal fatigue” is not a real or recognized medical condition; there is no scientific evidence or data to support this concept.
• High cortisol is commonly blamed for stress, anxiety, weight gain, and fatigue, but it is rarely the cause unless clear evidence of Cushing’s syndrome is present. Features of Cushing’s syndrome to look for include diabetes, hypertension, significant unexplained weight gain, skin changes, and proximal myopathy.

Sharing strategies for GPs when faced with unfamiliar symptoms or patient requests based on pseudoscientific information. Dr Wyld encourages clinicians to be honest about knowledge gaps, consult reputable sources, and maintain open communication with patients.

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In this episode of The Good GP, host Dr Maria Li continues her conversation with Dr Katherine Wyld, a Queensland-based endocrinologist, exploring the topic of menopause pseudoscience and its impact on patient care. This second part in the hormones series explores the growing prevalence of misinformation around menopause and hormone therapy, and practical guidance for general practitioners.

Dr Wyld discusses several areas of menopause care commonly affected by false or misleading information, including:

• The use of hormone monitoring during treatment. Dr Wyld clarifies that routine measurement of estrogen and progesterone levels is not recommended for guiding menopause treatment. Dosing should be based on symptoms.
• Testosterone therapy in menopause. Evidence supports its use only for hypoactive sexual desire disorder; benefits for other menopause symptoms are not proven. Common side effects include acne, excess hair growth, and skin oiliness.
• Bioidentical hormone therapy. The term is unregulated and used as a marketing tool. Standard, regulated formulations are safer and more effective.
• Use of high-dose estrogen. Prescribing above recommended limits increases risk and is not backed by safety data. Referral to a specialist is advised for complex cases.
• Strategies for GPs when encountering unfamiliar therapies or requests for non-evidence-based treatments.When unsure, consult guidelines or colleagues and use trusted resources for evidence-based answers.

They aim to support GPs in navigating menopause-related consultations, equipping them to communicate clearly, critically evaluate new trends, and provide safe, evidence-based care to their patients.

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