 https://drjustincoleman.files.wordpress.com/2020/04/alcohol_gp_sceptics_final.mp3 (43 mins)  GP team Liz Sturgiss and Justin Coleman bring the GP Sceptics podcast back to life, and this time it’s all about alcohol…but not in a good way. Liz leads a Monash University project called REACH — for you, that’s “Reducing alcohol-related harm in General Practice”. As usual, I’m just the guy who asks the dumb questions on your behalf, as you while away your time during coronavirus lockdown. This podcast is all about encouraging behaviour change. The experts in the podcast are Liz herself (you’ll recognise her distinctive voice and smart questions) and two of our favourite GP-experts (see below) who have built their careers on maximising the chances of someone reducing their alcohol intake as a result of an ordinary consultation with their GP. Nothing fancy, but if every GP got 10 per cent better at it, the effect on Australia’s physical and mental health would be formidable. Dr Paul Grinzi is a GP in North Melbourne who educates about alcohol and other drugs for the RACGP. We ask him about his tricks of the trade when it comes to taking an accurate history of alcohol consumption, and he describes how to subtly prompt patients to come up with their own ideas of what might motivate them to change. I loved his concept of GPs being ‘actively curious’ in what makes the patient tick. Listen in to find out how to become a ‘travel agent of change’. Dr Hester Wilson is a Sydney GP, a lead clinician in the GLAD (GP Liaison in Alcohol and other Drug) Project, and Chair of the RACGP Addiction Medicine Network. She discusses the new Australian Guidelines on reducing health risks from drinking alcohol (2020). Although you may have never thought of yourself as a cheerleader, Hester describes how GPs should cheer people on towards healthier behaviours. Finally, Liz takes me to task with a ‘What would Justin do?’ dilemma, which quite frankly was my easiest yet. I blitzed it! Happy listening to your 43 minutes of GP education. Soundcloud and Apple links will be added soon.

<a href="https://drjustincoleman.files.wordpress.com/2020/04/alcohol_gp_sceptics_final.mp3" rel="nofollow" target="_blank">https://drjustincoleman.files.wordpress.com/2020/04/alcohol_gp_sceptics_final.mp3</a> (43 mins) <a href="https://soundcloud.com/justin-coleman-31/podcast-14-alcohol-gps-reducing-harms" rel="noopener nofollow" target="_blank"></a><a href="https://soundcloud.com/justin-coleman-31/podcast-14-alcohol-gps-reducing-harms" rel="noopener nofollow" target="_blank"></a> GP team Liz Sturgiss and Justin Coleman bring the GP Sceptics podcast back to life, and this time it’s all about alcohol…but not in a good way. Liz leads a Monash University project called <a href="https://www.monash.edu/medicine/spahc/general-practice/research-projects/reach" rel="nofollow" target="_blank">REACH</a> — for you, that’s “Reducing alcohol-related harm in General Practice”. As usual, I’m just the guy who asks the dumb questions on your behalf, as you while away your time during coronavirus lockdown. This podcast is all about encouraging behaviour change. The experts in the podcast are Liz herself (you’ll recognise her distinctive voice and smart questions) and two of our favourite GP-experts (see below) who have built their careers on maximising the chances of someone reducing their alcohol intake as a result of an ordinary consultation with their GP. Nothing fancy, but if every GP got 10 per cent better at it, the effect on Australia’s physical and mental health would be formidable. <a href="https://www.facebook.com/DrGrinzi/" rel="noopener nofollow" target="_blank">Dr Paul Grinzi</a> is a GP in North Melbourne who educates about alcohol and other drugs for the RACGP. We ask him about his tricks of the trade when it comes to taking an accurate history of alcohol consumption, and he describes how to subtly prompt patients to come up with their own ideas of what might motivate them to change. I loved his concept of GPs being ‘actively curious’ in what makes the patient tick. Listen in to find out how to become a ‘travel agent of change’. <a href="https://www.linkedin.com/in/drhesterwilson/?originalSubdomain=au" rel="noopener nofollow" target="_blank">Dr Hester Wilson</a> is a Sydney GP, a lead clinician in the GLAD (GP Liaison in Alcohol and other Drug) Project, and Chair of the RACGP Addiction Medicine Network. She discusses the new <a href="https://www.nhmrc.gov.au/health-advice/alcohol" rel="noopener nofollow" target="_blank">Australian Guidelines on reducing health risks from drinking alcohol (2020)</a>. Although you may have never thought of yourself as a cheerleader, Hester describes how GPs should cheer people on towards healthier behaviours. Finally, Liz takes me to task with a ‘What would Justin do?’ dilemma, which quite frankly was my easiest yet. I blitzed it! Happy listening to your 43 minutes of GP education. Soundcloud and Apple links will be added soon.

