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Description
Australian Family Physician is the official journal of The Royal Australian College of General Practitioners
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Available Episodes (129)
Dr Aleeta Fejo talks about being an indigenous doctor, efforts to increase the number of indigenous doctors in Australia, and helping out Santa for disadvantaged indigenous childre
I thought that this story started when I was 28 years of age, but actually, it started before I was born. I am a Larrakia Traditional Owner, inherited from my father, and I am a Warramunga...
Dr Tricia Nagel talks about the successful use of a brief goal setting intervention in remote indigenous communities. You don't need special skills, client self-care is enhanced, and...
Detection and treatment of mental illness in indigenous communities is often complicated by cross cultural difference, social complexity and comorbid disorders.
GP Dr Andrew Knight talks to Dr Kathryn O'Connor about his approach to assessment and management of case study "Serge" who presents saying "I've been bleeding from the bowels". Patient...
Much undifferentiated illness is seen in general practice. Patients with a vague feeling of general unwellness may have multiple unrelated problems, serious underlying pathology, definite...
GP Dr Louise Stone discusses assessment and management of osteoarthritis in General Practice with Dr Kathryn O'Connor. Patient history is important; especially duration and severity...
Aches and pains are commonly seen in general practice and osteoarthritis may be an underlying cause. Chronic pain can be very distressing for patients and management may be challenging...
Dr Michael Harrison discusses pathology testing in the tired patient with Dr Kathryn O'Connor. International guidelines on pathology testing in the tired patient vary and all are consensus...
Pathology tests are often ordered by general practitioners to investigate patients with nonspecific complaints such as malaise and tiredness.
Nick Collins, a GP from Leumeah, New South Wales, discusses planning for pandemic flu and the checklists from his article in October AFP, ‘Plan your pandemic- a guide for GPs’ with...
Influenza A virus has a range of subtypes characterised by the display of particular surface structures and is associated with significant symptoms and a tendency to cause epidemics...
Dr Steven Rudolphy discusses straight forward ways for the busy GP to improve asthma management with Dr Jenny Presser. Although asthma mortality rates in Australia have declined, our...
Asthma mortality rates in Australia have declined over the past 20 years but are not low by international standards.
Associate Professor Geoffrey Mitchell talks with Dr Jenny Presser about the role of the GP at different stages in a patient's cancer journey. The good news is that Australian cancer...
The incidence of cancer is rising, so the workload of managing cancer is increasing rapidly. Among the advances in cancer care are advances in coordination of care, with team care being...
In the longer term over 70% of people who have had depression experience disease recurrence. Dr Cate Howell discusses with Dr Jenny Presser how to identify those most at risk of relapse...
Depression is a potentially recurring or chronic disorder. The provision of evidence based treatment and effective practice organisation is central to chronic disease management, and...
Mr Sean Mackay discusses with Dr Carolyn O'Shea surgical causes of upper abdominal pain and some of the investigations that can help to make the diagnosis of a surgical cause.
In Australia, abdominal pain is a common presenting complaint in the general practice setting. Identifying a surgical cause is important and warrants prompt specialist referral.
Associate Professor Paul Pavli talks to AFP audio about the importance of a good history and examination in rationally selecting investigations to assist in assessing upper abdominal...
Upper abdominal pain is a common problem with an extraordinary diversity of possible causes. Many patients have no structural disease, and making the correct diagnosis can be a cha
Alison Fogarty and Grant Blashki talk about the GreenClinic project and what effect it had on the practices involved.
Don Henry, ACF Executive Director, talks about the importance of projects such as the GreenClinic project.
GreenClinic was a pilot educational program developed by the Australian Conservation Foundation and Doctors for the Environment Australia.
Dr Jaycen Cruikshank discusses the assessment and management of ventricular tachycardia, supraventricular tachycardia, atrial fibrillation and bradycardia with Dr Kathryn O'Connor.
Diagnosis of acute arrhythmias requires recognition and interpretation of important electrocardiogram (ECG) findings, and knowledge of Australian resuscitation guidelines.
Dr Kathryn Browning Carmo discusses the role of the GP in managing the neonate before transfer to a tertiary centre with Dr Kathryn O'Connor. Early phone contact with the local Neonatal...
