The podcast from The BMJ that tackles the everyday challenges of being a GP
Burnout with Rachel Morris, Cat Chatfield and Abi Rimmer
Burnout has become something of a buzzword recently, but has now been officially classified as a syndrome caused by the workplace. Over the course of the pandemic, clinicians have been under more stress than ever, and evidence shows that burned out doctors are more likely to make medical errors.
As the pressure being piled onto GPs, and other medical professionals, is only increasing, the adage of ‘put your own oxygen mask on first’ has never been more apt, but many of us feel that we simply do not have the time or energy to devote to self-care. In this week’s episode, we discuss how to recognise the early signs of burnout, and how struggling with stress can feel like a personal failure.
We also talk about practical measures we can take to build resilience within teams, and to safeguard our own mental health, in order to help lessen the burden on individuals and on healthcare systems more widely.
Rachel Morris is a GP and educator, leading training courses in leadership and resilience, and she is also the host of the You Are Not a Frog podcast.
Cat Chatfield is the research integrity editor for The BMJ, and the wellbeing campaign lead, as well as being a ‘resting’ GP. She hosts the BMJ Wellbeing podcast.
Abi Rimmer is a reporter, and the editor for BMJ Careers. She co-hosts the BMJ Wellbeing podcast with Cat.
Health anxiety with Guy Edwards and Helen & Peter Tyrer
In general practice, doctors commonly see patients who are experiencing varying degrees of health anxiety, which can be difficult to navigate. GPs often want to offer reassurance, but reassurance can be like a drug to these patients: the more reassurance they receive, the more they need. In this week’s episode, we discuss how new technology which allows patients to check symptoms at home (such as pulse oximeters) may increase anxiety levels, and how our stock phrase “keep an eye on it” may be the worst thing we could say to patients with health anxiety. We also talk about the therapeutic value of a GP visit, and the importance of letting anxious patients know that all of their symptoms – physical and mental – will be taken seriously.
Guy Edwards is a patient who developed health anxiety around five years ago.
Helen Tyrer is a former GP, a senior research fellow at Imperial College London and is the author of ‘Tackling Health Anxiety: A CBT Handbook’.
Peter Tyrer is a professor of Community Psychiatry in the Centre for Mental Health in the Division of Experimental Medicine at Imperial College London.
Long Breath - Whitney Robinson on getting out the vaccines
In this episode, we're bringing you the full interview, a deep breath, with Whitney Robinson, a social epidemiologist and associate professor at UNC Chapel Hill.
Whitney gives us her take on how we should be thinking about risk when it comes to covid-19 infection and vaccine rollout. This is a nuanced conversation about the health and economic disparities of covid-19 the consequences of failing to reach the most vulnerable groups, and the importance of tackling this from a community level.
GPs vs. surgeons with Clara Munro and Sarah Robinson
There is a common perception of surgery that it’s an old boys’ club, and that anyone joining the profession is expected to match the archetypal personality type in order to fit in. Whilst this is starting to change in some specialities, it does still present a challenge, especially to junior staff trying to establish themselves. The relationship between primary and secondary care can be quite remote, and approaches towards patient care can sometimes seem at odds with each other.
In this week’s episode, we discuss the paradigm shift that COVID-19 has caused in the management of specialist consultations, as well as the obstacles to having successful open conversations between GPs and specialists, and how we might overcome them in order to provide better care for patients. We also ask, should we refer a patient with a suspected hernia for an ultrasound?
Clara Munro is a general surgeon based in the North East of England and a clinical fellow at the Faculty of Medical Leadership and Management. She is also the editorial registrar at The BMJ.
Sarah Robinson is an upper GI surgeon at the Northumbria Healthcare NHS Foundation Trust. Her areas of interest include hernia surgery and upper GI cancers.
Vaccines and headaches - with Heather Angus-Leppan and Whitney Robinson
Two topics currently being hotly discussed in the media and in clinical practice are headaches after the COVID vaccine, and the impact that structural racism is having on vaccine uptake.
Headache and fever are common symptoms after a vaccination, but there are concerns about the potential link between the AstraZeneca vaccine and blood clots, and these concerns, exacerbated by the recent frenzy of media coverage, may be damaging the general public’s faith in the vaccination programme, and impacting uptake.
In this week’s episode, we discuss how GPs may safely assess for cerebral venous sinus thrombosis (CSVT) in a patient presenting with a headache post vaccine, and the difficulty of gauging the scale of the risk of blood clots. We also talk about the controversial Sewell Report, which concluded that institutional racism is no longer a problem in the UK, and how, once we reach a post-COVID world, we need to focus more on wellbeing and work towards a fairer healthcare system for all.
Heather Angus-Leppan is a consultant neurologist, and epilepsy lead at the Royal Free London NHS Foundation Trust, as well as an honorary senior lecturer at UCL and Imperial College London.