Podcast 14: Alcohol-related harm in general practice

https://drjustincoleman.files.wordpress.com/2018/11/pod-13-quinn_final.mp3  Few ever talk about it, but it’s not just doctors who are courted by the medical industry. Nurses are also frequently targeted when it comes to promoting pharmaceuticals and medical devices. Barely anyone except Quinn Grundy talks about it, in fact, so Liz Sturgiss and Justin Coleman point the microphone at this registered nurse who did her PhD on that very topic. The extent of what Quinn reveals will surprise you…it most certainly surprised all the nurse managers who were sure she would find nothing when she started digging. From surgical devices to wound dressings and pharmaceutical purchasing committees, it turns out nurses have far more influence on where money gets spent than most people assume, not least the nurses themselves. The only ones not surprised are the companies who have been pouring substantial resources into reps educating nurses, thereby ensuring their brand features prominently when it comes to spending taxpayers or patients’ money. Unlike marketing to doctors, there are no legal restrictions to marketing to most nurses, and few health services have even considered the issue. I know nurses at my general practice continue to see ‘educational’ reps who promote expensive wound dressings, glucometers and other devices, a full 10 years after our GPs stopped seeing reps altogether. The discussions around the ethics of this seem to be a decade behind, within a nursing profession which is otherwise such a champion at the forefront of promoting best practice. Dr Quinn Grundy is a postdoctoral research assistant at the Charles Perkins Centre at the University of Sydney, soon to assume a faculty position at the University of Toronto. She has just launched her wonderfully titled book Infiltrating Healthcare: How Marketers Work Underground to Influence Nurses   [The code DNB290818 gives a 15% discount] Quinn mentions the dataset  Pharmaceutical industry payments to healthcare professionals which is my go-to database for discovering the degree of links between doctors quoted in media articles and the pharmaceutical industry. That dataset was almost going to sit on my website here, actually, after a friend of mine collated all the reports mandated under the Medicines Australia transparency arrangements. However, I figured the University of Sydney had better lawyers and thicker skin, so I facilitated its publication there. Also in the podcast, Liz delves into the Therapeutic Guidelines series and finds they come up clean as a whistle when it comes to independent expertise. Such a fantastic evidence-based resource for prescribers! Justin interviewed Susan Phillips, the CEO of eTG, at the recent GP18 conference. In the final segment we look at the latest controversy from wonderful troublemaker John Ioannidis who has dreamed up a world where professional associations don’t get to author their own guidelines.

<a href="https://drjustincoleman.files.wordpress.com/2018/11/pod-13-quinn_final.mp3" rel="nofollow" target="_blank">https://drjustincoleman.files.wordpress.com/2018/11/pod-13-quinn_final.mp3</a> <a href="https://soundcloud.com/justin-coleman-31/gp-sceptics-podcast-13-pharma-courts-nurses-too" rel="nofollow" target="_blank"></a> Few ever talk about it, but it’s not just doctors who are courted by the medical industry. Nurses are also frequently targeted when it comes to promoting pharmaceuticals and medical devices. Barely anyone except Quinn Grundy talks about it, in fact, so Liz Sturgiss and Justin Coleman point the microphone at this registered nurse who did her PhD on that very topic. The extent of what Quinn reveals will surprise you…it most certainly surprised all the nurse managers who were sure she would find nothing when she started digging. From surgical devices to wound dressings and pharmaceutical purchasing committees, it turns out nurses have far more influence on where money gets spent than most people assume, not least the nurses themselves. The only ones not surprised are the companies who have been pouring substantial resources into reps educating nurses, thereby ensuring their brand features prominently when it comes to spending taxpayers or patients’ money. Unlike marketing to doctors, there are no legal restrictions to marketing to most nurses, and few health services have even considered the issue. I know nurses at my general practice continue to see ‘educational’ reps who promote expensive wound dressings, glucometers and other devices, a full 10 years after our GPs stopped seeing reps altogether. The discussions around the ethics of this seem to be a decade behind, within a nursing profession which is otherwise such a champion at the forefront of promoting best practice. Dr Quinn Grundy is a postdoctoral research assistant at the Charles Perkins Centre at the University of Sydney, soon to assume a faculty position at the University of Toronto. She has just launched her wonderfully titled book <a href="http://www.footprint.com.au/product-detail.asp?SubSection=%27grundy%27&amp;product=9781421426754&amp;ParentPage=product%2Dlisting%2Easp%3Fkeywords%3Dgrundy%26scope%3Dbooks%26Category%3D" rel="nofollow" target="_blank">Infiltrating Healthcare: How Marketers Work Underground to Influence Nurses</a>   [The code DNB290818 gives a 15% discount] Quinn mentions the dataset <a href="https://researchdata.ands.org.au/968458/968458" rel="noopener nofollow" target="_blank"> Pharmaceutical industry payments to healthcare professionals</a> which is my go-to database for discovering the degree of links between doctors quoted in media articles and the pharmaceutical industry. That dataset was almost going to sit on my website here, actually, after a friend of mine collated all the reports mandated under the Medicines Australia transparency arrangements. However, I figured the University of Sydney had better lawyers and thicker skin, so I facilitated its publication there. Also in the podcast, Liz delves into the <a href="https://tgldcdp.tg.org.au/etgcomplete" rel="noopener nofollow" target="_blank">Therapeutic Guidelines</a> series and finds they come up clean as a whistle when it comes to independent expertise. Such a fantastic evidence-based resource for prescribers! Justin interviewed Susan Phillips, the CEO of eTG, at the recent GP18 conference. In the final segment we look at the latest controversy from wonderful troublemaker <a href="https://en.wikipedia.org/wiki/John_Ioannidis" rel="noopener nofollow" target="_blank">John Ioannidis</a> who has dreamed up a world where professional associations don’t get to author their own guidelines.

