Australian Family Physician audio

Interview: Are they safe in there? - Patient safety and trainees in the practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 07 Feb 2012 09:00:00 +1100

Dr Pat Byrnes is an experience GP, supervisor and educator. His focus article in the January–February 2012 issue of AFP considers issues of patient safety when trainees are seeing the patient. The article provides both background theory and practical ideas about how to detect ‘unconscious incompetence’. The podcast interview particularly focuses on the practical aspects of methods to assist to ascertain what is happening behind the consulting room door.

Article: Interview: Are they safe in there? - Patient safety and trainees in the practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 07 Feb 2012 09:00:00 +1100

Interview: Microbiological contamination of spirometers – an exploratory study in general practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 07 Feb 2012 09:00:00 +1100

Dr Kerry Hancock is an Adelaide GP and Senior Lecturer at the University of Adelaide. Her article, titled ‘Microbiological contamination of spirometers – an exploratory study in general practice’ reports on research they have done locally testing spirometers.

Article: Microbiological contamination of spirometers – an exploratory study in general practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 07 Feb 2012 09:00:00 +1100

Dr Kerry Hancock is an Adelaide GP and Senior Lecturer at the University of Adelaide. Her article, in the research section of the January-February 2012 AFP, titled ‘Microbiological contamination of spirometers – an exploratory study in general practice’ reports on research they have done locally testing spirometers. The results provide directions for future research, and she provides some useful advice for all practices with spirometers.

Interview: Teaching medical students - Tips from the frontline

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 07 Feb 2012 09:00:00 +1100

Dr James Best is an experienced GP teacher, who was awarded RACGP supervisor of the year in 2010, who provides an insight into why he teachings and tips for preparing to teach and implementing in the diverse general practice day.

Article: Teaching medical students - Tips from the frontline

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 07 Feb 2012 09:00:00 +1100

Interview: Multiple sclerosis - diagnosis, management and prognosis

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 12 Dec 2011 09:00:00 +1100

Dr Benjamin K-T Tsang discusses the role of the GP in the diagnosis and management of MS.

Article: Multiple sclerosis - diagnosis, management and prognosis

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 12 Dec 2011 09:00:00 +1100

Dr Benjamin K-T Tsang discusses the role of the GP in the diagnosis and management of MS.

Interview: Motor neurone disease - caring for the patient in general practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 12 Dec 2011 09:00:00 +1100

Dr Matthew Kiernan discusses the role of the GP in the diagnosis and management of motor neurone disease.

Article: Motor neurone disease - caring for the patient in general practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 12 Dec 2011 09:00:00 +1100

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Interview: Traumatic brain injury - longterm care of patients in general practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 12 Dec 2011 09:00:00 +1100

Dr Lyndal Trevena discusses the role of the GP in the diagnosis and management of traumatic brain injury.

Article: Traumatic brain injury - longterm care of patients in general practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 12 Dec 2011 09:00:00 +1100

Dr Lyndal Trevena discusses the role of the GP in the diagnosis and management of traumatic brain injury.

Interview: Intimate partner violence - identification and response in general practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 09 Nov 2011 09:00:00 +1100

Associate Professor Kelsey Hegarty from the Department of General Practice at the Univesity of Melbourne talks about intimate partner violence and the important role GPs have in detection and management.

Article: Intimate partner violence - identification and response in general practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 09 Nov 2011 09:00:00 +1100

Intimate partner violence is a common problem among women attending general practice, with around one in 10 women currently experiencing physical, sexual or emotional abuse by a partner.

Interview: Benzodiazepines - Their role in aggression and why GPs should prescribe with caution

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 15 Nov 2011 09:00:00 +1100

Dr Katy Jones, former Senior Research Fellow at Turning Point Alcohol and Drug Centre weighs the evidence for a link between benzodiazepines and aggression.

Article: Benzodiazepines - Their role in aggression and why GPs should prescribe with caution

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 15 Nov 2011 09:00:00 +1100

Dr Katy Jones, former Senior Research Fellow at Turning Point Alcohol and Drug Centre weighs the evidence for a link between benzodiazepines and aggression.

Interview: Aggressive behaviour - Prevention and management in the general practice environment

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Thu, 17 Nov 2011 09:00:00 +1100

Associate Professor Moira Sim, head of the school of medical sciences, director of the systems and intervention research centre for health at Edith Cowan University, clinical associate professor at the university of western Australia and a practising GP talks about the prevention and management of aggressive behaviour in general practice.

Article: Aggressive behaviour - Prevention and management in the general practice environment

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Thu, 17 Nov 2011 09:00:00 +1100

Aggressive behaviour is commonly encountered in the general practice setting and can often be de-escalated using good communication skills.

Interview: Urinary stone disease: assessment and management

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 24 Oct 2011 09:00:00 +1100

Mr Simon Bariol talks about the role of the GP in assessing and managing urinary stone disease.

Article: Urinary stone disease – assessment and management

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 24 Oct 2011 09:00:00 +1100

Data from the Australian Institute of Health and Welfare showed an annual incidence of 131 cases of upper urinary tract stone disease per 100 000 population in 2006–2007.1 An upper urinary tract stone is the usual cause of what is commonly called ‘renal colic’, although it is more technically correct to call the condition ‘ureteric colic’.

Interview: Autism Spectrum Disorders

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 13 Sep 2011 09:00:00 +1000

Emeritus Professor Bruce Tonge and Dr Avril Brereton discuss autism spectrum disorders and the role of the general practitioner in detection and management.

Article: Autism spectrum disorders

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 13 Sep 2011 09:00:00 +1000

Autism spectrum disorders (ASDs) are serious neurodevelopmental disorders affecting approximately one in 160 Australians. Symptoms are apparent during the second year of life causing impairments in social interaction, communication and behaviour with restricted and stereotyped interests.

Interview: Breastfeeding - Evidence based guidelines for the use of medicines

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 13 Sep 2011 09:00:00 +1000

Dr Lisa Amir discusses breast feeding and medications. She discusses where to find evidence about medicines and breastfeeding, some general principles and also some common clinical scenarios.

Article: Breastfeeding - Evidence based guidelines for the use of medicines

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 13 Sep 2011 09:00:00 +1000

General practitioners may consider prescribing medicines for breastfeeding women during the postpartum period. Most medicines can be used safely during breastfeeding at the recommended dose, however there are exceptions that necessitate caution.

Interview: Problem drinking - detection, assessment and management in general practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 16 Aug 2011 09:00:00 +1000

Dr Apo Demirkol talks about the role of the GP in detecting, assessing and managing problem drinking.

Article: Problem drinking – detection and assessment in general practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 16 Aug 2011 09:00:00 +1000

Alcohol has long been an integral part of the social life of many Australians. However, alcohol is associated with significant harm to drinkers, and also to nondrinkers.

Interview: Risky Drinking among young Australians - causes, effects and implications for GPs

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 16 Aug 2011 09:00:00 +1000

Amy Pennay talks about the importance of acknowledging the social, cultural and economic drivers of risky drinking in young people and outlines a comprehensive strategy for addressing risky drinking in youg people by general practitioners.

Article: Risky drinking among young Australians – causes, effects and implications for GPs

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 16 Aug 2011 09:00:00 +1000

Rates of risky drinking among young Australians have increased substantially over the past 2 decades, resulting in significant community concern.

Interview: Psoriasis

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 06 Jul 2011 09:00:00 +1000

Dr Philip Clarke talks about the very common skin condition of psoriasis – considering issues in diagnosis and management with a focus on general practice

Article: Psoriasis

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 06 Jul 2011 09:00:00 +1000

Psoriasis is one of the more common rashes presenting to general practice.

Interview: Hair and nails

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 05 Jul 2011 09:00:00 +1000

Dr Paul Grinzi discusses common hair and nail problems that are seen in general practice and provides an approach to those.

Article: Hair and nails

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 05 Jul 2011 09:00:00 +1000

Hair and nails are elements of dermatology that can often be omitted from the dermatological assessment. However, there are common and distressing hair and nail conditions that require diagnosis and management.

Interview: Nondiabetic retinal pathology – prevalence in diabetic retinopathy screening

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 04 Jul 2011 09:00:00 +1000

Dr Nathan Neilson has been involved in some research looking at the prevalence of non diabetic retinal pathology when screening for diabetic retinopathy in general practice and discusses what this might mean for general practice.

Article: Nondiabetic retinal pathology – prevalence in diabetic retinopathy screening

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 04 Jul 2011 09:00:00 +1000

To determine the prevalence of photographic signs of nondiabetic retinal pathology in Australian general practice patients with diabetes.

Interview: Mental health risk assessment - a guide for GPs

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 22 Jun 2011 09:00:00 +1000

Dr Sivasankaran Balaratnasingam discusses risk assessment of patients with possible mental disorders and provides suggestions regarding measures that may be undertaken to manage risk in psychiatric emergencies.

Article: Mental health risk assessment – a guide for GPs

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 22 Jun 2011 09:00:00 +1000

Risk assessment of patients in general practice is a challenging area of clinical practice. Competing interests of managing patient wishes, consideration of duty to warn others and invoking the Mental Health Act while practising in a medicolegally accountable manner can be difficult.

Interview: Borderline personality disorder and substance use

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 21 Jun 2011 09:00:00 +1000

Professor Dan Lubman discusses how the general practitioner can provide effective support for patients with co-occurring borderline personality disorder and substance use disorder, including approaches to assessment and treatment, the therapeutic relationship, referral pathways and managing risk and chronic suicidality.

Article: Managing borderline personality disorder and substance use – an integrated approach

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 21 Jun 2011 09:00:00 +1000

Although substance use is a common feature of borderline personality disorder, regular use is associated with greater levels of psychosocial impairment, psychopathology, self harm and suicidal behaviour and leads to poorer treatment outcomes.

Interview: Anxiety disorders

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 20 Jun 2011 09:00:00 +1000

Professor Michael Kyrios discusses the diagnosis, assessment and management of anxiety disorders in the general practice setting.

Article: Anxiety disorders – assessment and management in general practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 20 Jun 2011 09:00:00 +1000

Anxiety is a normal physiological response to a threat. Anxiety disorders occur when this normal physiological response is associated with high levels of autonomic arousal, erroneous cognitions and dysfunctional coping strategies.

Interview: Online resources and management tools for anxiety and depression

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sun, 19 Jun 2011 09:00:00 +1000

Julia Reynolds discusses the diverse range of online resources and management tools for anxiety and depression offered by Australian providers and the ways in which general practitioners can assist their patients to access these resources.

Article: Anxiety and depression – online resources and management tools

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sun, 19 Jun 2011 09:00:00 +1000

There are significant unmet needs for psychological interventions for anxiety and depression in the population. e-health resources complement existing services by providing high quality information, symptom prevention, management interventions and peer support.

Interview: Menopausal transition – assessment in general practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 27 May 2011 09:00:00 +1000

Dr Sue Reddish is a GP who discusses how she approaches the assessment of a women in menopausal transition.

Article: Menopausal transition – assessment in general practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 27 May 2011 09:00:00 +1000

The presentation of a woman in midlife can be an opportunity for both the woman and her doctor to consider a wide range of issues that may be impacting on quality of life or that present a risk to her future health.

Interview: What works? Evidence for lifestyle and nonprescription therapies in menopause

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sat, 28 May 2011 09:00:00 +1000

Dr Emma Warnecke discusses what we know about the evidence for non prescription options for symptom management in the menopause. She also reminds us of the opportunities for identification and management of risk factors at this time.

Article: What works? Evidence for lifestyle and nonprescription therapies in menopause

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sat, 28 May 2011 09:00:00 +1000

Effective prescription medications are available to treat menopausal symptoms. However, due to adverse effects and risks associated with use, many women are seeking complementary and alternative options to treat their symptoms. Nonpharmacological options for the management of menopausal symptoms are widely available and frequently used.

