The Good GP Talking HealthTech

In this episode, host Dr Catherine Bourke is joined by Dr Gill Cowen, a multi-talented expert with roles including a senior lectureship at Curtin Medical School and a clinical research fellow at the Curtin Health Innovation Research Institute, to discuss advancements in concussion management.
Defining concussion and elaborating on the latest Australian Sports Commission concussion guidelines released in February 2024. They covered various aspects of concussion, including preventive measures in sports, the importance of strict adherence to game rules, and the role of mouthguards and helmets. Dr Cowen clarifies that loss of consciousness is not required for a concussion diagnosis and outlines the serious conditions that GPs must not overlook.
Gaining insights into available diagnostic tools such as the post-concussion symptom score, SCAT 6, and the Vestibular Ocular Motor Screening Tool (VOMS). Dr Cowen also updates on current recommendations for post-concussion management, moving away from complete rest and instead advocating for relative rest and limited screen time in the initial 48 hours. They also discussed return-to-play protocols, particularly the revised 14-day symptom-free period before re-engaging in contact sports and a minimum 21-day interval for returning to play.

They emphasise a conservative approach to repeated concussions within a season and acknowledge ongoing research on chronic traumatic encephalopathy (CTE) and its association with repetitive head trauma. Dr Cowen highlights that, in the current absence of predictive tools, a cautious management approach should be employed.

References:
Concussion guidelines: https://www.connectivity.org.au/clinical-guidance/health-guidelines/Concussion Fact Sheets: https://www.connectivity.org.au/guidance-for-clinicians/fact-sheets/Free short concussion courses: https://www.connectivity.org.au/courses/State Head Injury Unit Concussion Program: https://www.nmhs.health.wa.gov.au/Hospitals-and-Services/Public-Health/Head-Injury/ConcussionmTBI Healthpathway: https://wa.communityhealthpathways.org/246668.htmVestibular oculomotor screening (VOMS): https://www.youtube.com/watch?v=CJF6kJcFGqESport-related concussion: https://sma.org.au/resources/concussion/

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.
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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

In this episode of The Good GP, host Dr Anna Mullins welcomes back Dr Chris Conyard, an upper limb surgeon based in Brisbane, to discuss elbow tendinopathies. He shares his expertise on the natural history of elbow tendinopathies, their examination, and effective management strategies.
They begin with an overview of elbow tendinopathies, including their prevalence, clinical presentation, and challenges associated with treatment. Dr Conyard highlights the importance of rest and specific eccentric loading exercises in rehabilitation and explains the typical clinical course.
Delving into the physical examination of the elbow, touching on specific tests such as Cozen's test to diagnose tennis elbow and techniques for identifying golfer's elbow. They discuss the relevance of imaging in diagnosis, specifically when it should be considered, particularly in cases of suspected arthritis or when initial management fails.

Dr Conyard also provides valuable insights into non-operative management, including the use of topical NSAIDs, physiotherapy, and braces. He advises caution against steroid injections and suggests PRP injections as a potential second-line treatment. Concluding with advice on when to refer patients to specialists and the utility of specific imaging and nerve conduction studies.

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

In this episode, Dr Anna Mullins speaks with Dr Chris Conyard, an orthopaedic surgeon with a fellowship in upper limb surgery, about the management of rotator cuff tears and frozen shoulders.
Dr Conyard sheds light on the natural history of shoulder conditions, particularly the prevalence and progression of rotator cuff tears. He highlights the significance of various risk factors, including hand dominance, manual labour, diabetes, and smoking. Dr Conyard also discusses the impact of muscle atrophy and fatty infiltration on surgical outcomes.
Providing a detailed overview of the shoulder examination for rotator cuff tears, covering essential tests such as the supraspinatus test, external rotation test, and subscapularis tests. Dr Conyard emphasises the role of functional assessment and the importance of early intervention in acute tears.

They also covered imaging and first-line treatments, including the use of steroid injections. Dr Conyard explains when to consider steroid injections and the implications of repeat injections. He offers guidance on when GPs should refer patients to specialists, particularly in cases of acute tears, symptomatic progression, and failed non-operative interventions.

Dr Conyard addresses the management of frozen shoulder, highlighting the usefulness of steroid injections and hydrodilatation, particularly in the initial phases of the condition. He also discusses when to consider referral for surgical interventions such as manipulation under anaesthesia (MUA) and arthroscopic release, backed by evidence from the UK Frost Trial.