GP Sceptics podcast 13: Nurses’ conflicts-of-interest

Resilience

By Kat Ritchie https://drjustincoleman.files.wordpress.com/2017/10/pod12_final.mp3  What keeps a doctor resilient, when dealing with a high-pressure job helping patients who are distressed and traumatised? How can doctors balance empathy with self-care? Does easing a patient’s burden imply carrying it for them? Dr Genevieve Yates teaches the art of resilience to doctors around the nation, and here we distil one podcast-worth of her wisdom. Listen to it after a long day at work, or when you’re feeling vulnerable. Even better, listen in bed, where Justin’s soporific opinions will guide you towards a replenishing sleep. Look after yourself, folks. In Liz’s Special Source, Liz takes a look at the funding and influences behind ‘Therapeutic Guidelines’ — hint: it comes out clean. Liz reveals her pin-up nerdy-researcher boy (Justin’s is Ben Goldacre), and we invite Dr Google into the GP surgery. All this and more, in our final podcast for this ‘RACGP Year’ (October to October). NEXT UP will be our live podcast at the annual RACGP conference in Melbourne. (Yes, that IS Justin’s photo on that link page. My, doesn’t he look worth listening to!)  We invite all of GP17 to join us in an hour of fun as we go live for the first time on the Saturday morning, at GP Sceptics live podcast – Interpreting media headlines. Our Guest: Dr Genevieve Yates is a multi-talented GP who does a little bit of everything. She is the RACGP Queensland Censor, teacher for MDA National, facilitator for the Black Dog Institute, was previously Assoc Director of Training for NCGPT, and has won Australia’s Medical Educator of the Year. She is an accomplished author, plays violin in the Australian Doctors’ Orchestra, acts on TV and on stage, and co-wrote GP the Musical. Quite frankly, she makes us sick. References: Balme E, Gerada C, Page L. Doctors need to be supported, not trained in resilience BMJ Careers, Sept 2015 Kearns H, Gardiner M. The Ultimate Time Management Guide for GPs (and in fact anyone in general practice) Published by Thinkwell Beyond Blue National Mental Health Survey of Doctors and Medical Students 2013 Heneghan C, Goldacre B, Mahtani K. Why clinical trial outcomes fail to translate into benefits for patients  Interesting reading:  Doctors’ Mental Health Program A Beyond Blue program for health services

By Kat Ritchie <a href="https://drjustincoleman.files.wordpress.com/2017/10/pod12_final.mp3" rel="nofollow" target="_blank">https://drjustincoleman.files.wordpress.com/2017/10/pod12_final.mp3</a> <a href="https://soundcloud.com/justin-coleman-31/gp-sceptics-podcast-12-resilience" rel="noopener nofollow" target="_blank"></a> What keeps a doctor resilient, when dealing with a high-pressure job helping patients who are distressed and traumatised? How can doctors balance empathy with self-care? Does easing a patient’s burden imply carrying it for them? Dr Genevieve Yates teaches the art of resilience to doctors around the nation, and here we distil one podcast-worth of her wisdom. Listen to it after a long day at work, or when you’re feeling vulnerable. Even better, listen in bed, where Justin’s soporific opinions will guide you towards a replenishing sleep. Look after yourself, folks. In Liz’s Special Source, Liz takes a look at the funding and influences behind ‘Therapeutic Guidelines’ — hint: it comes out clean. Liz reveals her pin-up nerdy-researcher boy (Justin’s is Ben Goldacre), and we invite Dr Google into the GP surgery. All this and more, in our final podcast for this ‘RACGP Year’ (October to October). NEXT UP will be our live podcast at the <a href="http://gp17.com.au/program/" rel="noopener nofollow" target="_blank">annual RACGP conference in Melbourne.</a> (Yes, that IS Justin’s photo on that link page. My, doesn’t he look worth listening to!)  We invite all of GP17 to join us in an hour of fun as we go live for the first time on the Saturday morning, at <a href="http://gp17.com.au/program-saturday/#event-204" rel="noopener nofollow" target="_blank">GP Sceptics live podcast – Interpreting media headlines</a>. Our Guest: Dr Genevieve Yates is a multi-talented GP who does<a href="https://genevieveyates.com/about/" rel="noopener nofollow" target="_blank"> a little bit of everything</a>. She is the RACGP Queensland Censor, teacher for MDA National, facilitator for the Black Dog Institute, was previously Assoc Director of Training for NCGPT, and has won Australia’s Medical Educator of the Year. She is an accomplished author, plays violin in the Australian Doctors’ Orchestra, acts on TV and on stage, and co-wrote GP the Musical. Quite frankly, she makes us sick. References: Balme E, Gerada C, Page L. <a href="http://careers.bmj.com/careers/advice/Doctors_need_to_be_supported,_not_trained_in_resilience" rel="noopener nofollow" target="_blank">Doctors need to be supported, not trained in resilience</a> BMJ Careers, Sept 2015 Kearns H, Gardiner M. <a href="http://www.ithinkwell.com.au/the-ultimate-time-management-guide" rel="noopener nofollow" target="_blank">The Ultimate Time Management Guide for GPs (and in fact anyone in general practice)</a> Published by Thinkwell Beyond Blue <a href="https://www.beyondblue.org.au/docs/default-source/research-project-files/bl1148-report---nmhdmss-exec-summary_web.pdf?sfvrsn=4" rel="noopener nofollow" target="_blank">National Mental Health Survey of Doctors and Medical Students</a> 2013 Heneghan C, Goldacre B, Mahtani K. <a href="https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-017-1870-2" rel="noopener nofollow" target="_blank">Why clinical trial outcomes fail to translate into benefits for patients </a> Interesting reading:  <a href="https://www.beyondblue.org.au/about-us/about-our-work/workplace-mental-health/about-the-doctors-mental-health-program" rel="noopener nofollow" target="_blank">Doctors’ Mental Health Program</a> A Beyond Blue program for health services