Interview: Depression in general practice – consultation duration and problem solving therapy

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sun, 29 May 2011 09:00:00 +1000

A/Prof David Pierce is a GP who has done some research showing that experienced GPs are able to integrate structured problem solving psychological therapies into their consultations with depressed patients after training without increasing the duration of the consultation.

Article: Depression in general practice – consultation duration and problem solving therapy

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sun, 29 May 2011 09:00:00 +1000

General practitioners have expressed concern that consultations offering psychological therapy approaches will take up too much time. However, problem solving therapy (PST) for depression may be able to be used within the time constraints of general practice. This study investigates whether GPs’ concerns that PST would result in unacceptably long consultations are justified.

Interview: Sex and perimenopause

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 30 May 2011 09:00:00 +1000

Professor Sue Davis discusses issues around sex and the perimenopause. She provides a structure for considering the causes, information on assessment and a summary of some of the key elements in management.

Article: Sex and perimenopause

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 30 May 2011 09:00:00 +1000

The World Health Organization has defined sexual health as ‘a state of physical, emotional, mental and social wellbeing related to sexuality; it is not merely the absence of disease, dysfunction or infirmity’. Surveys conducted across a range of cultures demonstrate that the vast majority of women believe sexual activity to be important and it has been shown higher levels of physical pleasure in sex are significantly associated with higher levels of emotional satisfaction.

Interview: People with disabilities – a rewarding challenge in general practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 04 May 2011 09:00:00 +1000

Dr Jane Tracy discusses in detail the health care of a person with Down Syndrome including the importance of considering preventive health issues, as well as conditions more prevalent in people with Down syndrome. Tips for communication and useful resources are also considered.

Article: People with disabilities – a rewarding challenge in general practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 04 May 2011 09:00:00 +1000

Welcome to an issue of Australian Family Physician that is particularly close to my heart. My son has an intellectual disability, and I understand firsthand the importance and challenges of maintaining optimal health in this group of patients.

Interview: Cerebral palsy in childhood

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 03 May 2011 09:00:00 +1000

Professor Dinah Reddihough discusses cerebral palsy in childhood, including the range of conditions it can include and provides a structure for management. She also discusses what GPs should consider in an undifferentiated presentation of a child with cerebral palsy.

Article: Cerebral palsy in childhood

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 03 May 2011 09:00:00 +1000

Cerebral palsy is the most common cause of physical disability in childhood. While some children have only a motor disorder, others have a range of problems and associated health issues.

Interview: Sex and intellectual disability – dealing with sexual health issues / Women with intellectual disabilities – a study of sexuality, sexual abuse and protection skills

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 02 May 2011 09:00:00 +1000

Dr Gillian Eastgate discusses two articles looking at the issues of intellectual disability and sexual health. The research article explores the understanding of sexual relationships, education and abuse amongst women with an intellectual disability. The focus article then considers the clinical issues in the area for GPs.

Article: Sex and intellectual disability – dealing with sexual health issues

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 02 May 2011 09:00:00 +1000

Sexual health is a vital but often neglected aspect of healthcare for people with intellectual disability. It may initially be difficult for the general practitioner to raise sexuality issues with patients with intellectual disability, but there is potential for simple interventions that offer great benefit.

Article: Women with intellectual disabilities – a study of sexuality, sexual abuse and protection skills

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 02 May 2011 09:00:00 +1000

Sexual abuse and abusive relationships are known to be especially common in people with intellectual disability. This study explored how women with intellectual disability understand sex, relationships and sexual abuse, the effects of sexual abuse on their lives, and how successfully they protect themselves from abuse.

Interview: Appointments – getting it right

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 07 Feb 2011 09:00:00 +1000

Dr Andrew Knight talks about appointment systems and how to get them right. He discusses measuring demand, understanding and measuring delay and then ways that practices have made changes to improve their appointment systems.

Article: Appointments – getting it right

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 07 Feb 2011 09:00:00 +1000

Only 36% of sick Australians report being able to get an appointment on the day they need it, which is poor by international standards.

Interview: Peer review – a safety and quality improvement initiative in a general practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 04 Feb 2011 09:00:00 +1000

Dr Angela Rutherford, a Melbourne GP, discusses a peer review process for the GPs in a practice, including how it works and the benefits they have found.

Article: Peer review – a safety and quality improvement initiative in a general practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 04 Feb 2011 09:00:00 +1000

A general practice in inner city Melbourne (Victoria), committed to ensuring quality standards of clinical care, developed a process for peer review of their doctors’ performance.

Interview: Why haven’t I changed that? Therapeutic inertia in general practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Thu, 03 Feb 2011 09:00:00 +1000

Dr Pat Byrnes discusses the concept of therapeutic inertia, the reasons it occurs and provides practical examples of how it can be overcome in clinical general practice.

Article: Why haven’t I changed that? Therapeutic inertia in general practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Thu, 03 Feb 2011 09:00:00 +1000

There are multiple gaps between evidence and practice in our health system. The relatively new concept of ‘therapeutic inertia’ is useful to understand why these gaps persist.

Interview: Indigenous health – a role for private general practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 02 Feb 2011 09:00:00 +1000

Dr Paul Johanson discusses the Majellan Model, which is where a private general practice has worked with the local indigenous community to improve access to general practice. He describes how it was developed and the positives for all participants, as well as some challenges.

Article: Indigenous health – a role for private general practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 02 Feb 2011 09:00:00 +1000

The Aboriginal and Torres Strait Islander life expectancy gap is associated with lower primary care usage by Indigenous Australians.

Interview: General practice – workforce gaps now and in 2020

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 01 Feb 2011 09:00:00 +1000

Dr Chris Harrison discusses research that considers gaps in the general practice workforce. It considers the impact of issues like the age and sex of the population and how much time they spend with the GP, changes in the population, where people live and where GPs work to provide some information about what might be the general practice workforce needs in 2020

Article: General practice – workforce gaps now and in 2020

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 01 Feb 2011 09:00:00 +1000

The general practice workforce required for Australia in the future will depend on many factors, including geographic areas and patient utilisation of general practice services.

Interview: End stage heart failure patients – palliative care in general practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Thu, 02 Dec 2010 09:00:00 +1000

Professor Davidson discusses the term palliative care, and how if is used in patients with chronic heart failure. She discusses the challenges involved in providing palliative care and advanced care planning to these patients, including challenges specific to general practice care and ensuring that cultural, psychological, social and spiritual needs are met along with medical needs.

Article: End stage heart failure patients – palliative care in general practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Thu, 02 Dec 2010 09:00:00 +1000

Chronic heart failure is common, particularly in older individuals, and comorbidities are frequent. Patients with end stage heart failure can be highly symptomatic and require careful monitoring and treatment adjustment to improve symptoms.

Interview: Acute pulmonary oedema – Management in General Practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 01 Dec 2010 09:00:00 +1000

Dr Baird discusses the syndrome of acute heart failure, and its possible clinical presentations. He briefly discussions precipitants and causes of cardiac failure, and the different types of cardiac failure, namely systolic versus diastolic heart failure.

Article: Acute pulmonary oedema – Management in General Practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 01 Dec 2010 09:00:00 +1000

Acute pulmonary oedema is a life threatening emergency that requires immediate intervention with a management plan and an evidence based treatment protocol.

Interview: Addison disease – diagnosis and initial management

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 03 Nov 2010 09:00:00 +1000

Dr Aris Siafarikas discusses Addison Disease, which is a trap for the unwary as it is rare and can present in non specific, but very serious ways.

Article: Addison disease – diagnosis and initial management

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 03 Nov 2010 09:00:00 +1000

Adrenal insufficiency is a rare disease caused by either primary adrenal failure (Addison disease) or by impairment of the hypothalamic-pituitary-adrenal axis. Steroid replacement therapy normalises quality of life, however, adherence can be problematic.

Interview: Small dose... big poison

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 02 Nov 2010 09:00:00 +1000

Professor George Braitberg discusses issues his article ‘Small dose…big poison' which considers children and ingestions of medications and many items found in every household.

Article: Small dose... big poison

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 02 Nov 2010 09:00:00 +1000

It is not possible to identify all toxic substances in a single journal article. However, there are some exposures that in small doses are potentially fatal.

Interview: Transient ischaemic attacks – assessment and management

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 01 Nov 2010 09:00:00 +1000

Dr Elaine Leung discusses why transient ischaemic attacks are a trap for the unwary and provides information on the importance and diagnosis.

Article: Transient ischaemic attacks – assessment and management

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 01 Nov 2010 09:00:00 +1000

Transient ischaemic attacks (TIAs) can be challenging to diagnose, but early assessment and effective management can reduce the subsequent risk of stroke.

Interview: Substance misuse – management in the older population

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 26 Oct 2010 09:00:00 +1000

Professor Dan Lubman discusses issues in substance misuse in the older population, including frequency, harms, issues to consider in the older population and tips on assessment and management.

Article: Interview: Substance misuse – management in the older population

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 26 Oct 2010 09:00:00 +1000

The proportion of Australians aged over 65 years is increasing. Although screening and treatment for alcohol and drug issues has traditionally focused on those aged less than 65 years, there is growing evidence of alcohol and drug related harm among older people.

Interview: Aging and sexuality

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 25 Oct 2010 09:00:00 +1000

Dr Lesley Yee, a sexual health physician, discusses issues in aging and sexuality. This includes the changes associated with aging and the varying impacts these may have. She also provides some practical ideas to assist in raising the topic and providing advice.

Article: Aging and sexuality

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 25 Oct 2010 09:00:00 +1000

Sexuality has become a medical issue in association with aging. This is due to a number of factors, including increasing age of survival, a positive societal construct that promotes sexuality as important for quality of life as we age, and the medicalisation of sexuality with the advent of prescription medications to treat sexual dysfunction.

Interview: End of life care – the importance of advance care planning

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sun, 24 Oct 2010 09:00:00 +1000

End of life care and advanced care planning is a very important topic that can be difficult to raise. Dr Susan Lee discusses how patients expect their doctor to raise the topic, suggestions about how to raise the topic and assist in the discussion and also some resources that may be helpful.

Article: End of life care – the importance of advance care planning

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sun, 24 Oct 2010 09:00:00 +1000

Communication about end of life care may involve difficult conversations for patients, family members and health professionals. However, a lack of understanding of a person’s wishes about their future care may result in a loss of dignity for the person, and additional distress for their family members and health professionals and burden to the healthcare system.

Interview: Bones beyond 70 – insights into osteoporosis management in the elderly

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sat, 23 Oct 2010 09:00:00 +1000

Osteoporosis is a major health concern with an aging population. Professor Charles Inderjeeth discusses his research based on a clinical audit about the current assessment and management of osteoporosis in those aged 70 years or more which found areas that can be improved.

Article: Bones beyond 70 – insights into osteoporosis management in the elderly

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sat, 23 Oct 2010 09:00:00 +1000

Bone mineral density is presently the only reliable diagnostic test for osteoporosis.

Interview: Rheumatoid Arthritis

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 28 Sep 2010 09:00:00 +1000

Dr Ngian talks to Dr Deepa Daniel about rheumatoid arthritis, a chronic disease which is known to cause significant irreversible joint damage and disability if the so-called 'window of opportunity' for treatment is missed. Dr Ngian discusses the aetiology and typical clinical features of rheumatoid arthritis, and the investigations required if this type of arthritis is suspected, to ensure early recognition and referral.

Article: Rheumatoid arthritis

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 28 Sep 2010 09:00:00 +1000

Rheumatoid arthritis is a chronic disease that can cause irreversible joint damage and significant disability. With a prevalence of 1%, it has a considerable cost to the community. Diagnosis is based on a combination of clinical and laboratory features. Patients typically present with a symmetrical polyarthritis of the small joints of the hands and feet accompanied by early morning stiffness and, occasionally, constitutional symptoms.

Interview: Cannabis and psychosis and affective disorders

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 27 Sep 2010 09:00:00 +1000

Prof Lubman talks to Dr Jenni Parsons about cannabis use; the complex pharmalogy that underlies its the physical and psychosocial effects; and the links between cannabis and psychosis and affective disorders.