Rural general practitioners involved in obstetric service delivery may have occasion to support the sick or premature newborn requiring transfer. This should be achievable for short...
Anne Fraser, clinical psychologist from the State child Development Centre in Western Australia discusses oppositional defiant disorder (ODD) with Dr Jenni Parsons. The discussion centres...
Oppositional defiant disorder (ODD) is defined as a repetitive and persistent pattern of opposition, defiant, disobedient and disruptive behaviours toward authority figures persisting...
Dr Jill Sewell discusses the underlying causes, assessment and management of school refusal with Dr Jenni Parsons. School refusal is a heterogeneous and multifactorial problem that
School refusal occurs in 1–5% of all school children and has major social, emotional and educational implications for the child.
Dr Michael Harari discusses practical tips to gain a child's confidence in medical consultations with Dr Jenni Parsons. The judicious use of silliness, without acting the fool, can
Engaging children in a clinical setting is kind to the child and their family, and is a useful clinical tool. Each of us will have our own way of getting through a child's fears and...
Christopher Brown, consultant ENT surgeon, Melbourne Nasal and Sinus Clinic, discusses the management of chronic rhinosinusitis in adults with Dr Jenni Parsons. The discussion focuses...
Chronic rhinosinusitis (CRS) is a common condition in the community, with significant morbidity and financial implications.
Professor Robert Berkowitz discusses the management of ear, nose and throat problems in children with Dr Jenni Parsons. The focus is on when to refer to an otolaryngologist for recurrent...
This article provides a general approach in determining when to refer a child to an otolaryngologist.
Professor Stephen O'Leary discusses technological advances in treatment of hearing impairment including digital technology in hearing aids, cochlear implantation and the bone anchored...
The treatment of hearing impairment is rapidly evolving. Despite this, a significant number of adults with hearing impairment receive inadequate treatment or rehabilitation, resulting...
Dr Meredith Makeham author of the series of articles in AFP on the Threats to Australian Patient Safety (TAPS) study discusses the TAPS study and some of the findings relating to errors,...
The Threats to Australian Patient Safety (TAPS) Study collected 648 anonymous reports about threats to patient safety from a representative random sample of Australian general prac
Maintaining an INR in the therapeutic range is an important area of patient management and safety. Kate Hodge talks about a program and evaluation to assist in a rural region.
Oral anticoagulation management is difficult in rural settings because of reduced patient access to pathology testing and medical management.
Associate Professor Jo Douglass outlines issues for GPs and patients in diagnosing and managing food allergy in adults.
There is a marked increase in the prevalence of food allergies. Food allergy can cause fatal anaphylaxis and the victims are most often adolescents and young adults.
Dr Marnie Robinson talk to AFP audio about 2 of the April theme articles on Allergy. She discusses paediatric allergy, including allergy tests, and the latest in allergy prevention
The prevalence of allergic disease has increased considerably in recent decades and Australia has one of the highest rates of allergic disease in the world.
Allergic diseases (asthma, atopic dermatitis, allergic rhinitis and food allergy) are the commonest chronic diseases of childhood.
Dr Karen McKertich discusses procedural and surgical treatments for urinary incontinence in women.
A range of surgical treatment options is available for women suffering from stress and urge urinary incontinence refractory to conservative and medical management.
Dr Karen McKertich discusses assessment of urinary incontinence in women.
The aims of assessing urinary incontinence in women are to define the diagnosis, exclude other pathology and guide management. Treatment can be initiated when urinary incontinence is...
Dr Patricia Neumann discusses physiotherapy for urinary incontinence
International guidelines recommend treatment for urinary incontinence by a health professional such as a pelvic floor or continence physiotherapist with specialised training in the
Overweight and obese adolescents face significant problems with their physical and emotional health. Professor Kate Steinbeck outlines the GP’s role in advocating for these kids and...
The prevalence of overweight and obesity continues to increase in adolescents. Community level management is necessary as specialist services are limited.
Dr Melissa Kang has a special interest in the sexual health of young people. In this interview, she observes changing patterns in youth sexual activity and some basic principles of...
In this podcast, Melissa Kang attempts to enlighten Steve Trumble on successful communication with young people about their sexuality and sexual risks.