GP Sceptics podcast 12: Doctors’ resilience

Unexplained, by Kat Ritchie https://drjustincoleman.files.wordpress.com/2017/08/pod11_timo_completel1.mp3  Medically unexplained symptoms (MUS) are physical symptoms not sufficiently explained by an underlying medical condition after adequate examination and investigation, over a period of time (usually defined in months, rather than weeks). GPs face patients in this situation regularly, and not surprisingly, find it difficult to deal with. Our training focuses on reaching elusive diagnoses through the scientific method of testing and discarding hypotheses until – eureka! – we land upon the right one. But what happens when, like the stockade, that eureka fails us? And if you think that’s frustrating for the diagnostician, try being the patient! In this podcast, we interview a GP from the Netherlands who is at the forefront of this field. Dr Tim Olde Hartman was the lead author of the MUS guidelines (pdf) developed for the Dutch College of General Practitioners. The guide’s popularity soon made it clear that this is a universal problem around the world, nowhere more apparent than in general practice. When a series of specialist appointments have failed to diagnose a medical cause for a persistent symptom, the advice is inevitably “go back and see your GP”. This podcast is for those GPs. Liz was lucky enough to meet Tim Olde Hartman during a sabbatical to the Netherlands, where she teed up this podcast interview. In Liz’s Special Source segment, we discuss the wonderful HANDI guide – the RACGP Handbook of Non-Drug Interventions. Justin’s factoid “Null but not void” looks at the media’s responsibility to write articles about negative findings, not just positive ones. Enjoy! References: Dr Tim Olde Hartman’s profile at Radboud Institute for Health Sciences Olde Hartman T et al. NHG Guideline on Medically Unexplained Symptoms (MUS) Huisarts Wet 2013;56(5):222-30. den Boeft N et al. How should we manage adults with persistent unexplained physical symptoms? BMJ 2017;356:j268  RACGP The Handbook of Non-Drug interventions (HANDI): making effective non-drug treatments more visible and easier to use. Jaklevic M Null but not void: Why health journalists need to stop ignoring negative studies Health News Review, March 2017 Interesting reading: van Dessel N et al. Cochrane Systematic Review: Non-pharmacological interventions for somatoform disorders and medically unexplained physical symptoms (MUPS) in adults

Unexplained, by Kat Ritchie <a href="https://drjustincoleman.files.wordpress.com/2017/08/pod11_timo_completel1.mp3" rel="nofollow" target="_blank">https://drjustincoleman.files.wordpress.com/2017/08/pod11_timo_completel1.mp3</a> <a href="https://soundcloud.com/justin-coleman-31/gp-sceptics-podcast-11-unexplained-symptoms" rel="noopener nofollow" target="_blank"></a><a href="https://itunes.apple.com/us/podcast/gp-sceptics-podcast-11-medically-unexplained-symptoms/id1169245180?i=1000390868091&amp;mt=2" rel="noopener nofollow" target="_blank"></a> Medically unexplained symptoms (MUS) are physical symptoms not sufficiently explained by an underlying medical condition after adequate examination and investigation, over a period of time (usually defined in months, rather than weeks). GPs face patients in this situation regularly, and not surprisingly, find it difficult to deal with. Our training focuses on reaching elusive diagnoses through the scientific method of testing and discarding hypotheses until – eureka! – we land upon the right one. But what happens when, like the stockade, that eureka fails us? And if you think that’s frustrating for the diagnostician, try being the patient! In this podcast, we interview a GP from the Netherlands who is at the forefront of this field. Dr Tim Olde Hartman was the lead author of the <a href="https://www.nhg.org/sites/default/files/content/nhg_org/uploads/standaard/download/final_m102_solk_guideline_sk_mei13_0.pdf" rel="noopener nofollow" target="_blank">MUS guidelines (pdf)</a> developed for the Dutch College of General Practitioners. The guide’s popularity soon made it clear that this is a universal problem around the world, nowhere more apparent than in general practice. When a series of specialist appointments have failed to diagnose a medical cause for a persistent symptom, the advice is inevitably “go back and see your GP”. This podcast is for those GPs. Liz was lucky enough to meet Tim Olde Hartman during a sabbatical to the Netherlands, where she teed up this podcast interview. In Liz’s Special Source segment, we discuss the wonderful <a href="http://www.racgp.org.au/handi" rel="noopener nofollow" target="_blank">HANDI</a> guide – the RACGP Handbook of Non-Drug Interventions. Justin’s factoid “Null but not void” looks at the media’s responsibility to write articles about negative findings, not just positive ones. Enjoy! References: Dr Tim Olde Hartman’s <a href="http://www.rihs.nl/about-us/our-people/RIHSPi?pi=11288" rel="noopener nofollow" target="_blank">profile </a>at Radboud Institute for Health Sciences Olde Hartman T et al. <a href="https://www.nhg.org/sites/default/files/content/nhg_org/uploads/standaard/download/final_m102_solk_guideline_sk_mei13_0.pdf" rel="noopener nofollow" target="_blank">NHG Guideline on Medically Unexplained Symptoms (MUS) </a>Huisarts Wet 2013;56(5):222-30. den Boeft N et al. <a href="http://www.bmj.com/content/356/bmj.j268" rel="noopener nofollow" target="_blank">How should we manage adults with persistent unexplained physical symptoms?</a> BMJ 2017;356:j268 RACGP <a href="http://www.racgp.org.au/handi" rel="noopener nofollow" target="_blank">The Handbook of Non-Drug interventions</a> (HANDI): making effective non-drug treatments more visible and easier to use. Jaklevic M <a href="https://www.healthnewsreview.org/2017/03/negative-studies/" rel="noopener nofollow" target="_blank">Null but not void: Why health journalists need to stop ignoring negative studies</a> Health News Review, March 2017 Interesting reading: van Dessel N et al. Cochrane Systematic Review: <a href="http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD011142.pub2/abstract" rel="noopener nofollow" target="_blank">Non-pharmacological interventions for somatoform disorders and medically unexplained physical symptoms (MUPS) in adults</a>