Article: Cannabis and mental health – management in primary care

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 27 Sep 2010 09:00:00 +1000

Cannabis is the most widely used illicit drug in Australia. Regular use has been associated with increased risk for a range of harms, including the development and exacerbation of mental disorders.

Interview: Opioid dependence – Management in general practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 3 Aug 2010 09:00:00 +1000

Dr Frei talks to Dr Deepa Daniel about the management of opioid dependence using opioid pharmacotherapy, as part of a comprehensive chronic illness management strategy.

Article: Opioid dependence – Management in general practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 3 Aug 2010 09:00:00 +1000

Addiction to opioids, or opioid dependence, encompasses the biopsychosocial dysfunction seen in illicit heroin injectors, as well as aberrant behaviours in patients prescribed opioids for chronic nonmalignant pain.

Interview: Party drugs – Use and harm reduction

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 2 Aug 2010 09:00:00 +1000

Dr Frei talks to Dr Deepa Daniel about the risks associated with the use of the so-called ‘party drugs’, and discusses a useful approach to general practitioner assessment and management of patients who may be using party drugs.

Article: Party drugs – use and harm reduction

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 2 Aug 2010 09:00:00 +1000

Party drug use, the intermittent use of stimulants, ecstasy and so-called ‘designer drugs’ at dance parties or ‘raves’, is now part of the culture of many young Australians.

Interview: Pulmonary embolism

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 5 Jul 2010 09:00:00 +1000

Dr Simon McRae, author of the article on pulmonary embolism in the July edition of AFP, discusses key issues in the diagnosis and management of pulmonary embolism, particularly considering the general practice setting.

Article: Pulmonary embolism

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 5 Jul 2010 09:00:00 +1000

Pulmonary embolism remains a common and potentially preventable cause of death.

Interview: Epicentre of influenza

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 24 May 2010 09:00:00 +1000

Dr Jenny Bocquet talks to Dr Deepa Daniel about her qualitative research project exploring the early experience of selected frontline general practices in managing the 2009 H1N1 influenza outbreak. Dr Bocquet discusses the context of why she decided to perform this study, how her research was carried out, and the type of general practices involved. She discusses her how the general practices fared, including the strategies they used to manage, and whether they coped or were supported by government services. Dr Bocquet goes on to discuss how we can approach things differently in future flu seasons, and where we go from here to ensure greater preparation and support from government health services.

Article: Epicentre of influenza – the primary care experience in Melbourne, Victoria

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 24 May 2010 09:00:00 +1000

General practice in Australia is expected to play a major role in responding to an influenza pandemic. This study investigated the experience of frontline general practice during the H1N1 influenza pandemic of 2009.

Interview: Meningococcal sepsis, croup, and minor head injuries in children

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 25 May 2010 09:00:00 +1000

Dr Mike Starr talks to Dr Deepa Daniel about three childhood emergency presentations: meningococcal sepsis, croup, and minor head injuries, all of which are of significant importance in general practice. For each presentation, Dr Starr discusses which children are at risk, possible presentations, what to watch out for in history and examination, necessary investigations, and important management considerations in a general practice and a hospital setting.

Article: Meningococcal sepsis

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 25 May 2010 09:00:00 +1000

Meningococcal disease remains a significant illness with an overall mortality of around 8%. The majority of deaths occur in the first 24 hours, before the commencement of specialist care. Missing a diagnosis of meningococcal disease is a fear among health care practitioners.

Article: Croup – assessment and management

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 25 May 2010 09:00:00 +1000

Croup is a common childhood disease characterised by sudden onset of a distinctive barking cough that is usually accompanied by stridor, hoarse voice, and respiratory distress resulting from upper airway obstruction. The introduction of steroids in the treatment of croup has seen a significant reduction in hospital admissions and improved outcomes for children.

Article: Minor head injuries in children – an approach to management

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 25 May 2010 09:00:00 +1000

Traumatic head injury is a common occurrence in the paediatric population, with the majority of patients sustaining only mild head injury.

Interview: Emergency management of type 1 diabetes in children

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 26 May 2010 09:00:00 +1000

Dr Aris Siafarikas talks to Dr Deepa Daniel about how to approach the assessment and management of a child presenting in diabetic ketoacidosis due to Type 1 diabetes.

Article: Type 1 diabetes in children - Emergency management

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 26 May 2010 09:00:00 +1000

Fifteen to sixty-seven percent of patients with new onset type 1 diabetes mellitus (T1DM) present in diabetic ketoacidosis (DKA), of which approximately 79% initially see their general practitioner. Diabetic ketoacidosis is the most common cause of diabetes related deaths, mainly due to cerebral oedema that occurs in 0.4–3.1% of patients.

Interview: Compassionate listening - Managing psychological trauma in refugees

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 28 Apr 2010 09:00:00 +1000

Dr Joanne Gardiner is a GP counsellor at Foundation House Refugee Mental Health Clinic and a GP at Doutta Galla Community Health Centre Medical Centre in Melbourne. In this podcast she talks to Dr Rachel Lee about compassionate listening and managing psychological trauma in refugees. Dr Gardiner stresses the importance of good rapport, taking time and addressing patient's concerns. She discusses the important intersection between physical and psychological trauma and the need for GPs to address both aspects. She provides helpful tips on how to sensitively ask about and deal with disclosures of trauma. Dr Gardiner discusses the three different phases of managing trauma and the importance of self-care for GPs working in this area.

Article: Compassionate listening - Managing psychological trauma in refugees

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 28 Apr 2010 09:30:00 +1000

The physical and psychosocial effects of trauma in refugees are wide ranging and long lasting. They can affect symptom presentation, the patient-doctor relationship and management of refugee victims of trauma.

Interview: Mental health - Cultural competence

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 9 Apr 2010 12:00:00 +1000

Dr John Furler is a senior research fellow from the Primary Care Research Unit at the Department of General Practice at Melbourne University and a practicing GP at a community health centre. In this podcast he talks to Dr Rachel Lee about mental health and cultural competence. Dr Furler discusses concepts of depression and anxiety and why cultural and socioeconomic factors are important in mental health work in general practice. He stresses the need to have a flexible approach to this area rather than overly generalising about how different cultural groups may present. Dr Furler discusses the important influence that interpreters can have on consultations and how GPs can go about negotiating a shared understanding with their patients.

Article: Mental health - Cultural competence

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 9 Apr 2010 12:00:00 +1000

Depression, and its associated anxiety, is very common in the community and frequently managed in general practice. Yet it remains a problematic concept. Differing views of depression influence both clinical practice and research.

Interview: Culture and ethnicity in end of life care

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 9 Apr 2010 11:00:00 +1000

Associate professor Katherine Clark talks to Dr Rachel Lee about the importance of culture and ethnicity in end of life care, the importance of recognising each patient and family as unique and sensitively asking them what is important to them and what sort of care and support they need.

Article: End of life care - The importance of culture and ethnicity

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 9 Apr 2010 11:00:00 +1000

Australia is a culturally and ethnically diverse country. Within such diversity there will be differing beliefs systems about death and dying. This may be a challenging prospect for health professionals.

Interview: Using interpreter services

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Thu, 8 Apr 2010 11:00:00 +1000

Associate Professor Christine Phillips talks to Dr Rachel Lee about how GPs and practices can most effectively use interpreter services.

Article: Using interpreters - A guide for GPs

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Thu, 8 Apr 2010 11:00:00 +1000

Australia is one of the most multilingual countries in the world. In their working lives, all doctors will need to communicate with patients whose languages they do not speak.

Interview: Flying and lung diseases

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 16 Mar 2010 11:00:00 +1000

Dr Matthew Peters discusses issues around flying and lung diseases, including COPD, asthma and sleep apnoea.

Article: Patients with lung disease - Fit to fly?

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 16 Mar 2010 11:00:00 +1000

Commercial air travel is cheap and accessible. Many patients living ever better lives despite chronic lung disease wish to, and do, fly. Statistics tell us that misadventure is rare and that flight must be safe for the majority of people.

Interview: Investigating chronic lung conditions

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 10 Mar 2010 11:00:00 +1000

Associate Professor Graham Simpson talks about the investigations that are appropriate in general practice for chronic lung conditions.

Article: Investigation in chronic lung disease - Too much, too little, just right!

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 10 Mar 2010 11:00:00 +1000

Lung problems are common in general practice. History and examination are invaluable; however considered selection of investigations can assist the clinician to reach a diagnosis.

Interview: COPD diagnosis and management

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 09 Mar 2010 11:00:00 +1000

Dr Julia Walters discusses COPD diagnosis and management in general practice, including the important roles general practice can play now and in the future.

Article: COPD - Diagnosis, management and the role of the GP

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 09 Mar 2010 11:00:00 +1000

Chronic obstructive pulmonary disease (COPD) is a common condition characterised by breathlessness, cough and sputum production. However these are nonspecific, common symptoms which may be misattributed; resulting in a possible underdiagnosis of COPD.

Interview: Breast cancer diagnosis

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 08 Mar 2010 11:00:00 +1000

Dr Andrew Beattie is a GP in Coffs Harbour who decided to look back at the diagnosis of breast cancer over 20 years in his practice. He discusses why he did this and what he found.

Article: Detecting breast cancer in a general practice - Like finding needles in a haystack?

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 08 Mar 2010 11:00:00 +1000

Breast cancer contributes the largest burden of cancer related disease in Australian women. Early detection is an important part of the general practitioner's work, with clinical audit recommended to help improve the quality of such work.

Interview: The role of the sports and exercise medicine physician

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 19 Feb 2010 11:00:00 +1000

David Humphries, MBBS (Hons), FACSP, FFSEM (UK) is a sport and exercise medicine (SEM) physician and Past President, Australasian College of Sports Physicians (ACSP). He talks to Kath O'Connor the role of the SEM physician. Most sports and exercise related injuries and problems in the GP setting are relatively straightforward; GPs can contact a SEM physician for more complex issues.

Article: Sport and exercise medicine – a new specialty

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 19 Feb 2010 11:00:00 +1000

Sport and exercise medicine (SEM) incorporates a diverse range of disciplines. These include: disease and injury prevention, management of medical problems in exercising individuals, management of soft tissue injuries sustained during exercise, and exercise prescription for improving physical fitness and treating disease.

Interview: PAP testing in the post HPV vaccine era

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 05 Jan 2010 11:00:00 +1000

Dr Stella Heley MBBS FAChSHM is Senior Liaison Physician, Victorian Cytology Service Melbourne. In this podcast Stella talks to Dr Jenni Parsons about the ongoing need for routine PAP screeing in young women, despite the good overall takeup of the quadrivalent HPV vaccine in this cohort.

Article: PAP testing in the post HPV vaccine era

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 15 Dec 2009 11:00:00 +1000

This article looks at why a substantial number of young women who have been vaccinated with the HPV vaccine will still have Pap test abnormalities.

Interview: IBS or intolerance?

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 15 Dec 2009 11:00:00 +1000

Prof Terry Bolin is Conjoint Associate Professor of Medicine at the University of New South Wales and Consultant Emeritus at the Prince of Wales Hospital. In this podcast, he talks to Dr Rachel Lee about the relationship between food and irritable bowel symptoms. Prof Bolin highlights that many of the symptoms of IBS are exacerbated by foods and that dietary review has an important role in managing IBS. Prof Bolin describes the effects of different carbohydrates such as lactose and fructose and emphasizes that symptoms are more common with excessive consumption. This podcast and the article provide information to the GP about how to assess and treat dietary components to IBS.

Article: IBS or intolerance?

