In this episode, the Good GP interviews Professor Creswell (Cres) Eastman on Hypothyroidism in pregnancy.

This episode covers how pregnancy affects the thyroid, the complications, case detection, treatment and management.  

Prof Cresman (Cres) Eastman is a world-renowned endocrinologist and the principal medical advisor to the Australian Thyroid Foundation. He is also the Clinical Professor of Medicine at the Westmead Clinical School, University of Sydney and remains in active clinical practice as a Consultant Physician in Endocrinology and as an aviation medical consultant.

Resources:
Australian Thyroid Foundation: https://thyroidfoundation.org.au/ 

American Thyroid Association guidelines: https://www.liebertpub.com/doi/full/10.1089/thy.2016.0457 

Journal of Clinical Endocrinology and Metabolism:  Management of Thyroid Dysfunction during Pregnancy and Postpartum: An Endocrine Society Clinical Practice Guideline 
https://academic.oup.com/jcem/article/97/8/2543/2823170?searchresult=1

Hypothyroidism in pregnancy – Episode 90

The Good GP, the education podcast for busy GPs; brought to you by Dr Tim Koh, Dr Krystyna DeLange and Dr Sean Stevens.

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Disclaimer: The Good GP podcasts are for informational purposes only and do not constitute medical advice. Always seek the advice of a specialist GP or other qualified health provider with any questions you may have regarding a medical condition.

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In this episode of The Good GP, Dr Sean Stevens and Dr Rebecca Goadby welcome Dr Alison Creagh to discuss the differences between older progesterone-only pills - such as levonorgestrel and norethisterone - and the newer drospirenone ones. Alison outlines how the older pills primarily work through cervical mucus and, to some extent, blocking ovulation, while the newer drospirenone pills are more effective at blocking ovulation and have a wider window of time for pill intake. The impact on bleeding is also highlighted, with the drospirenone pills leading to more regular bleeding during the withdrawal section. Discussing the cost and payment options for the different pills, with the older pills being more cost-effective for those with healthcare cards, while the newer ones are more forgiving in terms of timing. Additionally, contraindications and missed pill windows for the two types of pills are explored, with specific attention to potassium levels in relation to the newer drospirenone pills. Alison further delves into the advice for the missed pill window and the potential side effects for both types of progesterone-only pills. The variability in individual responses to these pills is highlighted, as well as the potential need to try different types if hormonal side effects arise. The episode concludes with Sean Stevens thanking Alison Creagh for her valuable insights and highlighting the important takeaways from the discussion. The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialization. Learn more at Talking HealthTech. If you have any questions or would like to contact The Good GP, send an email to thegoodgp@gmail.com Mentioned in this episode: Proudly supported by Medtech Global: The Good GP Podcast is sponsored by Medtech Global, they help GPs be GPs by working with clinicians in Australia and New Zealand to develop Patient Management Systems and healthcare technology. Visit the link for more information:  Medtech Global

Exploring Progesterone Only Pills: Understanding Old and New Types with Dr Alison Creagh

In this episode of The Good GP, host Dr Sean Stevens is joined by Dr Alison Creagh, a GP specialising in women's health and sexual and reproductive health, with over 20 years of experience in this field. Alison sheds light on the issue of intimate partner violence and its impact on the health of those affected, particularly women. She discusses how intimate partner violence differs from domestic violence and emphasises the importance of GPs in addressing this prevalent issue. Delving into why patients may be reluctant to discuss intimate partner violence with their GPs and offers insights into how GPs can effectively broach this sensitive topic with their patients. Alison provides practical guidance on identifying potential signs of intimate partner violence and outlines gentle and effective approaches for GPs to initiate conversations with their patients. Furthermore, Alison shares valuable resources and support services available to GPs and patients dealing with intimate partner violence, emphasising the need for confidentiality and sensitivity in handling such cases. Concluding with the discussion on additional learning opportunities and resources for GPs to further their understanding and approach in addressing intimate partner violence. Resources for Getting Help on Intimate Partner Violence across Australia: National 1800 RESPECT Counselling, information and referral for people experiencing abuse, friends and family and health professionals.  1800 737 732 MensLine Australia For men with concerns about abuse, including those who are abusive.  1300 789 978 White Ribbon Lists national helplines available according to needs.  whiteribbon.org.au/helplines  ACT Domestic Violence Crisis Service  02 6280 0900 NSW NSW Domestic Violence Line Counselling and referrals for women experiencing DV  1800 656 463 
 NSW Department Communities and Justice Online information source, with quick exit buttons https://dcj.nsw.gov.au/children-and-families/family-domestic-and-sexual-violence.html  
 Women’s Domestic Violence Court Advocacy Services Provide information, advocacy and referrals for women and children, and support accessing restraining orders legalaid.nsw.gov.au/about-us/our-partners/womens-domestic-violence-court-advocacy-program  
 NT Domestic, family and sexual violence page from NT government Lists local support services according to region nt.gov.au/law/crime/domestic-family-and-sexual-violence/get-help-for-domestic-family-and-sexual-violence  
 QLD DVConnect Womensline Support, accommodation, counselling and referrals for women experiencing family or domestic violence  1800 811 811 
 DVConnect Mensline Support, counselling and referrals for men affected  1800 600 636 
 Government Domestic & Family Violence page Information about services available qld.gov.au/community/getting-support-health-social-issue/support-victims-abuse/domestic-family-violence  
 Domestic Violence Prevention Centre Counselling, practical support, safety planning and referrals  07 5532 9000 
 SA Domestic and family violence & sexual assault support services Listings of supports available for specific issues sa.gov.au/topics/family-and-community/safety-and-health/domestic-violence-and-sexual-assault/support-services  
 Domestic Violence Crisis Line Crisis counselling, support and accommodation referrals  1800 800 098 
 TAS Family Violence Counselling and Support Service Information, support, safety planning, assistance with police, referrals  1800 608...

