The Good GP

Join your host Dr Krystyna de Lange for this episode of The Good GP Podcast, featuring Dr Ian Coulson, a consultant dermatologist from the United Kingdom and editor-in-chief of DermNet. This is part two of a two-part series on eczema, produced in collaboration with DermNet.

Dr Coulson outlines essential non-pharmacological management techniques for eczema, emphasising the importance of using emollients correctly. He introduces the concept of GTBR (Get the Basics Right) to ensure that these steps are followed closely. Providing insights into selecting the correct type of emollient based on individual patient needs and preferences. 

Moving to the pharmacological management of eczema, Dr Coulson explains the appropriate use of topical corticosteroids. He offers practical advice on choosing the right potency and type of corticosteroid, and the concept of weekend treatment to maintain control. He also touches on the importance of avoiding steroid overuse and educates on steroid withdrawal syndrome.

For cases where eczema is more severe or unmanageable, Dr Coulson discusses advanced treatment options like phototherapy and systemic agents like cyclosporine, azathioprine, and methotrexate. 

Dr Coulson's emphasis on a holistic approach—combining both baselines with advanced treatments—could help GPs with practical strategies to manage eczema more effectively in their practice.

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

The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialisation. Learn more at www.talkinghealthtech.com/podcast/network

If you have any questions or would like to contact The Good GP, send an email to [email protected]. Visit www.thegoodgp.com.au for previous episodes and more information.

Join your host Dr Krystyna de Lange for this episode of The Good GP Podcast, featuring Dr Ian Coulson, a consultant dermatologist from the United Kingdom and editor-in-chief of DermNet. This is part one of a two-part series on eczema, produced in collaboration with DermNet.

Dr Coulson provides an overview of eczema, its different types, and classifications. The differences of eczema and dermatitis, with exceptions such as perioral dermatitis. He classifies eczema into endogenous and exogenous types and explains their varied etiologies and common presentations, including atopic eczema, seborrheic eczema, irritant eczema, allergic contact dermatitis, and more.

Discussing atopic eczema, focusing on its onset, clinical features in different age groups, and the differences between acute and chronic eczema. Dr Coulson shares insights into identifying eczema mimics, such as fungal infections, scabies, and even cutaneous lymphoma, emphasising the importance of careful history-taking and examination.

Dr Coulson then outlines the investigations that may be required for patients with eczema. He covers mycology testing, biopsy considerations, and the limited value of allergy tests like PRIC and RAST in the context of eczema management.

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

The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialisation. Learn more at www.talkinghealthtech.com/podcast/network

If you have any questions or would like to contact The Good GP, send an email to [email protected]. Visit www.thegoodgp.com.au for previous episodes and more information.

In this special episode of The Good GP, recorded live at GP24 in Perth, host Dr Krystyna de Lange interviews Dr Anna Mullins on the topic of prescribing exercises for falls reduction and pelvic floor health.

Dr Anna Mullins is a Brisbane-based GP with a passion for lifestyle medicine and preventative health. As a former exercise physiologist, she emphasises how simple exercises can benefit patients with cardiovascular disease, metabolic disorders, mental health issues, and even cancer.

Dr Mullins highlights the importance of muscle strengthening and balance training, especially in the elderly. Dr Mullins outlines practical exercises that can easily be incorporated into daily routines, such as performing modified push-ups against a wall. 

They delve into exercises aimed at reducing falls risk in elderly patients. Describing specific exercises such as balancing on one foot, Tai Chi, and yoga, which not only improve physical health but also offer social connection benefits. Muscle strengthening activities like modified push-ups, squats, and core exercises, which are essential for maintaining functional independence and preventing falls.

Discussing maintenance pelvic floor health, especially in postnatal care. Dr Mullins shares techniques for activating pelvic floor muscles and core strength early in the postnatal phase, with starting these exercises soon after childbirth. 

The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialisation. Learn more at www.talkinghealthtech.com/podcast/network

If you have any questions or would like to contact The Good GP, send an email to [email protected]. Visit www.thegoodgp.com.au for previous episodes and more information.

In this special episode of The Good GP, recorded live at GP24 in Perth, host Dr Tim Koh talks with Dr Luca Crostella, an experienced gastroenterologist, about the diagnosis of inflammatory bowel disease (IBD).

Providing an insightful overview of IBD, including Crohn's disease and ulcerative colitis. Dr Crostella highlights common symptoms such as pain, bleeding, and urgency, and explains the diagnostic challenge posed by the variable nature of these diseases.

They delve into the diagnostic markers and tests for IBD, such as ESR, CRP, and fecal calprotectin levels, along with the role of endoscopic findings. Emphasising the difference of IBD from other conditions like irritable bowel syndrome (IBS) and non-steroidal anti-inflammatory drug (NSAID).

Dr Crostella shares practical tips for general practitioners on how to handle patients with suspected IBD and outlines the pre-referral investigations that can be beneficial. The implications of smoking and obesity in the prognosis of IBD and the potential role of diet in disease management.

The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialisation. Learn more at www.talkinghealthtech.com/podcast/network

If you have any questions or would like to contact The Good GP, send an email to [email protected]. Visit www.thegoodgp.com.au for previous episodes and more information.

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

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

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

The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialisation. Learn more at www.talkinghealthtech.com/podcast/network

If you have any questions or would like to contact The Good GP, send an email to [email protected]. Visit www.thegoodgp.com.au for previous episodes and more information.

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

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

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

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

The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialisation. Learn more at www.talkinghealthtech.com/podcast/network

If you have any questions or would like to contact The Good GP, send an email to [email protected]. Visit www.thegoodgp.com.au for previous episodes and more information.

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

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

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

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

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

The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialisation. Learn more at www.talkinghealthtech.com/podcast/network

If you have any questions or would like to contact The Good GP, send an email to [email protected]. Visit www.thegoodgp.com.au for previous episodes and more information.

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

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

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

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

The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialisation. Learn more at www.talkinghealthtech.com/podcast/network

If you have any questions or would like to contact The Good GP, send an email to [email protected]

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

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

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

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

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

The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialisation. Learn more at Talking HealthTech.

If you have any questions or would like to contact The Good GP, send an email to [email protected]

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

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

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

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

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

Links & Resources:

Rome Iv Diagnostic Criteria For Fgids

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

Patient Education Material

Irritable Bowel Syndrome (IBS)

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

Resources From The Australian Journal Of General Practice

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

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

Research Instruments/Projects

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

• https://link.springer.com/article/10.1007/s10620-017-4599-6

The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialisation. Learn more at www.talkinghealthtech.com/podcast/network

If you have any questions or would like to contact The Good GP, send an email to [email protected]