Young Australian people aged 12–25 years are sexually active at a younger age and have more sexual partners compared to previous generations. Pregnancy and sexually transmitted infection...
Dr Graham Fleming is a GP in rural South Australia who saw a problem with youth suicide in his area and went ahead and fixed it. He talks about practical approaches to adolescent mental...
About 15% of the adolescent population suffers a mental health problem. Although a large percentage of these adolescents present to their general practitioner at least once a year,
Cardiac pacemakers have come a long way in the 50 years since the first model needed its batteries changed after 3 hours. Dr Geoff Toogood discusses the indications for cardiac pac
Since the first cardiac pacemaker was inserted in 1958 vast changes have occurred in both the technology of the devices and their indications.
Dr Peter Kistler talks with Steve Trumble in the first of three podcasts on the management of cardiac arrhythmias. This interview focuses on his article in the pharmacological treatment...
Cardiac arrhythmias may present with palpitations, chest pain, shortness of breath, dizziness and syncope. Diagnosis may be complicated by an inability to document the arrhythmia particularly...
Atrial fibrillation is becoming increasingly common, especially in older people. In this podcast, Dr Peter Kistler discusses the control of rate and rhythm in atrial fibrillation.
Atrial fibrillation affects a significant proportion of the Australian population, affecting approximately 5% of people over 65 years of age.
In the final of his three podcasts, Dr Peter Kistler looks at the use of cardiac catheters in the management of arrhythmias.
Pharmacological management of arrythmias is not curative, is sometimes difficult, and may be associated with significant morbidity.
Your first day in general practice can be a mixture of excitement and terror. Victorian registrar Dr Emily Walsh explains how she survived her first training term, and felt like a
After trying a couple of other disciplines in medicine I have finally found the career that suits me. If you, like me, are interested in most things, enjoy meeting people and can’t
Malaria is more than an inconvenience for Australian travellers; it is a serious disease that kills and injures millions of people each year. Dr Trish Batchelor talks with Steve Trumble...
Malaria remains endemic in over 100 countries worldwide. Travellers to these countries may be at risk of contracting disease. Assessing risk on an individual basis can be challengi
Dr Tony Gherardin discusses the approach to the intending traveller. What do they need to know and what does their GP need to tell them?
Australians are great travellers and the need for travel health advice can be a common presentation in general practice. General practitioners should be an important source of accurate...
Many Australian travellers baulk at the idea of paying for vaccines before they set off on their great adventures. But, as Dr Sonny Lau explains to Steve Trumble, GPs can help even
Immunisation is very cost effective. It provides high level immunity against a range of general and travel specific pathogens. There are more vaccines available as research and development...
Dr Louise Stone looks at what's going on with some of our most challenging patients: those who somatise their problems. Are we helping by proving to them that there's "nothing wrong"...
Somatising disorders are a common, complex and disabling cluster of disorders. Research suggests that general practitioners find this group of patients challenging. The disorders are...
Cognitive Behavioural Therapy is revolutionising the way GPs treat patients with anxiety and depression. Dr Sarah Edelman talks about what types of CBT work best in the general practice...
It is well established that some individuals have an inherent disposition toward experiencing anxiety more readily than others. These individuals are prone to high levels of autonomic...
Medication has no place in the management of mild depression, and only a limited role in moderate depression. Severe depression usually requires drug treatment and Dr Steve Ellen discusses...
Depression and anxiety are common presentations in general practice and medications are one of the key treatment strategies.
GPs occupy a unique position in being able to help people who are going through major life events. Professor David Clarke talks about the various coping strategies people use, and how...
General practitioners often see patients who are struggling with a change in their life circumstances. When this change involves illness, the GP is well placed to provide support and...
Postmenopausal bleeding is always a cause for concern. An obvious, benign cause could be obscuring a carcinoma. Gynaecological oncologist Dr Alison Brand talks to Steve Trumble about...
Postmenopausal bleeding is a common complaint from women seen in general practice.
Why do we do routine clinical breast and pelvic examinations in asymptomatic women? Is there any evidence that it increases the detection of breast or gynaecological malignancies? Associate...