GP Sceptics podcast 11: Medically Unexplained Symptoms

Mice-level research, by Kat Ritchie https://drjustincoleman.files.wordpress.com/2017/05/pod10_senior_full-edit.mp3  We invite Dr Tim Senior to reflect on being a GP for disadvantaged groups. He discusses General Practitioners at the Deep End, an initiative involving 100 general practices serving the most socio-economically deprived populations in Scotland. Tim works at Tharawal, an Aboriginal and Torres Strait Islander health service in Western Sydney, and is also a prolific writer and thought-leader in Australian general practice. Although Tim has never advertised the fact, @TimSenior plus @realDonaldTrump together have almost as many twitter followers as @KimKardashian. Justin calls out a couple of Australian researchers who overplayed a ‘breakthrough’ anti-ageing pill that has only been tested in mice.  In doing so, Justin happily overplays his own role in the subsequent Media Watch TV episode where he was (very briefly) shown raising an eyebrow about the miracle pill. And we introduce the new segment ‘Liz’s special source’. This segment is a chance for Liz to showcase a reliable, independent source of medical information. First up is the Trip Database, which Liz actually uses mid-consultation. Tim is wise, Liz is sharp, and Justin can only admire them both from the shallow end. References:  General Practitioners at the Deep End, University of Glasgow website Tim Senior on twitter Media love a miracle, Media Watch episode 3 April 2017, ABC television. Trip database, which describes itself as “a smart, fast tool for you to find high-quality clinical research evidence”. And we agree.

Mice-level research, by Kat Ritchie <a href="https://drjustincoleman.files.wordpress.com/2017/05/pod10_senior_full-edit.mp3" rel="nofollow" target="_blank">https://drjustincoleman.files.wordpress.com/2017/05/pod10_senior_full-edit.mp3</a> <a href="https://itunes.apple.com/us/podcast/gp-sceptics-podcast-10-gps-at-the-deep-end/id1169245180?i=1000385628453&amp;mt=2" rel="noopener noreferrer nofollow" target="_blank"></a><a href="https://soundcloud.com/justin-coleman-31/gp-sceptics-podcast-10-gps-at-the-deep-end" rel="noopener noreferrer nofollow" target="_blank"></a> We invite Dr Tim Senior to reflect on being a GP for disadvantaged groups. He discusses <a href="http://www.gla.ac.uk/researchinstitutes/healthwellbeing/research/generalpractice/deepend/" rel="noopener noreferrer nofollow" target="_blank">General Practitioners at the Deep End</a>, an initiative involving 100 general practices serving the most socio-economically deprived populations in Scotland. Tim works at Tharawal, an Aboriginal and Torres Strait Islander health service in Western Sydney, and is also a prolific writer and thought-leader in Australian general practice. Although Tim has never advertised the fact, <a href="https://twitter.com/timsenior" rel="noopener noreferrer nofollow" target="_blank">@TimSenior</a> plus @realDonaldTrump together have almost as many twitter followers as @KimKardashian. Justin calls out a couple of Australian researchers who overplayed a ‘breakthrough’ anti-ageing pill that has only been tested in mice.  In doing so, Justin happily overplays his own role in the subsequent Media Watch <a href="http://www.abc.net.au/mediawatch/transcripts/s4647548.htm" rel="noopener noreferrer nofollow" target="_blank">TV episode</a> where he was (very briefly) shown raising an eyebrow about the miracle pill. And we introduce the new segment ‘Liz’s special source’. This segment is a chance for Liz to showcase a reliable, independent source of medical information. First up is the Trip Database, which Liz actually uses mid-consultation. Tim is wise, Liz is sharp, and Justin can only admire them both from the shallow end. References:  <a href="http://www.gla.ac.uk/researchinstitutes/healthwellbeing/research/generalpractice/deepend/" rel="noopener noreferrer nofollow" target="_blank">General Practitioners at the Deep End</a>, University of Glasgow website <a href="https://twitter.com/timsenior" rel="noopener noreferrer nofollow" target="_blank">Tim Senior</a> on twitter <a href="http://www.abc.net.au/mediawatch/transcripts/s4647548.htm" rel="noopener noreferrer nofollow" target="_blank">Media love a miracle</a>, Media Watch episode 3 April 2017, ABC television. <a href="https://www.tripdatabase.com/" rel="nofollow" target="_blank">Trip database</a>, which describes itself as “a smart, fast tool for you to find high-quality clinical research evidence”. And we agree.

GP Sceptics podcast 10: GPs at the Deep End

Justin’s lycra legs, by Kat Ritchie https://drjustincoleman.files.wordpress.com/2017/04/pod9-final.mp3  Justin dons his finest lycra and tackles Dr George Crisp, WA chair of Doctors for the Environment Australia. How do health gains in the doctor’s surgery stack up against environmental and population-based interventions? Could the nanny state be good for our grandchildren, and does Liz actually believe in wind farm health conspiracies? Liz wonders if her recent public health-screening day with medical students did anyone any good, while Justin suspects that ego is, at least in his case, a dirty word. We encourage listeners to join Doctors for the Environment Australia  References: The Cost-Effectiveness of Environmental Approaches to Disease Prevention Chokshi D, Farle T. N Engl J Med 367;4 July 2012 Upstream or downstream? By medical student Victoria Smith Med J Aust 2015; 203 (10): 412-413