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 15 Dec 2009 11:00:00 +1000

Interview: The laparoscopic adjustable gastric band (LAGB) for obesity

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 04 Dec 2009 10:00:00 +1000

Wendy Brown, MBBS(Hons), PhD, FACS, FRACS is Deputy Director, Centre for Obesity Research and Education and Associate Professor, Department of Surgery, Monash University and Visiting Medical Officer, The Alfred Hospital. She discusses the LAGB procedure and the importance of follow up and a multidisciplinary approach to achieve sustained weight loss and manage problems and complications. Sustained weight loss and improved quality of life following a LAGB procedure depends on a multidisciplinary team (including surgeon, GP, nurse, dietician and psychologist) to meet patient needs of band adjustments, ongoing education about food choices and exercise, monitoring for nutritional and device complications and coping with psychological issues. Roles for the GP in the team include monitoring for ‘alert symptoms’ of volume reflux, nocturnal aspiration, regular regurgitation or vomiting which may indicate a complication; reinforce healthy eating and exercise messages; and adjusting the doses of antihypertensive and diabetic medications as weight loss occurs. When the amount of fluid in the band is optimal the patient feels satisfied with 2-3 small meals per day of solid food with weight loss of about 0.5-1kg per week and does not experience adverse symptoms.

Article: Laparoscopic adjustable gastric banding

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 04 Dec 2009 10:00:00 +1000

The laparoscopic adjustable gastric band is a useful tool in the treatment of severe obesity. It is a safe and durably effective procedure, however, optimal results depend upon the patient participating in a process of lifelong care.

Interview: Mammalian bites

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 02 Dec 2009 10:00:00 +1000

Dr Claire Dendle is an infectious diseases physician in the Department of Infectious Diseases at Southern Health, Melbourne, Victoria. In this podcast, she talks to Dr Kathryn O’Connor about what GPs need to know the assessment and management of mammalian bites. In the setting of a mammalian bite, history and examination is directed at assessing whether the bite has damaged underlying structures or is at high risk of infection. Treatment of mammalian bites involves cleaning and irrigation and a decision about the use of antibiotics. Primary wound closure is usually only recommended in selected wounds where cosmesis is an issue. Patients should be provided with detailed instructions and reviewed after 24-48 hours. GPs have an important role in secondary prevention of animal bites.

Article: Management of mammalian bites

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 02 Dec 2009 10:00:00 +1000

Mammalian bites are a significant public health problem in Australia, with the majority of bites coming from dogs. Complications include tissue damage from the bite itself, infection and post-traumatic stress disorder.

Interview: Dengue fever

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 30 Nov 2009 10:00:00 +1000

Dr Danille Esler is a general practitioner and Senior Public Health Registrar at Cairns Public Health Unit in Cairns, Queensland. In this podcast, she talks to Dr Kathryn O’Connor about what GPs need to know about the clinical and public health ramifications of Dengue. The epidemiology of Dengue fever has changed in recent years and there has been a recent outbreak of the disease in northern Queensland. GPs can find out about recent outbreaks on the websites of the World Health Organisation, Centers for Disease Control and, in the case of outbreaks in Queensland, Queensland Health. Most commonly, Dengue presents as a debilitating illness lasting 7-10 days. The GP role involves exclusion of other illnesses such as malaria, appropriate diagnostic testing, monitoring for the development of Dengue Haemorrhagic Fever (DHF) and prevention of spread. Dengue is a notifiable disease; if a general practitioner suspects dengue, early notification is vital.

Article: Dengue - Clinical and public health ramifications

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 30 Nov 2009 10:00:00 +1000

Dengue virus infection is spread by the mosquito vector Aedes aegypti and causes significant morbidity and mortality worldwide. In Australia, it is an important cause of fever in the returned traveller and recent outbreaks have occurred in northern Queensland. A comprehensive understanding of the clinical and public health ramifications of dengue infection is essential for general practitioners.

Interview: Spider bites

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 20 Nov 2009 10:00:00 +1000

George Braitberg is Professor of Emergency Medicine at Monash University and Director of Emergency Medicine at Southern Health, Melbourne, Victoria. In this podcast, he talks to Dr Kathryn O’Connor about what GPs need to know the assessment and management of spider bites. He discusses problems with spider identification, the importance of toxindrome recognition and the controversy surrounding necrotizing arachnidism in Australia. In addition, he describes the clinical effects and treatment of redback and funnelweb spider envenomation.

Article: Spider bites - Assessment and management

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 20 Nov 2009 10:00:00 +1000

Spider bite is common, but most species cause minimal or no effects. Patients may be misinformed regarding the nature and consequences of a bite. Understanding the current literature can assist the physician in the management of spider bite patients.

Interview: Retinopathy: Screening recommendations

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 6 Oct 2009 11:00:00 +1000

Dr Geoffrey Spurling talks to Dr Rachel Lee about what GPs need to know about screening patients for retinopathy. Geoffrey highlights that a quarter of Australians with diabetes are not appropriately screened. He outlines the factors involved and describes who to screen and how often they require screening.

Article: Retinopathy – screening recommendations

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 6 Oct 2009 11:00:00 +1000

Type 2 diabetes mellitus is an increasingly prevalent presentation in Australian general practice, where most patients receive their preventive care and management.

Interview: Reducing vision loss in chronic eye disease

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 5 Oct 2009 11:00:00 +1000

Dr Anthony Fong talks to Dr Rachel Lee about how GPs can help maintain vision for patients with chronic eye disease. Anthony focuses on three common conditions – cataract, age related macular degeneration and glaucoma. He details the common risk factors, presentations and management strategies for each of these important conditions along with valuable information about primary and secondary prevention strategies that the GP can use and educate patients about.

Article: Reducing vision loss in chronic eye disease

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 5 Oct 2009 11:00:00 +1000

Ocular disease in its early stages may be asymptomatic and insidious. Three of the leading causes of visual loss are cataract, age related macular degeneration and glaucoma.

Interview: Medical Assistants... developing a role in primary care

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 2 Oct 2009 11:00:00 +1000

Abbe Anderson, MBA, is CEO GPpartners, Lutweyche, Queensland. She discusses the role and training of Medical Assistants in primary care with Jenni Parsons. Medical assistants undertake a variety of administrative, reception and clinical duties in a primary care setting work under the supervision of doctors, nurses or practice managers. A 12 month TAFE course has been developed to train staff for this role. The clinical tasks that can be undertaken by medical assistants include wound dressings; venepuncture; and vision, hearing, height, weight and blood pressure checks. This role potentially provides flexibility of staffing in medical practices, with medical assistants undertaking administrative or clinical duties as required, freeing up nursing time for chronic disease management and more complex tasks. It also formalises and provides specific training for a role many medical receptionists have already partially undertaken in the primary care setting.

Article: Medical assistants - A primary care workforce solution?

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 2 Oct 2009 11:00:00 +1000

A new medical assistant training program has been developed as an innovative solution to the workforce pressures facing general practice in Australia.

Interview: TB... what's new, what's not?

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 24 Aug 2009 11:00:00 +1000

Dr Anna Ralph, MBBS, MPH, DTM&H, FRACP, is an infectious diseases physician and PhD scholar untertaking research in tuberculosis. She discusses whats new in diagnosis and management of the very old disease of TB with Dr Jenni Parsons. Despite lower incidence of TB in Australia compared to other places in the world, TB remains a significant problem in a number of at risk groups including migrants from sub Saharan Africa, India, Vietnam, the Phillipines, China and Indonesia; patients with HIV; and Indigenous Australians. While newer diagnostic tests (interferon gamma release assays) are available, they have some limitations and in Australia sputum microscopic examination and cuture remains the main method of diagnosis in symptomatic individuals. Developments in pharmacotherapy include a metronidazole related antibiotic and agents targeting MTB genes. However, the standard first line treatment remains 6 months of rifampicin, isoniazid plus pyrazinamide and ethambutol for the first 2 months. In Australia, patients with TB are managed in specialty treatment units, the GP has an important roole in avoiding diagnostic delay, infection control, avoiding drug interactions (particularly with rifampicin), nutrition, smoking cessation, psychological support and encouraging adherence to therapy.

Interview: My hands shake: classification and treatment of tremor

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 2 Sep 2009 11:00:00 +1000

David Williams is a neurologist and associate professor of neurology at the Alfred Hospital in melbourne, Victoria. In this podcast, he talks to Dr Kathryn O'Connor about what GPs need to know about how to assess, investigate and treat patients who present with tremor.

Article: My hands shake - Classification and treatment of tremor

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 2 Sep 2009 11:00:00 +1000

Tremor is the most common movement disorder in the community and is defined as a rhythmic oscillatory movement of a body part. Classification of tremors is helpful for accurate diagnosis, prognosis and treatment. Most tremors can be separated according to the state in which they occur, that is, during rest or action. Other clinical features, including frequency, amplitude and associated neurological signs, further define tremor.

Interview: HIV…chronic disease management

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 26 Aug 2009 11:00:00 +1000

Justin Denholm, BMed MBioethics, is a research registrar, Victorian infectious Diseases Service, Royal Melbourne Hospital. He discusses the current issues in long term management of patients living with HIV with Jenni Parsons. Patients with HIV treated with combination antiviral therapy (cART) now often have rapid and sustained control of HIV viraemia (often to undetectable levels) and a sustained increase in CD4+ T-cell counts. This has resulted in decreased opportunistic infections and increased longevity.

Article: Long term management of people with HIV

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 26 Aug 2009 11:00:00 +1000

Advances in the treatment of human immunodeficiency virus (HIV) have resulted in sustained improvements in the general health and longevity of people living with the virus. Primary care continues to be predominantly delivered by high caseload general practitioners and specialists, but GPs with limited HIV experience are increasingly likely to have contact with HIV positive patients through shared care arrangements.

Article: What’s new in TB?

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 24 Aug 2009 11:00:00 +1000

Australia has among the world’s lowest rates of tuberculosis (TB). However, it remains a leading global cause of morbidity and mortality. In Australia, TB remains more common in Indigenous than non-Indigenous Australians, and rates are rising among migrants, reflecting changing immigration patterns and rising rates in their homelands.

Interview: Dementia - community needs versus primary care services

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 25 Aug 2009 11:00:00 +1000

Dr Fiona Millard, MBChB, FRACGP, MGP is an adjunct senior lecturer in Aged Care at James Cook University. She discusses research she has published in August 2009 AFP on what patients with dementia and their carers required from primary care providers, and the knowledge, attitudes and beliefs of health providers about dementia. Important themes from patients and carers include the need for timely investigation of symptoms, early and accurate diagnosis , explanation and support in the home. Up to 35% of GPs in the postal survey component said they preferred not to look after patients with dementia and about 15% of primary health providers indicated they thought early diagnosis may be harmful.

Article: Dementia – who cares? - A comparison of community needs and primary care services

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 25 Aug 2009 11:00:00 +1000

Health professionals have varying levels of knowledge about, and interest in, providing dementia services. This article compares patient experiences in dealing with dementia with the perceived role of health care providers in providing dementia care.

Interview: Blistering skin

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 27 Jul 2009 11:00:00 +1000

Dr Belinda Welsh, MBBS, MMed, FACD, is consultant dermatologist, St Vincent's Hospital Melbourne and Sunbury Dermatology and Skin Cancer Clinic, Sunbury. Belinda discusses the causes and clinical features of a variety of bullous skin rashes with Dr Jenni Parsons. Belinda discusses distinguishing features such as blister location, presence of mucosal involvement or whether the blisters are tense and intact (indicating dermal blistering) or fragile (indicating superficial blistering). Most presentations to GPs will be the result of infection, topical contact reaction, insect bites or drug reactions. However, if common conditions such as these are excluded, then often histology and immunofluoresence is required for diagnosis. Early referral to a dermatologist is recommended for Immunobullous disorders and serious non immunobullous diosorders such as porphyria cutanea tarda.

Article: Blistering skin conditions

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 27 Jul 2009 11:00:00 +1000

Blistering of the skin can be due to a number of diverse aetiologies. Pattern and distribution of blisters can be helpful in diagnosis but usually biopsy is required for histopathology and immunofluoresence to make an accurate diagnosis.