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In this episode, host Tim Koh is joined by Dr Michael Wright, Chief Medical Officer for Avant Mutual and Chair of RACGP Expert Committee on Funding and Health System Reform, to discuss the do's and don'ts of telehealth consulting. They delve into the guidelines set by the Medical Board of Australia, the legislative requirements for Medicare billing, and the considerations for conducting telehealth consultations effectively.  Michael emphasises the importance of maintaining the standard of care, patient identification, consent, and privacy protection in telehealth consultations. He also addresses the challenges and limitations of telehealth, including the need to transition to face-to-face consultations when necessary, staying compliant with Medicare billing requirements, and protecting oneself from potential issues and complaints related to telehealth consultations.  Discussing the implications of patients accessing medical advice from outside of Australia and the responsibilities of GPs practising telehealth while travelling abroad. Exploring the use of other forms of communication, such as SMS, electronic messaging, and email, in patient consultation and information provision. Resources & Links:Telehealth - Telehealth – what you need to know - Avant by doctors for doctorsGuidelines - https://www.medicalboard.gov.au/Codes-Guidelines-Policies/Telehealth-consultations-with-patients.aspx
For Medical Practitioners in General Practice  Stay updated on the latest in healthcare, delivery, and digital health by visiting Talking HealthTech, the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialization. If you have any questions or would like to contact The Good GP, send an email to thegoodgp@gmail.com Mentioned in this episode: Proudly supported by Medtech Global: The Good GP Podcast is sponsored by Medtech Global, they help GPs be GPs by working with clinicians in Australia and New Zealand to develop Patient Management Systems and healthcare technology. Visit the link for more information:  Medtech Global

The Evolving Landscape of Telehealth: GPs Adaptation, Challenges, and Legal Considerations

In this episode of The Good GP, Dr Sean Stevens welcomes Dr Paul Effler, Medical Coordinator of the Communicable Disease Control Directorate in WA, to discuss the new RSV immunisation, Nirsevimab. They explore the differences between traditional vaccines and Nirsevimab, its effectiveness, safety, target group, and the likelihood of a national rollout. They also dive into the seasonal patterns of RSV and the co-administration of Nirsevimab with other vaccines. Providing valuable insights into the development and potential impact of this new immunisation. The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialization. Learn more at www.talkinghealthtech.com/podcast/network If you have any questions or would like to contact The Good GP, send an email to thegoodgp@gmail.com Mentioned in this episode: Proudly supported by Medtech Global: The Good GP Podcast is sponsored by Medtech Global, they help GPs be GPs by working with clinicians in Australia and New Zealand to develop Patient Management Systems and healthcare technology. Visit the link for more information:  Medtech Global

Nirsevimab and the RSV Immunisation Strategy: The Good GP Special Episode

In this episode of The Good GP, Dr Sean Stevens welcomes Dr Sarah Heynemann, a Melbourne-based early career medical oncologist and PhD candidate with Sydney Health Ethics, The University of Sydney. Dr Heynemann brings valuable insights into the changes in cancer care and cancer survivorship over the years. She discusses the impact of advances in cancer therapies, such as immunotherapy and targeted therapies, on the prognosis and quality of life for patients with cancer, particularly those with historically poor prognoses. She emphasises the need for GPs to be aware of the ongoing supportive care needs of patients, even if the tumour appears stable, and highlights the importance of effective communication across multidisciplinary teams for comprehensive cancer survivorship care.  Additionally, Sarah sheds light on upcoming cancer therapies and emphasises the evolving role of GPs in navigating the complexities of cancer care. Recommending two key resources – the Victorian Comprehensive Cancer Centre’s online course for primary care practitioners and the Australian Cancer Survivorship Centre based out of Peter MacCallum Cancer Centre. She also mentions an recent article in the Journal of Clinical Oncology which provides an overview of the future of survivorship for patients living with metastatic cancer. Resources & Links:'Cancer Survivorship for Primary Care Practitioners' VCCC course starts 25th March 2024. Weblink here: https://www.futurelearn.com/courses/cancer-survivorshipAustralian Cancer Survivorship Centre based at Peter MacCallum Cancer Centre https://www.petermac.org/patients-and-carers/support-and-wellbeing/life-after-treatment
The article Sarah referenced was published last year in the Journal of Clinical Oncology https://ascopubs.org/doi/10.1200/JCO.22.02212?url_ver=Z39.88-2003&rfr;_id=ori:rid:crossref.org&rfr;_dat=cr_pub%20%200pubmed
  The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialization. Learn more at Talking HealthTech  
 If you have any questions or would like to contact The Good GP, send an email to thegoodgp@gmail.com Mentioned in this episode: Proudly supported by Medtech Global: The Good GP Podcast is sponsored by Medtech Global, they help GPs be GPs by working with clinicians in Australia and New Zealand to develop Patient Management Systems and healthcare technology. Visit the link for more information:  Medtech Global

Hypothyroidism in pregnancy – Episode 90

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