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

In this episode, Dr Krystyna de Lange is joined again by Dr Allison Hempenstall, a General Practitioner and Public Health Physician from Far North Queensland, to discuss acute post-streptococcal glomerulonephritis (APSGN).
Dr Hempenstall begins by defining APSGN and explaining how it is an acute autoimmune kidney condition triggered by a group A strep (GAS) infection. She elaborates on the socio-economic risk factors and the presence of nephrotoxic strains of group A strep that increase susceptibility to APSGN. Comparison is made with acute rheumatic fever, noting both similarities and differences.
Covering the classic triad of symptoms for APSGN – hypertension, haematuria, and oedema – and how to diagnose the condition through clinical presentations and laboratory investigations. Dr Hempenstall explains the importance of identifying haematuria through urine analysis and performing necessary tests for recent strep infections and complement levels (C3 and C4).
They then move to the appropriate management strategies, including the use of intramuscular penicillin for eradicating strep and symptom management through antihypertensives and fluid management. Dr Hempenstall emphasises the necessity of involving paediatricians for cases requiring hospitalisation and mentioning that any persistent hypertension in children should be addressed promptly.

Lastly, outlining longer-term follow-up protocols, stressing the importance of regular blood pressure and urine checks post-diagnosis and the role of health education in preventing future occurrences. Special attention to the importance of contact tracing and prophylactic measures for household contacts in order to curb the spread of nephrotoxic strains of group A strep.

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

In this episode of The Good GP, host Dr Krystyna de Lange is joined by Dr Allison Hempenstall, a General Practitioner and Public Health Physician from Far North Queensland, to discuss acute rheumatic fever and rheumatic heart disease.
Dr Hempenstall begins by defining acute rheumatic fever as an immunological response to group A streptococcus, which can lead to a constellation of symptoms impacting the heart and joints. She explains the progression from acute rheumatic fever to rheumatic heart disease, a condition characterised by permanent valvular damage to the heart following of acute rheumatic fever.
Outlining the symptoms and diagnostic criteria for acute rheumatic fever, referencing the Jones criteria and the helpful tools available such as the Rheumatic Heart Disease Guidelines and the ARF and RHD app. She also provides insight into the criteria's major and minor manifestations, including carditis, polyarthritis, Sydenham’s chorea, Erythema marginatum, subcutaneous nodules, fever, elevated inflammatory markers, and prolonged PR interval on ECG.

Highlighting the necessary steps for diagnosing acute rheumatic fever, including auscultating the heart, documenting fever, performing a 12-lead ECG, and obtaining relevant blood tests. The need for bedside documentation and comprehensive differential diagnosis is also covered.

In terms of management, Dr Hempenstall focused on creating a culturally safe environment and initiating treatment for suspected acute rheumatic fever promptly. This includes administering intramuscular penicillin and managing symptoms with paracetamol, with specialist consultation as needed. She also stresses the importance of early echocardiograms and the involvement of public health units.

For long-term management, Dr Hempenstall discussed the necessity of secondary prophylaxis with penicillin injections and regular echocardiograms. She emphasises the continuing role of primary care practitioners in follow-up care, ensuring adherence to prophylaxis schedules, and coordinating ongoing specialist reviews and yearly dental checks.

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

In this episode of The Good GP, host Dr Krystyna de Lange welcomes back Dr Tim Jones, a General Practitioner and medical educator with a special interest in general paediatrics. Dr Jones shares his expertise on toddler sleep challenges, providing valuable insights and practical advice for GPs on how to address common sleep issues in young children.
Dr Jones discusses the variability of toddler sleep, emphasising the importance of sleep quality over quantity. He explains that while the average three-year-old requires about 12 hours of sleep per night, this can range from as little as nine hours to as much as 15 hours. The focus is on ensuring that the child is happy, healthy, and well-rested.
Dr Jones talks on the common presentations of toddler sleep issues in a general practice setting. He discusses the importance of thorough history-taking and screening for underlying medical conditions that might affect sleep, such as obstructive sleep apnea, eczema, and allergies. He emphasises the role of family dynamics, daytime sleep patterns, screen use, sugar intake, and physical activity in influencing sleep behaviour.
Various sleep strategies are explored, including addressing nighttime fears, managing dependency on specific items or people, and handling early morning wake-ups. Dr Jones highlights techniques like worry boxes, monster traps, and the "camping out" method to help children feel safe and transition to independent sleep.

Addressing the cautious use of pharmacological interventions, particularly melatonin, emphasising the lack of long-term safety data and potential side effects. He advises focusing on behavioural and environmental techniques before considering medication.

Dr Jones shares a valuable resource for practitioners: the Murdoch Children's Research Institute's "Sleep with Kip" website,
(https://sleepwithkip.com/) which offers evidence-based resources to support early childhood sleep.

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