Interview: Skin and systemic disease

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 13 Jul 2009 11:00:00 +1000

Dr Adriene Lee, BSc(Med), MBBS(Hons), FACD,is visiting dermatologist, St Vincent's Hospital and Monash Medical Centre, and Lecturer, Department of General Practice, Monash University, Victoria. She discusses the association between skin problems and systemic disease with Dr Jenni Parsons. Adrienne discusses skin conditions such as generalised pruritis, cutaneous vasculitis and erythema that may be an indicator of an underlying systemic condition; skin conditions that are much more rare but have an association with occult malignancy; and typical skin manifestations of connective tissue disorders.

Article: Skin manifestations of systemic disease

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 13 Jul 2009 11:00:00 +1000

Dermatologic complaints are a common reason for presentation to a general practitioner. In some cases, one needs to determine if the complaint may be a manifestation of a more serious underlying systemic disease.

Interview: Difficult to diagnose and aggressive BCCs

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sun, 12 Jul 2009 11:00:00 +1000

Dr Steven Tomas, MBBS(Hons), MMed, FRACGP, CertDerm, CertSkinCanMed(SCSA), is a GP with a special interest in skin cancer managemen from Dubbo NSW. He discusses the features and management of subtypes of BCCs that have a more aggressive course with Dr Jenni Parsons.‘Infiltrative’ , ‘micronodular’ and ‘morphoeic’ BCCs can infiltrate widely and deeply with relatively little change in the overlying skin surface. Assessing the margins of the lesion histologically can bedifficult increases the chance of incomplete resection and recurrence. Recurrent or residual disease is more difficult to treat, and itself has higher recurrence and incomplete removal rates. These tumours require carefully planned, aggressive treatment to cure.

Article: Difficult to diagnose skin cancer - The ‘aggressive’ BCC

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sun, 12 Jul 2009 11:00:00 +1000

Basal cell carcinomas (BCCs) are common, and are regularly diagnosed and managed by Australian general practitioners.

Interview: Lesbian and bisexual women's sexual health

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 29 Jun 2009 11:00:00 +1000

Dr Ruth McNair is a GP and senior lecturer at the University of Melbourne. In this podcast she talks to Dr Kathryn O'Connor about what GPs need to know about lesbian and bisexual women's sexual health and the kinds of sexual health issues faced by this group of patients. In particular, it is important that GPs make their practice welcoming to lesbian and bisexual women. This can include providing signs and pamphlets in the waiting room, encouraging reception staff to use inclusive language and taking a non judgemental social and sexual history from patients. Ruth outlines important sexual health messages for lesbian and bisexual women including the need for pap smears and discussion of safer sex.

Article: Lesbian and bisexual women’s sexual health

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 29 Jun 2009 11:00:00 +1000

Lesbian and bisexual women have specific sexual health needs, including the need for information about transmission and prevention of sexually transmissible infections (STIs) between women, contraceptive and conception advice, and support regarding any abuse experiences.

Interview: Bacterial Vaginosis

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 30 Jun 2009 11:00:00 +1000

Dr Catriona Bradshaw is a sexual health physician at Melbourne Sexual health Centre and NHMRC research fellow at Melbourne and Monash Universities. In this podcast she talks to Dr Kathryn O'Connor about what GPs need to know about Bacterial Vaginosis. Bacterial Vaginosis is the most common cause of abnormal discharge in women of reproductive age and yet the precise pathophysiology is contraversial. Research is continuing into the cause of this disease, whether or not it is a sexually transmissible infection (STI) and to establish effective evidence based treatments. BV is diagnosed with the Amsel or Nugent methods and treatment is with oral metronidazole or vaginal clindamycin with the aim to reduce symptoms and/or prevent complications.

Article: Bacterial vaginosis - More questions than answers

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 30 Jun 2009 11:00:00 +1000

Bacterial vaginosis is the commonest cause of abnormal vaginal discharge in women of reproductive age and is associated with serious pregnancy related sequelae and increased transmission of sexually transmissible infections, including HIV. The aetiology, pathology, microbiology and transmission of bacterial vaginosis remain poorly understood.

Interview: Sleep and depression

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 06 May 2009 11:00:00 +1000

Professor Michael Berk discusses the relationship between sleep and depression and the clinical implications.

Article: Sleep and depression - Theory and practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 06 May 2009 11:00:00 +1000

Sleep disorders are particularly common in the primary care setting, and are intimately interlinked with depression.

Interview: Cancer Screening – pros, cons, choice, and the patient

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 20 Apr 2009 09:00:00 +1000

Dr Lyndal Trevena, author of ‘Cancer Screening – pros, cons, choice, and the patient’ in the April edition of AFP discusses some of the principles and controversies in cancer screening.

Article: Cancer Screening – pros, cons, choice, and the patient

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 20 Apr 2009 09:00:00 +1000

Cancer is a major cause of disability and death in Australia, with three government funded screening programs now in place nationally. As cancer screening tests are performed on healthy asymptomatic members within the community, one needs to consider whether the potential gains will outweigh possible harms. There are challenges for both practitioners and consumers in communicating about screening in practice.

Interview: Post traumatic stress syndrome

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 15 Apr 2009 09:00:00 +1000

David Forbes, Associate Professor, Australian Centre for Posttraumatic Mental Health, University of Melbourne, discusses the assessment and management of post traumatic stress syndrome (in particular the role of trauma focussed psychological therapy) with Dr Jenni Parsons. GPs can assist patients who have experienced trauma within the past 2 weeks by providing psychological first aid, and monitoring and assessment for the development of acute stress disorder and symptoms of PTSD. Trauma focused psychological treatment is the first line of treatment for PTSD, and in this interview David Forbes outlines what is involved in this specialised form of cognitive behavioural therapy.

Article: Post traumatic stress syndrome

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 15 Apr 2009 09:00:00 +1000

Approximately 50–65% of Australians are exposed to a traumatic event during their lifetime. Approximately 250 000 Australians suffer from post-traumatic stress disorder (PTSD) at any given time, making it one of the most common anxiety disorders. In May 2007, the Australian guidelines for the treatment of adults with acute stress disorder and posttraumatic stress disorder was published. In order to facilitate translation of evidence regarding PTSD into busy clinical practice, and particularly for general practitioners, a more succinct version of the guidelines has been developed.

Interview: Bowel cancer screening – a role for general practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 08 Apr 2009 09:00:00 +1000

Dr Linda Foreman talks about the bowel cancer screening, including the National Bowel Cancer Screening Program. She discusses the role of the GP in the program and also reminds us to consider patients who may not be in the program.

Article: Bowel cancer screening – a role for general practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 08 Apr 2009 09:00:00 +1000

Current Australian guidelines recommend regular screening with faecal occult blood tests (FOBT) in asymptomatic people over 50 years of age in order to reduce mortality from bowel cancer. After assessing the feasibility, acceptability and cost effectiveness of bowel cancer screening using FOBTs in an Australian setting, the Australian Government commenced the National Bowel Cancer Screening Program (NBCSP) in August 2006 among certain age groups.

Interview: Heart health: CHD management gaps in general practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 07 Apr 2009 09:00:00 +1000

Dr Nancy Huang, National Manager – Clinical Programs, Heart Foundation, talks about the article "Heart health: CHD management gaps in general practice". She discusses the concept of assessing absolute risk for all people over 45 years of age, and also the 3 key management gaps identified in CHD management relevant to general practice.

Article: Heart health: CHD management gaps in general practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 07 Apr 2009 09:00:00 +1000

For many years, the Heart Foundation has been involved in the development of evidence based clinical practice guidelines for the management of cardiovascular diseases and conditions, including coronary heart disease (CHD). However, the production of guidelines does not ensure the uptake of evidence based recommendations in practice.

Interview: Men and depression

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 17 Mar 2009 09:00:00 +1000

Kay Wilhelm, Conjoint Professor of Psychiatry, University of New South Wales, discusses the differences in presentations of depression between men and women with Dr Jenni Parsons. Men often display irritability and withdrawal in response to depression and are less likely than women to talk about their depression or how they feel. They tend to experience anxiety disorders less frequently than women. However, men’s greater risk taking and substance abuse have significant adverse physical and mental health outcomes. While men are usually wary about talking about their depression, they will discuss their feelings if provided with a safe environment in which to do so.Men are more generally accepting of ‘learning new tools to deal with stress’ than ‘support for emotional needs’, and men who are not psychologically literate will respond to psychoeducation that focuses on ‘need for change in lifestyle risk factors’. Men often do well with cognitive behavioural therapy (CBT) and problem solving techniques. Evidence about effects of depression on health, especially cardiac disease, can assist in gaining agreement for the use of antidepressants.

Article: Men and depression

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 17 Mar 2009 09:00:00 +1000

Interview: The newly single man

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 16 Mar 2009 09:00:00 +1000

Darren Russell, Director of Sexual Health, Cairns Sexual health Service, discusses health issues of the newly single man with Dr Jenni Parsons. For men who are newly single there are a range of health issues that may arise including sexual health, alcohol and drug use, stress and mood disorders. The spectrum of health concerns varies with the age of the man and his individual circumstances. Importantly, when a newly single man presents to a GP, it provides a window of opportunity to begin a dialogue on preventative health strategies.

Article: The newly single man

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 16 Mar 2009 09:00:00 +1000

Interview: HPV vaccination catch up program - utilisation by young Australian women

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sun, 15 Mar 2009 09:00:00 +1000

Edith Weisberg, Director of Research, Sydney Centre for Reproductive Health Research, Family planning New South Wales, discusses research into young women’s attitudes to and uptake of HPV vaccination with Dr Jenni Parsons. Two hundred and ninety-four women aged 15–26 years attending Family Planning NSW clinics completed the a questionnaire. Over 70% of the women had visited a GP in the previous 6 months but 40% were unaware that they could obtain free vaccination through a GP. Women 26 years old and under are eligible for free catch up HPV vaccination in 2009 but must have their first vaccination by 30 June 2009. After the end of 2009 women wanting HPV vaccination will need to pay for them themselves at a cost of approximately $140 for each of the 3 doses. General practitioners should use opportunistic visits by young women and recall and reminder systems to encourage women 26 years and under to commence vaccination by 30th June 2009.

Article: HPV vaccination catch up program - utilisation by young Australian women

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sun, 15 Mar 2009 09:00:00 +1000

Interview: Compounded medicines and ‘off label’ prescribing - a case for more guidance

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sat, 14 Mar 2009 09:00:00 +1000

Romano Fois, lecturer, Faculty of Pharmacy, University of Sydney, discusses benefits and risks of compounded medicines with Dr Jenni Parsons. There has been an increase in the prescribing and dispensing of individualised pharmacotherapy in the form of compounded medicines in recent years. These medicines are not may have important benefits to the patient but their use requires that the prescriber and pharmacist carefully assess the evidence regarding their use, weigh up the benefits and risks, provided detailed consumer information and report any adverse drug reactions.

Article: Compounded medicines and ‘off label’ prescribing - a case for more guidance

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sat, 14 Mar 2009 09:00:00 +1000

Interview: Overcoming communication barriers - working with patients with intellectual disabilities

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 13 Mar 2009 09:00:00 +1000

Jane Tracy, Education Director, centre for Developmental Disability Health Victoria, discusses successful communication in consultations with patients with intellectual disabilities with Dr Jenni Parsons. Jane discusses the range of verbal and non verbal communication that is used by patients with intellectual disabilities, including augmentative and alternative communication (AACT) systems. The principles of successful communication are to interact directly with the patient, tailor language appropriately, support communicative efforts, provide clear explanations and utilise pictures and diagrams, obtain additional information as necessary from carers and other sources with the patients permission and allow adequate time for consultations.

Article: Overcoming communication barriers - working with patients with intellectual disabilities

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 13 Mar 2009 09:00:00 +1000

Interview: Indigenous doctors

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 03 Dec 2008 09:00:00 +1000

Dr Aleeta Fejo talks about being an indigenous doctor, efforts to increase the number of indigenous doctors in Australia, and helping out Santa for disadvantaged indigenous children.

Article: Working toward a goal

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 03 Dec 2008 09:00:00 +1000

I thought that this story started when I was 28 years of age, but actually, it started before I was born. I am a Larrakia Traditional Owner, inherited from my father, and I am a Warramunga woman from my mother.