Whitney Robinson is an associate professor of epidemiology in the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill. She is also the co-host of the Acadames podcast https://www.acadamespodcast.com/
- "Black people need better vaccine access, not better vaccine attitudes" by Rhea Boyd, https://www.nytimes.com/2021/03/05/opinion/us-covid-black-people.html
- "The health-care industry doesn't want to talk about this single word," by Ron Wyatt, https://www.washingtonpost.com/opinions/2021/04/05/health-care-racism-medicine/
- "The Sewell report cited my work - just not the parts highlighting structural racism," by Michael Marmot, https://www.theguardian.com/commentisfree/2021/apr/07/sewell-report-structural-racism-research
- "Black Memes Matter: #LivingWhileBlack With Becky and Karen," by Apryl Williams, https://journals.sagepub.com/doi/10.1177/2056305120981047
Remote prescribing with Geva Greenfield and Benedict Hayhoe
The past year has seen an increase in antibiotic prescriptions, especially for broad-spectrum antibiotics. This might be due to the rise in teleconsultations, which limit the ability to examine patients, causing GPs to experience higher levels of uncertainty in making diagnoses.
This week, we discuss the impact that COVID-19, and COVID tests, have had on access to healthcare, the risk of antimicrobial resistance, and how the pandemic has altered the presentation and case mix seen in GP surgeries. With teleconsulting likely here to stay, how do we adjust to the changes in primary care provision, in order to prescribe with confidence? And how do we become good antibiotic stewards?
Geva Greenfield is a research fellow in the Department of Primary Care & Public Health at Imperial College London’s School of Public Health. His research focuses on primary care and health policy, and big healthcare data analytics.
Benedict Hayhoe is a London-based GP, and a clinical lecturer in the Department of Primary Care & Public Health at Imperial College London’s School of Public Health. His research interests include digital health and antimicrobial resistance.
Armitage A, Nellums L. Antibiotic prescribing in general practice during COVID-19. The Lancet Infectious Diseases 2020. https://doi.org/10.1016/S1473-3099(20)30917-8
de Lusignan S, Joy M, Sherlock J, Tripathy M, van Hecke O, Gbinigie O et al. PRINCIPLE trial demonstrates scope for in-pandemic improvement in primary care antibiotic stewardship. medRxiv. 2021. https://doi.org/10.1101/2021.02.02.21250902
Han SM, Greenfield G, Majeed A, Hayhoe B. Impact of Remote Consultations on Antibiotic Prescribing in Primary Health Care: Systematic Review. Journal of Medical Internet Research 2020; 22(11):e23482. https://doi.org/10.2196/23482
Hayhoe B, Butler C, Majeed A, Saxena S. Telling the truth about antibiotics: benefits, harms and moral duty in prescribing for children in primary care. Journal of Antimicrobial Chemotherapy 2018; 73(9):2298-2304. https://doi.org/10.1093/jac/dky223
Hayhoe B, Greenfield G, Majeed A. Is it getting easier to obtain antibiotics in the UK? British Journal of General Practice 2019; 69(679):54-55. https://doi.org/10.3399/bjgp19X700829
Morrell L, Buchanan J, Roope L, Pouwels K, Butler C, Hayhoe B et al.. Delayed Antibiotic Prescription by General Practitioners in the UK: A Stated-Choice Study. Antibiotics 2020; 9(608). https://doi.org/10.3390/antibiotics9090608
Shah S, Wordley, Thompson W.. How did COVID-19 impact on antibiotic prescribing across England? British Dental Journal 2020; 229(9):601-604. https://doi.org/10.1038/s41415-020-2336-6
van de Pol A, Boeijen J, Venekamp R, Platteel T, Damoiseaux R, Kortekaas M et al.. Impact of the COVID-19 Pandemic on Antibiotic Prescribing for Common Infections in The Netherlands: A Primary Care-Based Observational Cohort Study. Antibiotics 2021; 10(196). https://doi.org/10.3390/antibiotics10020196
Zhu N, Aylin P, Rawson T, Gilchrist M, Majeed A, Holmes A.. Investigating the impact of COVID-19 on primary care antibiotic prescribing in North West London across two epidemic waves. Clinical Microbiology and Infection 2021. https://doi.org/10.1016/j.cmi.2021.02.007
I love this podcast - it talks about important issues and manages to throw in some very useful up to date information but still remain lighthearted and fun to listen too. I love that the hosts don’t take themselves too seriously and are able to have a joke together. Always puts a smile on my face, thank you.
Ideal for busy GPs
The presenters have found a great way of providing accurate information relevant for GPs whilst making this podcast very easy to listen to during some busy times. Thank-you!
Relevant topics, informative but informal, serious but not boring