Justin’s lycra legs, by Kat Ritchie <a href="https://drjustincoleman.files.wordpress.com/2017/04/pod9-final.mp3" rel="nofollow" target="_blank">https://drjustincoleman.files.wordpress.com/2017/04/pod9-final.mp3</a> <a href="https://itunes.apple.com/us/podcast/gp-sceptics-podcast-9-the-environment/id1169245180?i=1000384493571&amp;mt=2" rel="nofollow" target="_blank"></a><a href="https://soundcloud.com/justin-coleman-31/gp-sceptics-podcast-9-the-environment" rel="nofollow" target="_blank"></a> Justin dons his finest lycra and tackles Dr George Crisp, WA chair of <a href="https://www.dea.org.au/" rel="nofollow" target="_blank">Doctors for the Environment Australia</a>. How do health gains in the doctor’s surgery stack up against environmental and population-based interventions? Could the nanny state be good for our grandchildren, and does Liz actually believe in wind farm health conspiracies? Liz wonders if her recent public health-screening day with medical students did anyone any good, while Justin suspects that ego is, at least in his case, a dirty word. We encourage listeners to join <a href="https://www.dea.org.au/" rel="nofollow" target="_blank">Doctors for the Environment Australia</a> References: <a href="http://www.nejm.org/doi/full/10.1056/NEJMp1206268#t=article" rel="nofollow" target="_blank">The Cost-Effectiveness of Environmental Approaches to Disease Prevention</a> Chokshi D, Farle T. N Engl J Med 367;4 July 2012 <a href="https://www.mja.com.au/journal/2015/203/10/upstream-or-downstream" rel="nofollow" target="_blank">Upstream or downstream?</a> By medical student Victoria Smith Med J Aust 2015; 203 (10): 412-413

GP Sceptics podcast 9: The Environment

‘Carrots &amp; Sticks’ by Kat Ritchie https://drjustincoleman.files.wordpress.com/2017/02/pod8-marketing_final.mp3  Doctors try to ‘sell’ behaviour change to patients, who are often reluctant to ‘buy’ the message. What tricks can we learn from the modern experts at selling? Justin and Liz bite the bitter bullet and enter the strange world of marketing. We grill Dr Ninya Maubach, whose former life involved a PhD in marketing, but who has now seen the light and is studying medicine at ANU. That’s a powerful combo when it comes to teaching doctors how to sell a message. Our starting point is a paper ‘Carrots, Sticks and Promises’, and it turns out that most of our attempts at behaviour change involve the least effective selling method: “I promise that if you stop this pleasurable thing today (e.g. smoking, lying on your couch), you will reap rewards in the future.” That message is pretty easy to trump (are we still allowed to use that word?), and plenty of full-time tobacco and food industry marketers know just how to trump it. Turns out the ‘stages of change’ model  we all learned (precontemplation, contemplation)may not be so useful after all.   References: Carrots, Sticks and Promises: a conceptual framework for the management of public health and social issue behaviors  Rothschild M, Journal of Marketing 1999 Stages of change model (Transtheoretical model) Wikipedia entry, accessed 2017 No Advertising Please campaign Coleman J et al, accessed 2017 One minute’s exercise – how much does it prolong your life? Inala Primary Care Journal Club, 2014 Thanks to Ninya Maubach (med student), Kat Ritchie (GP and artist)

‘Carrots &amp; Sticks’ by Kat Ritchie <a href="https://drjustincoleman.files.wordpress.com/2017/02/pod8-marketing_final.mp3" rel="nofollow" target="_blank">https://drjustincoleman.files.wordpress.com/2017/02/pod8-marketing_final.mp3</a> <a href="https://geo.itunes.apple.com/us/podcast/gp-sceptics-podcast-8-marketing/id1169245180?i=1000380981469&amp;mt=2" rel="nofollow" target="_blank"></a><a href="https://soundcloud.com/justin-coleman-31/gp-sceptics-podcast-8-marketing" rel="nofollow" target="_blank"></a> Doctors try to ‘sell’ behaviour change to patients, who are often reluctant to ‘buy’ the message. What tricks can we learn from the modern experts at selling? Justin and Liz bite the bitter bullet and enter the strange world of marketing. We grill <a href="https://www.linkedin.com/in/ninyamaubach/" rel="nofollow" target="_blank">Dr Ninya Maubach</a>, whose former life involved a PhD in marketing, but who has now seen the light and is studying medicine at ANU. That’s a powerful combo when it comes to teaching doctors how to sell a message. Our starting point is a paper ‘Carrots, Sticks and Promises’, and it turns out that most of our attempts at behaviour change involve the least effective selling method: “I promise that if you stop this pleasurable thing today (e.g. smoking, lying on your couch), you will reap rewards in the future.” That message is pretty easy to trump (are we still allowed to use that word?), and plenty of full-time tobacco and food industry marketers know just how to trump it. Turns out the ‘stages of change’ model  we all learned (precontemplation, contemplation)may not be so useful after all. References: <a href="http://classes.uleth.ca/200703/mgt3031e/carrotarticle%20-%20Social%20Marketing.pdf" rel="nofollow" target="_blank">Carrots, Sticks and Promises: a conceptual framework for the management of public health and social issue behaviors </a> Rothschild M, Journal of Marketing 1999 <a href="https://en.wikipedia.org/wiki/Transtheoretical_model" rel="nofollow" target="_blank">Stages of change model (Transtheoretical model)</a> Wikipedia entry, accessed 2017 <a href="http://noadvertisingplease.org/" rel="nofollow" target="_blank">No Advertising Please campaign</a> Coleman J et al, accessed 2017 <a href="https://ipcjc.wordpress.com/2014/02/13/one-minutes-exercise-life-extension/" rel="nofollow" target="_blank">One minute’s exercise – how much does it prolong your life?</a> Inala Primary Care Journal Club, 2014 Thanks to Ninya Maubach (med student), Kat Ritchie (GP and artist)