Interview: Brief interventions work in indigenous mental health

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 02 Dec 2008 09:00:00 +1000

Dr Tricia Nagel talks about the successful use of a brief goal setting intervention in remote indigenous communities. You don't need special skills, client self-care is enhanced, and co-morbid disorders are addressed in an integrated way. And it can be used in a wide variety of settings.

Article: Motivational care planning - Self management in indigenous mental health

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 02 Dec 2008 09:00:00 +1000

Detection and treatment of mental illness in indigenous communities is often complicated by cross cultural difference, social complexity and comorbid disorders.

Interview: I've been bleeding from the bowels

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 18 Nov 2008 09:00:00 +1000

GP Dr Andrew Knight talks to Dr Kathryn O'Connor about his approach to assessment and management of case study "Serge" who presents saying "I've been bleeding from the bowels". Patient history is important and open questions are especially helpful in complex presentations. Serge has multiple problems including tiredness, constipation and rectal bleeding. Causes of tiredness are many and varied and basic pathology can help exclude an organic cause. Screening for a psychogenic cause is important and the BATHE framework can is a useful method. It is important to address the patient's main concern; in this case "Serge" is concerned about cancer. Excluding cancer in Serge allows the GP to move onto other management priorities including lifestyle issues, possible sleep apnoea, cardiovascular risk and further psychological assessment.

Article: 'I've been bleeding from the bowel'

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 17 Nov 2008 09:00:00 +1000

Much undifferentiated illness is seen in general practice. Patients with a vague feeling of general unwellness may have multiple unrelated problems, serious underlying pathology, definite but indefinable pathology, and/or illness of psychological origin.

Interview: Aches and Pains and Osteoarthritis

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sun, 16 Nov 2008 09:00:00 +1000

GP Dr Louise Stone discusses assessment and management of osteoarthritis in General Practice with Dr Kathryn O'Connor. Patient history is important; especially duration and severity of pain. Alternative diagnoses should be considered and excluded. Education and patient self management are vital as the management of osteoarthritis happens mainly outside the consulting room. Treatment modalities include exercise, weight loss, topical and oral medications, appliances. Referral to a surgeon may be required to allow the patient to gather information about future treatment options. Oraganisations such as Arthritis Australia can play a key role.

Article: Aches, pains and osteoarthritis

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sat, 15 Nov 2008 09:00:00 +1000

Aches and pains are commonly seen in general practice and osteoarthritis may be an underlying cause. Chronic pain can be very distressing for patients and management may be challenging for the general practitioner. Osteoarthritis is a common cause of chronic pain and disability.

Interview: Pathology testing in the tired patient: a rational approach

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 14 Nov 2008 09:00:00 +1000

Dr Michael Harrison discusses pathology testing in the tired patient with Dr Kathryn O'Connor. International guidelines on pathology testing in the tired patient vary and all are consensus rather than evidence based. Dr Harrison discusses the incidence of tiredness, the pick up rate of serious disease for pathology testing in the tired patient and other important reasons for decisions about testing in the general practice setting. He explains that, despite the fact that best practice eludes definition, it is possible to be rational in our approach to this problem.

Article: Pathology testing in the tired patient - A rational approach

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Thu, 13 Nov 2008 09:00:00 +1000

Pathology tests are often ordered by general practitioners to investigate patients with nonspecific complaints such as malaise and tiredness.

Interview: Pandemic influenza

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 31 Oct 2008 09:00:00 +1000

Nick Collins, a GP from Leumeah, New South Wales, discusses planning for pandemic flu and the checklists from his article in October AFP, ‘Plan your pandemic- a guide for GPs’ with Dr Jenni Parsons. The discussion focuses on the practical strategies general practices can employ to both prior to and during a flu pandemic. Although the process can seen daunting, simple starting points of good staff and patient education, maintaining good infection control practices, encouraging good ‘cough etiquette’ and improving practice triage procedures will make significant differences and will have benefits to the practice in managing other infections and local disasters and improving patient safety and care.

Article: Plan your pandemic - A guide for GPs

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Thu, 30 Oct 2008 09:00:00 +1000

Influenza A virus has a range of subtypes characterised by the display of particular surface structures and is associated with significant symptoms and a tendency to cause epidemics and pandemics.

Interview: Improving asthma care

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 05 Sep 2008 09:00:00 +1000

Dr Steven Rudolphy discusses straight forward ways for the busy GP to improve asthma management with Dr Jenny Presser. Although asthma mortality rates in Australia have declined, our 'report card' in asthma management still has basic areas that need improvement, such as medication use and smoking cessation. He also talks about tricky areas - making sure of the diagnosis, differentiating asthma from COPD and wheezing in infants.

Article: Asthma management in general practice - A chronic disease health priority

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 05 Sep 2008 09:00:00 +1000

Asthma mortality rates in Australia have declined over the past 20 years but are not low by international standards.

Interview: Our changing role in cancer management

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Thu, 04 Sep 2008 09:00:00 +1000

Associate Professor Geoffrey Mitchell talks with Dr Jenny Presser about the role of the GP at different stages in a patient's cancer journey. The good news is that Australian cancer survivorship is increasing. Part of the improvement in cancer care world-wide is related to the development of a multidisciplinary team approach. There will be increasing opportunities for GPs to be involved in cancer care in the future, and there are some exciting new resources being developed.

Article: The role of general practice in cancer care

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Thu, 04 Sep 2008 09:00:00 +1000

The incidence of cancer is rising, so the workload of managing cancer is increasing rapidly. Among the advances in cancer care are advances in coordination of care, with team care being a preferred method.

Interview: Relapse Prevention in Depression

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 03 Sep 2008 09:00:00 +1000

In the longer term over 70% of people who have had depression experience disease recurrence. Dr Cate Howell discusses with Dr Jenny Presser how to identify those most at risk of relapse and recurrence and how to work with patients to improve that risk and develop a relapse prevention plan.

Article: Management of recurrent depression

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 03 Sep 2008 09:00:00 +1000

Depression is a potentially recurring or chronic disorder. The provision of evidence based treatment and effective practice organisation is central to chronic disease management, and these principles can be applied to managing depression.

Interview: Upper abdominal pain from a surgical perspective

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 20 Aug 2008 09:00:00 +1000

Mr Sean Mackay discusses with Dr Carolyn O'Shea surgical causes of upper abdominal pain and some of the investigations that can help to make the diagnosis of a surgical cause.

Article: Surgical causes of upper abdominal pain

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 20 Aug 2008 09:00:00 +1000

In Australia, abdominal pain is a common presenting complaint in the general practice setting. Identifying a surgical cause is important and warrants prompt specialist referral.

Interview: Assessing upper abdominal pain

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Thu, 21 Aug 2008 09:00:00 +1000

Associate Professor Paul Pavli talks to AFP audio about the importance of a good history and examination in rationally selecting investigations to assist in assessing upper abdominal pain.

Article: Rational investigation of upper abdominal pain

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Thu, 21 Aug 2008 09:00:00 +1000

Upper abdominal pain is a common problem with an extraordinary diversity of possible causes. Many patients have no structural disease, and making the correct diagnosis can be a challenge.

Interview: The GreenClinic project

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 22 Aug 2008 09:00:00 +1000

Alison Fogarty and Grant Blashki talk about the GreenClinic project and what effect it had on the practices involved.

Interview: Helping practices improve their environment

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 22 Aug 2008 09:00:00 +1000

Don Henry, ACF Executive Director, talks about the importance of projects such as the GreenClinic project.

Article: The GreenClinic pilot - Educational intervention for environmentally sustainable general practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 22 Aug 2008 09:00:00 +1000

GreenClinic was a pilot educational program developed by the Australian Conservation Foundation and Doctors for the Environment Australia.

Interview: Managing acute arrythmias

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 11 Jul 2008 09:00:00 +1000

Dr Jaycen Cruikshank discusses the assessment and management of ventricular tachycardia, supraventricular tachycardia, atrial fibrillation and bradycardia with Dr Kathryn O'Connor. Accurate ECG interpretation is vital and faxing an ECG to a cardiologist or tertiary emergency department can help. The unconscious patient will require rescuscitation as per the Australian Resuscitation Council guidelines and the conscious patient requires IV access, oxygen, continuous cardiac monitoring and definitive treatment depending on the rythmn disturbance.

Article: Initial management of cardiac arrhythmias

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 11 Jul 2008 09:00:00 +1000

Diagnosis of acute arrhythmias requires recognition and interpretation of important electrocardiogram (ECG) findings, and knowledge of Australian resuscitation guidelines.

Interview: Neonatal care before transfer

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Thu, 10 Jul 2008 09:00:00 +1000

Dr Kathryn Browning Carmo discusses the role of the GP in managing the neonate before transfer to a tertiary centre with Dr Kathryn O'Connor. Early phone contact with the local Neonatal Emergency Transport Service provides GPs with much needed support and allows initiation of retrieval. Priorities include keeping the infant warm, assessment and management of airway, breathing and circulation, basic investigations and fluid and antibiotic therapy as necessary. It is vital to prepare the family for the arrival of the retrieval team.

Article: Stabilising the newborn for transfer - Basic principles

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Thu, 10 Jul 2008 09:00:00 +1000

Rural general practitioners involved in obstetric service delivery may have occasion to support the sick or premature newborn requiring transfer. This should be achievable for short periods of time in most rural hospitals.

Interview: Does this child have oppositional defiant disorder (ODD)?

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 09 Jul 2008 09:00:00 +1000

Anne Fraser, clinical psychologist from the State child Development Centre in Western Australia discusses oppositional defiant disorder (ODD) with Dr Jenni Parsons. The discussion centres around distinguishing ODD from normal preschool or adolescent behaviour, associations with other behavioural and psychological problems and management strategies.

Article: Oppositional defiant disorder

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 09 Jul 2008 09:00:00 +1000

Oppositional defiant disorder (ODD) is defined as a repetitive and persistent pattern of opposition, defiant, disobedient and disruptive behaviours toward authority figures persisting for at least 6 months.

Interview: School refusal

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Thu, 19 Jun 2008 09:00:00 +1000

Dr Jill Sewell discusses the underlying causes, assessment and management of school refusal with Dr Jenni Parsons. School refusal is a heterogeneous and multifactorial problem that may relate to separation anxiety, anxiety-depression, learning difficulties, bullying, family dysfunction or the child needing to 'protect' a parent in situations of family violence or parental mental health problems.

Article: School refusal

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Thu, 19 Jun 2008 09:00:00 +1000

School refusal occurs in 1–5% of all school children and has major social, emotional and educational implications for the child.

Interview: Consultations with children

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 18 Jun 2008 09:00:00 +1000

Dr Michael Harari discusses practical tips to gain a child's confidence in medical consultations with Dr Jenni Parsons. The judicious use of silliness, without acting the fool, can set a child at ease and facilitate assessment, history taking and examination.

Article: Gaining children's confidence - The judicious use of silliness

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 18 Jun 2008 09:00:00 +1000

Engaging children in a clinical setting is kind to the child and their family, and is a useful clinical tool. Each of us will have our own way of getting through a child's fears and defences. Tomfoolery, distraction and imaginary play can lead to a rewarding clinical interaction.

Interview: Chronic Rhinosinusitis (CRC)

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 16 May 2008 09:00:00 +1000

Christopher Brown, consultant ENT surgeon, Melbourne Nasal and Sinus Clinic, discusses the management of chronic rhinosinusitis in adults with Dr Jenni Parsons. The discussion focuses on the practicalities of assessment, optimising medical management and surgical options for patients who have failed medical management.

Article: Chronic rhinosinusitis - 'It's my sinus doc!'

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 16 May 2008 09:00:00 +1000

Chronic rhinosinusitis (CRS) is a common condition in the community, with significant morbidity and financial implications.

Interview: ENT problems in children

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Thu, 15 May 2008 09:00:00 +1000

Professor Robert Berkowitz discusses the management of ear, nose and throat problems in children with Dr Jenni Parsons. The focus is on when to refer to an otolaryngologist for recurrent otitis media, adenotonsillar disease, suppurative complications of common infections and nasal injuries.

