In this week’s episode, the Good GP interviews vascular surgeon, Dr Samantha Peden on venous ulcers and chronic venous insufficiencies. 

We explore the prevalence in certain patients, presentations, the missed diagnoses and tips for differentiating venous and arterial ulcers. We also explore referrals and recommendations for GPs with patients presenting with possible venous disease, arterial disease and the management of venous ulcers, including dressing options. 

Dr Samantha Peden is a vascular surgeon at the Royal Brisbane, and Women’s Hospital.

Venous disease - Episode 98

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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In this episode, host Dr Sean Stevens welcomes Dr Michael Clements and Dr Kaylene Girgenti to discuss the practicalities and benefits of rural GP outreach. Dr Girgenti is a GP obstetrician with a unique practice split between Townsville and remote Karoombara Health Centre, which she commutes to by plane. Dr Clements is not only a pilot but also the Vice President of the RACGP, Chair of the Rural Faculty, and a practice owner of Clements Medical in Townsville and Magnetic Island. Dr Girgenti shares her motivations behind taking on rural work, emphasising the diversity and fulfilment it adds to her practice, alongside the notable appreciation from the communities she serves. She encourages early career GPs to seek diversity and engage with diverse work environments that rural practice presents. 
 Dr Clements discusses the journey of integrating remote services into his practice, explaining the initial challenges and the rewards that result from providing critical services to underserved areas. He outlines the strategic approach to adopting a rural clinic from the perspective of an urban practice and the role of funding and clinical governance. 
 They also touched upon the dynamics of GP service in rural areas, including the importance of continuity of care and the value it brings to both the community and the healthcare provider. 
 Concluding with advice for urban GPs looking to extend their services to rural communities, highlighting the potential of such a model for adding excitement, scope, and a sense of mission to their practice. 
 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 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

From City to Country: Michael Clements and Kaylene Girgenti on Adopting Rural Clinics

In this episode of The Good GP, host Dr Sean Stevens along with Dr Rebecca Goadby interview Dr Alison Creagh, renowned for her expertise in intimate partner violence and contraceptive management. Alison addresses managing the side effects of long-acting reversible contraceptives (LARCs), focusing on contraceptive implants and intrauterine devices (IUDs). Alison discusses the common issue of unpredictable bleeding with contraceptive implants, providing detailed insights into identifying potential causes, assessing the pattern of bleeding, and discussing management options with patients. She highlights the significance of ruling out abnormal causes and offers a range of strategies, including reassurance, combined pill usage, anti-inflammatory and hormonal options, and considering alternative contraceptives, if necessary. Additionally, she provides guidance on addressing weight gain, headaches, loss of libido, and concerns around fertility associated with long-acting contraceptives, dispelling myths and offering practical advice to reassure patients. Their discussion then delves into challenges related to IUD insertions, addressing potential pain, bleeding, and cramping post-insertion. Alison outlines strategies for pain management during insertion, discusses the normality of bleeding patterns post-insertion, and shares management options for heavier bleeding or cramping.  The conversation concludes with Alison demystifying fertility concerns associated with LARCs, providing clarity on the rapid return to normal fertility post-discontinuation of contraceptive methods. 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

LARCs: Navigating Side Effects and Fertility Concerns with Dr Alison Creagh

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...

Addressing Intimate Partner Violence: A Conversation with Dr. Alison Creagh on The Good GP

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

Venous disease - Episode 98

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