GP Sceptics podcast 8: Marketing

by Kat Ritchie   https://drjustincoleman.files.wordpress.com/2017/01/pod7_final.mp3  Just when you thought GP Sceptics put the E in evidence-based medicine, we pull the rug from underneath your trusting feet. Western Australian GP Casey Parker, of Broome Docs fame, joins our twosome to become the ‘third nerd’ – a role which fits him like a cardigan and a new pair of glasses. Casey delves into EBM’s dark recesses, where p-hackers subvert the concept of ‘significance’, and RCTs answer all the questions no one bothered asking. Justin discusses a hot-off-the-press systematic review revealing the over-optimism of doctors. And Liz? Liz invites us all aboard the EBM gravy train. Bonus nerd points for any listener who comments below correctly describing when affect is a noun and effect is a verb. This podcast is dedicated to the fond memory of the late Prof Gavin Mooney, editor of Evidence-based medicine in its place. Thanks to Dr Kat Ritchie for her brilliant artwork.  References: Dr Casey Parker hosts Broome Docs – full of educational podcasts for GPs! Casey describes his site as, “a single place for all you time-poor doctors to come and get quality education, clinical tips and interact with one another without having to search all over the internet. As a busy GP I am more than happy to stand on the shoulders of academic giants, I find the good ones have a great way of keeping the complex simple – just the way I like it.” Why Most Published Research Findings Are False Ioannidis J, PLOS Medicine 2005 Evidence-based medicine has been hijacked: a report to David Sackett Ioannidis J, Journal of Clinical Epidemiology, 2016 Angiotensin–Neprilysin Inhibition versus Enalapril in Heart Failure  NEJM, 2014 Alltrials; All Trials Registered | All Results Reported Clinicians’ expectations of the benefits and harms of treatments, screening, and tests: A systematic review Hoffmann T, Del Mar C, JAMA Internal Medicine 2017

by Kat Ritchie <a href="https://drjustincoleman.files.wordpress.com/2017/01/pod7_final.mp3" rel="nofollow" target="_blank">https://drjustincoleman.files.wordpress.com/2017/01/pod7_final.mp3</a> <a href="//geo.itunes.apple.com/us/podcast/gp-sceptics-podcast-7-ebm/id1169245180?i=1000380049548&amp;mt=2" rel="nofollow" target="_blank"></a><a href="https://soundcloud.com/justin-coleman-31/gp-sceptics-pod7-ebm-hijacked" rel="nofollow" target="_blank"></a> Just when you thought GP Sceptics put the E in evidence-based medicine, we pull the rug from underneath your trusting feet. Western Australian GP Casey Parker, of <a href="http://broomedocs.com/" rel="nofollow" target="_blank">Broome Docs</a> fame, joins our twosome to become the ‘third nerd’ – a role which fits him like a cardigan and a new pair of glasses. Casey delves into EBM’s dark recesses, where p-hackers subvert the concept of ‘significance’, and RCTs answer all the questions no one bothered asking. Justin discusses a hot-off-the-press systematic review revealing the over-optimism of doctors. And Liz? Liz invites us all aboard the EBM gravy train. Bonus nerd points for any listener who comments below correctly describing when affect is a noun and effect is a verb. This podcast is dedicated to the fond memory of the late Prof Gavin Mooney, editor of <a href="https://books.google.com.au/books?hl=en&amp;lr=&amp;id=0V2BAgAAQBAJ&amp;oi=fnd&amp;pg=PP1&amp;dq=Evidence-based+medicine+in+its+place.&amp;ots=L1nxUfZpUp&amp;sig=LD19ZjjSeQvhgDAyXz87DIF2PtU#v=onepage&amp;q=Evidence-based%20medicine%20in%20its%20place.&amp;f=false" rel="nofollow" target="_blank">Evidence-based medicine in its place.</a> Thanks to Dr Kat Ritchie for her brilliant artwork. References: Dr Casey Parker hosts <a href="http://broomedocs.com/" rel="nofollow" target="_blank">Broome Docs</a> – full of educational podcasts for GPs! Casey describes his site as, “a single place for all you time-poor doctors to come and get quality education, clinical tips and interact with one another without having to search all over the internet. As a busy GP I am more than happy to stand on the shoulders of academic giants, I find the good ones have a great way of keeping the complex simple – just the way I like it.” <a href="http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020124" rel="nofollow" target="_blank">Why Most Published Research Findings Are False</a> Ioannidis J, PLOS Medicine 2005 <a href="http://broomedocs.com/wp-content/uploads/2016/11/Letter-to-Sackett.pdf" rel="nofollow" target="_blank">Evidence-based medicine has been hijacked: a report to David Sackett</a> Ioannidis J, Journal of Clinical Epidemiology, 2016 <a href="http://www.nejm.org/doi/full/10.1056/NEJMoa1409077#t=article" rel="nofollow" target="_blank">Angiotensin–Neprilysin Inhibition versus Enalapril in Heart Failure </a> NEJM, 2014 <a href="http://www.alltrials.net/" rel="nofollow" target="_blank">Alltrials; All Trials Registered | All Results Reported</a> <a href="http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2596010" rel="nofollow" target="_blank">Clinicians’ expectations of the benefits and harms of treatments, screening, and tests: A systematic review</a> Hoffmann T, Del Mar C, JAMA Internal Medicine 2017

GP sceptics podcast 7: EBM Hijacked!

By Kat Ritchie https://drjustincoleman.files.wordpress.com/2016/12/pod-6-final-standard-qual.mp3  Liz shines when discussing her pet PhD topic – managing obesity in general practice. Nicely timed for Christmas. Which medications safely make us thinner, now amphetamines and tobacco have lost favour? And, if media images keep depicting Headless Fatties*, how can GPs raise the topic without adding to the stigma? Justin reveals that one of Australia’s biggest GP education companies is boasting it can change our prescribing habits at will – for a hefty fee. Build your own promotional campaign with Liz’s Magic Marketing, and discover the superpower Justin wishes he possessed but his family knows he doesn’t.  *Not our term – the podcast and link below place this memorable idiom in context. We wouldn’t insult Santa. References: Effects on Weight Reduction and Safety of Short-Term Phentermine Administration in Korean Obese People Yonsei Medical Journal, 2006 Headless fatties by Charlotte Cooper, 2007 Treating obesity seriously: when recommendations for lifestyle change confront biological adaptations Lancet, 2015. [But note authors’ multiple conflicts of interest] No Advertising Please campaign 2014 They wouldn’t do that, would they? The Medical Republic, 30 Nov 2016 World Obesity image bank Free usage for non-profit purposes