Article: When to refer a child to an otolaryngologist

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Thu, 15 May 2008 09:00:00 +1000

This article provides a general approach in determining when to refer a child to an otolaryngologist.

Interview: Treating hearing impairment

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 13 May 2008 09:00:00 +1000

Professor Stephen O'Leary discusses technological advances in treatment of hearing impairment including digital technology in hearing aids, cochlear implantation and the bone anchored hearing aid (BAHA).

Article: Hearing impairment - Technological advances and insights

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 13 May 2008 09:00:00 +1000

The treatment of hearing impairment is rapidly evolving. Despite this, a significant number of adults with hearing impairment receive inadequate treatment or rehabilitation, resulting in functional impairment and social isolation.

Interview: Threats to Australian Patient Safety (TAPS) study findings

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 15 Apr 2008 09:00:00 +1000

Dr Meredith Makeham author of the series of articles in AFP on the Threats to Australian Patient Safety (TAPS) study discusses the TAPS study and some of the findings relating to errors, harm and avoidance of errors.

Article: Lessons from the TAPS study - errors relating to medical records

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 15 Apr 2008 09:00:00 +1000

The Threats to Australian Patient Safety (TAPS) Study collected 648 anonymous reports about threats to patient safety from a representative random sample of Australian general practitioners.

Interview: Maintaining an INR in the therapeutic range

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 14 Apr 2008 09:00:00 +1000

Maintaining an INR in the therapeutic range is an important area of patient management and safety. Kate Hodge talks about a program and evaluation to assist in a rural region.

Article: Coordinated anticoagulation management in a rural setting

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 14 Apr 2008 09:00:00 +1000

Oral anticoagulation management is difficult in rural settings because of reduced patient access to pathology testing and medical management.

Interview: Issues in diagnosing and managing food allergy in adults

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 07 Apr 2008 09:00:00 +1000

Associate Professor Jo Douglass outlines issues for GPs and patients in diagnosing and managing food allergy in adults.

Article: Food allergy in adults

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 07 Apr 2008 09:00:00 +1000

There is a marked increase in the prevalence of food allergies. Food allergy can cause fatal anaphylaxis and the victims are most often adolescents and young adults.

Interview: Paediatric allergy tests and allergy prevention recommendations

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 04 Apr 2008 09:00:00 +1000

Dr Marnie Robinson talk to AFP audio about 2 of the April theme articles on Allergy. She discusses paediatric allergy, including allergy tests, and the latest in allergy prevention recommendations.

Article: Allergy prevention - Current recommendations and new insights

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 04 Apr 2008 09:00:00 +1000

The prevalence of allergic disease has increased considerably in recent decades and Australia has one of the highest rates of allergic disease in the world.

Article: Allergy testing and referral in children

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 04 Apr 2008 09:00:00 +1000

Allergic diseases (asthma, atopic dermatitis, allergic rhinitis and food allergy) are the commonest chronic diseases of childhood.

Interview: Surgical treatments for urinary incontinence in women

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 07 Mar 2008 09:00:00 +1000

Dr Karen McKertich discusses procedural and surgical treatments for urinary incontinence in women.

Article: Urinary incontinence - Procedural and surgical treatments for women

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 07 Mar 2008 09:00:00 +1000

A range of surgical treatment options is available for women suffering from stress and urge urinary incontinence refractory to conservative and medical management.

Interview: Assessment of urinary incontinence in women

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Thu, 06 Mar 2008 09:00:00 +1000

Dr Karen McKertich discusses assessment of urinary incontinence in women.

Article: Urinary incontinence - Assessment in women: stress, urge or both?

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Thu, 06 Mar 2008 09:00:00 +1000

The aims of assessing urinary incontinence in women are to define the diagnosis, exclude other pathology and guide management. Treatment can be initiated when urinary incontinence is categorised as stress, urge or mixed incontinence.

Interview: Physiotherapy for urinary incontinence

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 05 Mar 2008 09:00:00 +1000

Dr Patricia Neumann discusses physiotherapy for urinary incontinence

Article: Physiotherapy for urinary incontinence

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 05 Mar 2008 09:00:00 +1000

International guidelines recommend treatment for urinary incontinence by a health professional such as a pelvic floor or continence physiotherapist with specialised training in the management of pelvic floor disorders.

Interview: Overweight and obese adolescents

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sun, 12 Aug 2007 15:00:00 +1000

Overweight and obese adolescents face significant problems with their physical and emotional health. Professor Kate Steinbeck outlines the GP’s role in advocating for these kids and helping them reach realistic goals.

Article: Adolescent overweight and obesity - How best to manage in the general practice setting

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sat, 11 Aug 2007 15:00:00 +1000

The prevalence of overweight and obesity continues to increase in adolescents. Community level management is necessary as specialist services are limited.

Interview: Youth sexual activity

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 10 Aug 2007 15:00:00 +1000

Dr Melissa Kang has a special interest in the sexual health of young people. In this interview, she observes changing patterns in youth sexual activity and some basic principles of safe sexual behaviour.

Interview: Adolescent sex, contraception and health

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Thu, 09 Aug 2007 15:00:00 +1000

In this podcast, Melissa Kang attempts to enlighten Steve Trumble on successful communication with young people about their sexuality and sexual risks.

Article: Sex, contraception and health

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 08 Aug 2007 15:00:00 +1000

Young Australian people aged 12–25 years are sexually active at a younger age and have more sexual partners compared to previous generations. Pregnancy and sexually transmitted infection (STI) rates are high in this age group. Sexual violence, discrimination against same sex attracted youth, and associated health risk behaviours such as alcohol and drug use are also important sexual health issues for adolescents.

Interview: Practical approaches to adolescent mental health

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 07 Aug 2007 15:00:00 +1000

Dr Graham Fleming is a GP in rural South Australia who saw a problem with youth suicide in his area and went ahead and fixed it. He talks about practical approaches to adolescent mental health.

Article: The mental health of adolescents - Assessment and management

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 06 Aug 2007 15:00:00 +1000

About 15% of the adolescent population suffers a mental health problem. Although a large percentage of these adolescents present to their general practitioner at least once a year, often their mental health problems are not presented or are somatised. Unfortunately, without intervention many of these mental health problems progress into adulthood where they are often more difficult to solve.

Interview: Cardiac pacemakers

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 13 Jul 2007 16:00:00 +1000

Cardiac pacemakers have come a long way in the 50 years since the first model needed its batteries changed after 3 hours. Dr Geoff Toogood discusses the indications for cardiac pacing.

Article: Pacemaker therapies in cardiology

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Thu, 12 Jul 2007 15:00:00 +1000

Since the first cardiac pacemaker was inserted in 1958 vast changes have occurred in both the technology of the devices and their indications.

Interview: Management of cardiac arrhythmias: pharmacological treatment of supraventricular and ventricular tachycardias

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 11 Jul 2007 16:00:00 +1000

Dr Peter Kistler talks with Steve Trumble in the first of three podcasts on the management of cardiac arrhythmias. This interview focuses on his article in the pharmacological treatment of supraventricular and ventricular tachycardias.

Article: Pharmacologic management of tachycardia

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 10 Jul 2007 15:00:00 +1000

Cardiac arrhythmias may present with palpitations, chest pain, shortness of breath, dizziness and syncope. Diagnosis may be complicated by an inability to document the arrhythmia particularly when symptoms are infrequent and short lived.

Interview: Atrial fibrillation

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 09 Jul 2007 16:00:00 +1000

Atrial fibrillation is becoming increasingly common, especially in older people. In this podcast, Dr Peter Kistler discusses the control of rate and rhythm in atrial fibrillation.

Article: Management of atrial fibrillation

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sun, 08 Jul 2007 15:00:00 +1000

Atrial fibrillation affects a significant proportion of the Australian population, affecting approximately 5% of people over 65 years of age.

Interview: Management of arrhythmias: cardiac catheters

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sat, 07 Jul 2007 16:00:00 +1000

In the final of his three podcasts, Dr Peter Kistler looks at the use of cardiac catheters in the management of arrhythmias.

Article: Catheter ablation techniques in managing arrhythmias

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 06 Jul 2007 15:00:00 +1000

Pharmacological management of arrythmias is not curative, is sometimes difficult, and may be associated with significant morbidity.

Interview: Surviving training

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 05 Jun 2007 15:00:00 +1000

Your first day in general practice can be a mixture of excitement and terror. Victorian registrar Dr Emily Walsh explains how she survived her first training term, and felt like a real doctor at last.

Article: How to survive as a basic term registrar

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 04 Jun 2007 15:00:00 +1000

After trying a couple of other disciplines in medicine I have finally found the career that suits me. If you, like me, are interested in most things, enjoy meeting people and can’t stand the smell of the average hospital ward, then general practice may really appeal.

Interview: Malaria prevention and prophylaxis

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sat, 12 May 2007 15:00:00 +1000

Malaria is more than an inconvenience for Australian travellers; it is a serious disease that kills and injures millions of people each year. Dr Trish Batchelor talks with Steve Trumble about appropriate prevention and prophylaxis.

Article: Prevention of malaria in travellers

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 11 May 2007 15:00:00 +1000

Malaria remains endemic in over 100 countries worldwide. Travellers to these countries may be at risk of contracting disease. Assessing risk on an individual basis can be challenging.

Interview: The pre-travel consultation

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Thu, 10 May 2007 15:00:00 +1000

Dr Tony Gherardin discusses the approach to the intending traveller. What do they need to know and what does their GP need to tell them?

Article: The pre-travel consultation - An overview

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 09 May 2007 15:00:00 +1000

Australians are great travellers and the need for travel health advice can be a common presentation in general practice. General practitioners should be an important source of accurate and up-to-date information and provide appropriate travel medicine services.

Interview: Travel vaccination

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 08 May 2007 15:00:00 +1000

Many Australian travellers baulk at the idea of paying for vaccines before they set off on their great adventures. But, as Dr Sonny Lau explains to Steve Trumble, GPs can help even those on a tight budget to invest wisely in the right vaccines.

Article: Travel vaccination

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 07 May 2007 15:00:00 +1000

Immunisation is very cost effective. It provides high level immunity against a range of general and travel specific pathogens. There are more vaccines available as research and development of vaccines progresses. Some vaccines require multiple doses to induce long lasting protective immunity, and some will only induce protective immunity for a limited period of time.

Interview: Somatising disorders

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Thu, 12 Apr 2007 15:00:00 +1000

Dr Louise Stone looks at what's going on with some of our most challenging patients: those who somatise their problems. Are we helping by proving to them that there's "nothing wrong" when there clearly is?

Article: Somatising disorders - Untangling the pathology

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 11 Apr 2007 15:00:00 +1000

Somatising disorders are a common, complex and disabling cluster of disorders. Research suggests that general practitioners find this group of patients challenging. The disorders are complicated by the fact that doctors play a role in both their aetiology and maintenance. The interaction between the illness worry of the patient and the disease worry of the doctor can lead to escalating disability and the risk of iatrogenic disease.

Interview: Cognitive behaviour therapy in general practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 10 Apr 2007 15:00:00 +1000

Cognitive Behavioural Therapy is revolutionising the way GPs treat patients with anxiety and depression. Dr Sarah Edelman talks about what types of CBT work best in the general practice setting.

Article: Managing anxious patients - Cognitive behaviour therapy in general practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 09 Apr 2007 15:00:00 +1000

It is well established that some individuals have an inherent disposition toward experiencing anxiety more readily than others. These individuals are prone to high levels of autonomic arousal, exaggerated threat perception and dysfunctional coping strategies.

Interview: Pharmacological treatment for depression and anxiety

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sun, 08 Apr 2007 15:00:00 +1000

Medication has no place in the management of mild depression, and only a limited role in moderate depression. Severe depression usually requires drug treatment and Dr Steve Ellen discusses some golden rules for prescribing.

Article: Depression and anxiety - Pharmacological treatment in general practice

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sat, 07 Apr 2007 15:00:00 +1000

Depression and anxiety are common presentations in general practice and medications are one of the key treatment strategies.

Interview: How GPs can help patients adjusting to illness and other major life events

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 06 Apr 2007 15:00:00 +1000

GPs occupy a unique position in being able to help people who are going through major life events. Professor David Clarke talks about the various coping strategies people use, and how we can help them cope more effectively.

Article: Adjusting to illness and other major life events - How can GPs help?

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Thu, 05 Apr 2007 15:00:00 +1000

General practitioners often see patients who are struggling with a change in their life circumstances. When this change involves illness, the GP is well placed to provide support and practical assistance. However, research in this area has tended to concentrate on the patient who is overwhelmed and unable to cope, focusing on the negative consequences of anxiety and depression.

Interview: Postmenopausal bleeding

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 12 Mar 2007 14:00:00 +1100

Postmenopausal bleeding is always a cause for concern. An obvious, benign cause could be obscuring a carcinoma. Gynaecological oncologist Dr Alison Brand talks to Steve Trumble about how GPs should respond.

Article: The woman with postmenopausal bleeding

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sun, 11 Mar 2007 14:00:00 +1100

Postmenopausal bleeding is a common complaint from women seen in general practice.

Interview: Routine clinical breast and pelvic examinations in asymptomatic women

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sat, 10 Mar 2007 14:00:00 +1100

Why do we do routine clinical breast and pelvic examinations in asymptomatic women? Is there any evidence that it increases the detection of breast or gynaecological malignancies? Associate Professor Jill Thistlethwaite and Dr Rebecca Stewart used an RACGP Silagy Scholarship to find out.

Article: Clinical breast examination for asymptomatic women - Exploring the evidence

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 09 Mar 2007 14:00:00 +1100

Clinical breast examination (CBE) is often offered as a component of the well woman check or carried out at the request of an asymptomatic woman. In these cases the examination is a screening procedure, as opposed to a diagnostic CBE in a symptomatic woman.

Interview: Update on Pap tests

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Thu, 08 Mar 2007 14:00:00 +1100

The launch of Australia's new vaccine for preventing certain strains of Human Papilloma Virus holds great promise in reducing the incidence of cervical cancer. But do we run the risk of missing tumors by slackening off on cervical cytology screening? Dr Stella Heley provides an update on Pap tests in this brave new world.

Article: Pap test update

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 07 Mar 2007 14:00:00 +1100

2006 was an eventful year in the area of screening to prevent cervical cancer. New screening guidelines were introduced nationally in July, and in November the Australian Government agreed to fund one of the human papillomavirus (HPV) vaccines, Gardasil, under the National Immunisation Program.

Interview: Ovarian cancer

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 06 Mar 2007 14:00:00 +1100

Ovarian cancer is difficult to diagnose and hence it is often not detected before it is well advanced. Associate Professor Margaret Davey talks about some of the patient factors that should raise a GP's index of suspicion.

Article: Ovarian cancer - Diagnosis and management

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 05 Mar 2007 14:00:00 +1100

Epithelial ovarian cancer presents most often as late stage disease due to a lack of effective screening tests and vagueness of symptoms.

Interview: Effective management approaches to work related upper limb disorders

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 12 Dec 2006 15:00:00 +1100

Work related upper limb disorders are common, expensive and difficult to treat. Rheumatologist and occupational physician Dr Michael Shanahan talks to Steve Trumble about effective management approaches, and answers the question: 'where has all the RSI gone?'.

Article: Work related upper limb disorders

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 11 Dec 2006 15:00:00 +1100

Work related upper limb disorders (WRULDs) are among the most common workers' compensation claims. Their management is a challenge for medical practitioners for a range of reasons.

Interview: A S.T.R.A.T.E.G.Y. for getting the at risk patient back to work

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sun, 10 Dec 2006 15:00:00 +1100

Dr Berny Trifiletti shares her acronym for helping injured workers get back on the job.

Article: Getting the at risk patient back to work - A strategy

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sat, 09 Dec 2006 15:00:00 +1100

Achieving best outcomes in occupational injury management requires an emphasis upon identifying and managing those factors which – in addition to the medical condition – lead to progression to chronicity. The most studied common musculoskeletal workplace injury is low back pain.

Interview: Morale in the workplace

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 08 Dec 2006 15:00:00 +1100

Dr Peter Cotton is an organisational psychologist who believes that the "morale" in a workplace - and in the workers - plays a very significant part in determining health outcomes. In this interview he explains how two workers confronted with the same injury may respond differently depending on their emotional resilience.

Article: Occupational wellbeing - Management of injured workers with psychosocial barriers

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Thu, 07 Dec 2006 15:00:00 +1100

Although most injured workers return to work with minimal intervention, approximately 20% show levels of distress and disability beyond that expected for the injury. The level of morale in a workplace seems to play a major role in this.

Interview: The modern approach to getting back-injured workers back to work

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 06 Dec 2006 15:00:00 +1100

The management of acute low back pain is quite a challenging problem in general practice, especially when it is work-related and there are other issues at play. Dr John Low is an occupational physician from Subiaco, WA. He discusses the modern approach to getting back-injured workers back to work.

Article: Back injuries - Getting injured workers back to work

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 05 Dec 2006 15:00:00 +1100

Back problems are the seventh most common reason for seeking care in general practice in Australia. Despite medical advances, chronic disability from back pain is a major contributor to the burden of disease in society today.

Interview: Endometriosis

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sat, 04 Nov 2006 15:00:00 +1100

Endometriosis is a difficult condition to diagnose clinically; it also has major consequences for women in terms of pain, disablement and possible infertility. Dr David O'Callaghan gives Steve Trumble an update.

Article: Endometriosis - An update

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 03 Nov 2006 15:00:00 +1100

Endometriosis is one of the major causes of pelvic pain and subfertility in women.

Interview: Palliating symptoms in people with cancer and other diseases

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sat, 07 Oct 2006 15:00:00 +1000

Dr Jane Fischer talks about palliation of symptoms other than pain (including dyspnoea, nausea, constipation, and depression) in people with cancer and other diseases.

Article: Palliating symptoms other than pain

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 06 Oct 2006 15:00:00 +1000

Symptoms other than pain are a heavy burden for patients with either malignant or progressive nonmalignant disease and significantly reduce quality of life.

Interview: The three most challenging areas of palliative care

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Thu, 05 Oct 2006 15:00:00 +1000

Professor Patsy Yates discusses three of the most challenging areas of palliative care: when children are dying, when older people need decisions made, and when an Indigenous Australian is in need of palliation.

Article: Palliative care for specific populations

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 04 Oct 2006 15:00:00 +1000

Ensuring access for all Australians to high quality palliative care requires an understanding of special considerations for specific populations, including children, older persons, and Indigenous Australians.

Interview: Healthy weight

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sun, 06 Aug 2006 15:00:00 +1000

Rick Kausman talks about successful strategies for helping people be their most healthy weight

Article: If not dieting, now what?

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sat, 05 Aug 2006 15:00:00 +1000

Helping patients to achieve and maintain their most healthy weight is a common challenge. Giving a 'one size fits all' set of instructions to patients who are over their most healthy weight does not help.

Interview: General practice in the United Kingdom

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 23 Aug 2006 12:00:00 +1000

Dr Roger Neighbour, visiting President of the RCGP, talks with Steve Trumble about general practice in the United Kingdom and how it differs from Australia.

Interview: Practical wisdom

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 23 Aug 2006 12:00:00 +1000

Dr Roger Neighbour, visiting President of the RCGP, talks with Steve Trumble about one of the skills that lies at the core of being a general practitioner: "phronesis", or practical wisdom.

Interview: Medical workforce problems confronted by developing countries

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 12 Jul 2006 15:00:00 +1000

While we do have medical workforce problems in Australia, they are nothing compared to those confronted by developing countries. Dr Malcolm Moore is a GP in Albury NSW who has worked in Nepal teaching local doctors the art and science of general practice. He talks about what Australian GPs can do to assist countries such as Nepal.

Article: Opportunities and challenges for GPs in the developing world

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 11 Jul 2006 15:00:00 +1000

Australia has a well developed system of general practice and can be proud of the quality of its generalists. In many developing countries however, the idea of a trained generalist is not well understood. The global situation creates many opportunities and challenges for Australian general practitioners.

Interview: Practical approaches to the wounded child

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 10 Jul 2006 15:00:00 +1000

Children can be challenging customers at the best of times and no more so than when you are trying to repair their wounds. Fellow in Paediatric Emergency Medicine, Dr Ronan O'Sullivan, discusses practical approaches to the wounded child.

Article: Wound repair in children

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sun, 09 Jul 2006 15:00:00 +1000

Minor injuries in children are extremely common in the general practice setting.

Interview: The basic approach to assessment and management of leg ulcers

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sat, 08 Jul 2006 15:00:00 +1000

Leg ulcers are a common and time consuming problem in general practice. Poorly managed, they can result in unnecessary amputation or even death. One of Australia's leading wound management consultants discusses the basic approach to assessment and management.

Article: Leg ulcers - Causes and management

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 07 Jul 2006 15:00:00 +1000

A leg ulcer is not a disease but the manifestation of an underlying problem that requires a clear diagnosis.

Interview: Choosing dressings for skin ulcers

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Thu, 06 Jul 2006 15:00:00 +1000

The choice of dressings when managing skin ulcers is important, but not more so than making a proper assessment of the patient, their ulcer and the environment in which they exist. Associate Professor Keryln Carville discusses the use of the T.I.M.E. acronym to help choose the right approach.

Article: Which dressing should I use? - It all depends on the 'TIMEING'

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 05 Jul 2006 15:00:00 +1000

Wound management is more than the application of a dressing. It requires a comprehensive and informed approach to the assessment of the patient, their wound and their healing environment.

Interview: Teenagers with diabetes

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sat, 13 May 2006 15:00:00 +1000

Adolescence is a difficult time for most teenagers, but when you have a chronic illness such as diabetes it can be really tough.

Article: Teenagers with diabetes - management challenges

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Fri, 12 May 2006 15:00:00 +1000

During adolescence major hormonal, neuro-maturational, emotional and psychosocial changes occur within a relatively short time interval. The additional burden of living with a chronic disease such as type 1 diabetes can further add to the potential for instability.

Interview: Evidence based approach to foot assessment in patients with diabetes

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Thu, 11 May 2006 15:00:00 +1000

Careful foot assessment is an important part of GPs' comprehensive care of people with diabetes.

Article: Foot assessment in patients with diabetes

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Wed, 10 May 2006 15:00:00 +1000

Diabetes has long been associated with increased risk of foot ulceration and lower extremity amputation.

Interview: Type 2 diabetes

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Tue, 09 May 2006 15:16:00 +1000

Dr Jonathan Cohen presents a timely update on the pharmacotherapy of glycaemic control and other factors that modify cardiovascular risk for people with type 2 diabetes. Metformin is usually the first line, but what comes next?

Article: Type 2 diabetes - The pharmacotherapy of glycaemic control and risk factor modification

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Mon, 08 May 2006 15:00:00 +1000

Patients with diabetes have a high cardiovascular risk. In addition to achieving good glycaemic control, cardiovascular risk reduction is a vital component of management.

Interview: Computers can't listen

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sun, 07 May 2006 15:16:00 +1000

General practice is all about listening to our patients as they tell us the story of their health. Dr Chris Pearce discusses the impact that both computers and evidence-based medicine are having on our ability to practise in this patient centred manner. If we lose the patient's narrative, do we lose the plot?

Article: Computers can’t listen - Algorithmic logic meets patient centredness

web.admin@racgp.org.au (The Royal Australian College Of General Practitioners) — Sat, 06 May 2006 15:00:00 +1000

The doctor-patient relationship is crucial to the practice of medicine and yet the rise of science in the 19th and 20th centuries shifted doctors’ focus away from the patient toward another entity: the disease. Slowly, the medical profession is rediscovering the importance of the doctor-patient relationship.