By Kat Ritchie <a href="https://drjustincoleman.files.wordpress.com/2016/12/pod-6-final-standard-qual.mp3" rel="nofollow" target="_blank">https://drjustincoleman.files.wordpress.com/2016/12/pod-6-final-standard-qual.mp3</a> <a href="https://geo.itunes.apple.com/us/podcast/gp-sceptics-podcast-6-obesity/id1169245180?i=1000379092721&amp;mt=2" rel="nofollow" target="_blank"></a><a href="https://soundcloud.com/justin-coleman-31/podcast-6-obesity-christmas-edition" rel="nofollow" target="_blank"></a> Liz shines when discussing her pet PhD topic – managing obesity in general practice. Nicely timed for Christmas. Which medications safely make us thinner, now amphetamines and tobacco have lost favour? And, if media images keep depicting Headless Fatties*, how can GPs raise the topic without adding to the stigma? Justin reveals that one of Australia’s biggest GP education companies is boasting it can change our prescribing habits at will – for a hefty fee. Build your own promotional campaign with Liz’s Magic Marketing, and discover the superpower Justin wishes he possessed but his family knows he doesn’t. *Not our term – the podcast and link below place this memorable idiom in context. We wouldn’t insult Santa. References: <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2687747/pdf/ymj-47-614.pdf" rel="nofollow" target="_blank">Effects on Weight Reduction and Safety of Short-Term Phentermine Administration in Korean Obese People</a> Yonsei Medical Journal, 2006 <a href="http://charlottecooper.net/publishing/digital/headless-fatties-01-07/" rel="nofollow" target="_blank">Headless fatties</a> by Charlotte Cooper, 2007 <a href="http://insanemedicine.com/wp-content/uploads/2015/11/Treating-obesity-seriously-when-recommendations-for-lifestyle-change-confront-biological-adaptations.pdf" rel="nofollow" target="_blank">Treating obesity seriously: when recommendations for lifestyle change confront biological adaptations </a>Lancet, 2015. [But note authors’ multiple conflicts of interest] <a href="http://noadvertisingplease.org/" rel="nofollow" target="_blank">No Advertising Please</a> campaign 2014 <a href="http://www.medicalrepublic.com.au/they-wouldnt-do-that-would-they/" rel="nofollow" target="_blank">They wouldn’t do that, would they?</a> The Medical Republic, 30 Nov 2016 <a href="http://www.imagebank.worldobesity.org/" rel="nofollow" target="_blank">World Obesity image bank</a> Free usage for non-profit purposes

GP Sceptics podcast 6: Obesity – Christmas edition

Ten thousand miles away…Australia’s closest lyme-carrying tick https://drjustincoleman.files.wordpress.com/2016/12/pod5-final-1.mp3  To coincide with today’s Senate inquiry on how to catch Lyme Disease in Australia (short version – you can’t), Justin and Liz interview infectious disease expert Prof Frank Bowden, from Australian National University. Frank swats aside a series of claims by Australian lyme disease proponents, but sounds stumped when Justin asks whether sentinel chickens or sentinel ticks are better at keeping watch. The conversation takes a few twists, lurching from false positive US lab results to unrelated matters such as whether having sex before the game enhances or detracts from sports performance. You’ll have to listen to find out the answer.* *Or you could always cheat and read the reference below   References: Infectious: A doctor’s eye-opening insights into contagious diseases Frank Bowden’s book, published 2016, including the chapter “Lyme is the new black” Sexual Activity before Sports Competition: A Systematic Review Frontiers in physiology June 2016 By Neko Richiko

Ten thousand miles away…Australia’s closest lyme-carrying tick <a href="https://drjustincoleman.files.wordpress.com/2016/12/pod5-final-1.mp3" rel="nofollow" target="_blank">https://drjustincoleman.files.wordpress.com/2016/12/pod5-final-1.mp3</a> <a href="https://geo.itunes.apple.com/us/podcast/gp-sceptics-podcast-5-lyme/id1169245180?i=1000378457746&amp;mt=2" rel="nofollow" target="_blank"></a><a href="https://soundcloud.com/justin-coleman-31/gp-sceptics-podcast-5-lyme-diseasedont-get-sold-a-lemon" rel="nofollow" target="_blank"></a> To coincide with today’s Senate inquiry on how to catch Lyme Disease in Australia (short version – you can’t), Justin and Liz interview infectious disease expert Prof Frank Bowden, from Australian National University. Frank swats aside a series of claims by Australian lyme disease proponents, but sounds stumped when Justin asks whether sentinel chickens or sentinel ticks are better at keeping watch. The conversation takes a few twists, lurching from false positive US lab results to unrelated matters such as whether having sex before the game enhances or detracts from sports performance. You’ll have to listen to find out the answer.* *Or you could always cheat and read the reference below  References: <a href="https://www.newsouthbooks.com.au/books/life-and-other-infectious-diseases/" rel="nofollow" target="_blank">Infectious: A doctor’s eye-opening insights into contagious diseases</a> Frank Bowden’s book, published 2016, including the chapter “Lyme is the new black” <a href="http://journal.frontiersin.org/article/10.3389/fphys.2016.00246/full" rel="nofollow" target="_blank">Sexual Activity before Sports Competition: A Systematic Review</a> Frontiers in physiology June 2016 By Neko Richiko

GP Sceptics podcast 5: Lyme disease…don’t get sold a lemon

Two Australian GPs take an irreverent look at medical research. For sceptical clinicians and their patients.

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