Clinical breast examination (CBE) is often offered as a component of the well woman check or carried out at the request of an asymptomatic woman. In these cases the examination is a...
The launch of Australia's new vaccine for preventing certain strains of Human Papilloma Virus holds great promise in reducing the incidence of cervical cancer. But do we run the risk...
2006 was an eventful year in the area of screening to prevent cervical cancer. New screening guidelines were introduced nationally in July, and in November the Australian Government...
Ovarian cancer is difficult to diagnose and hence it is often not detected before it is well advanced. Associate Professor Margaret Davey talks about some of the patient factors that...
Epithelial ovarian cancer presents most often as late stage disease due to a lack of effective screening tests and vagueness of symptoms.
Work related upper limb disorders are common, expensive and difficult to treat. Rheumatologist and occupational physician Dr Michael Shanahan talks to Steve Trumble about effective...
Work related upper limb disorders (WRULDs) are among the most common workers' compensation claims. Their management is a challenge for medical practitioners for a range of reasons.
Dr Berny Trifiletti shares her acronym for helping injured workers get back on the job.
Achieving best outcomes in occupational injury management requires an emphasis upon identifying and managing those factors which – in addition to the medical condition – lead to progression...
Dr Peter Cotton is an organisational psychologist who believes that the "morale" in a workplace - and in the workers - plays a very significant part in determining health outcomes.
Although most injured workers return to work with minimal intervention, approximately 20% show levels of distress and disability beyond that expected for the injury. The level of morale...
The management of acute low back pain is quite a challenging problem in general practice, especially when it is work-related and there are other issues at play. Dr John Low is an occupational...
Back problems are the seventh most common reason for seeking care in general practice in Australia. Despite medical advances, chronic disability from back pain is a major contributor...
Endometriosis is a difficult condition to diagnose clinically; it also has major consequences for women in terms of pain, disablement and possible infertility. Dr David O'Callaghan
Endometriosis is one of the major causes of pelvic pain and subfertility in women.
Dr Jane Fischer talks about palliation of symptoms other than pain (including dyspnoea, nausea, constipation, and depression) in people with cancer and other diseases.
Symptoms other than pain are a heavy burden for patients with either malignant or progressive nonmalignant disease and significantly reduce quality of life.
Professor Patsy Yates discusses three of the most challenging areas of palliative care: when children are dying, when older people need decisions made, and when an Indigenous Australian...
Ensuring access for all Australians to high quality palliative care requires an understanding of special considerations for specific populations, including children, older persons,
Rick Kausman talks about successful strategies for helping people be their most healthy weight
Helping patients to achieve and maintain their most healthy weight is a common challenge. Giving a 'one size fits all' set of instructions to patients who are over their most healthy...
Dr Roger Neighbour, visiting President of the RCGP, talks with Steve Trumble about general practice in the United Kingdom and how it differs from Australia.
Dr Roger Neighbour, visiting President of the RCGP, talks with Steve Trumble about one of the skills that lies at the core of being a general practitioner: "phronesis", or practical...
While we do have medical workforce problems in Australia, they are nothing compared to those confronted by developing countries. Dr Malcolm Moore is a GP in Albury NSW who has worked...
Australia has a well developed system of general practice and can be proud of the quality of its generalists. In many developing countries however, the idea of a trained generalist
Children can be challenging customers at the best of times and no more so than when you are trying to repair their wounds. Fellow in Paediatric Emergency Medicine, Dr Ronan O'Sullivan,...
Minor injuries in children are extremely common in the general practice setting.
Leg ulcers are a common and time consuming problem in general practice. Poorly managed, they can result in unnecessary amputation or even death. One of Australia's leading wound management...
A leg ulcer is not a disease but the manifestation of an underlying problem that requires a clear diagnosis.
The choice of dressings when managing skin ulcers is important, but not more so than making a proper assessment of the patient, their ulcer and the environment in which they exist.
Wound management is more than the application of a dressing. It requires a comprehensive and informed approach to the assessment of the patient, their wound and their healing envir
Adolescence is a difficult time for most teenagers, but when you have a chronic illness such as diabetes it can be really tough.
During adolescence major hormonal, neuro-maturational, emotional and psychosocial changes occur within a relatively short time interval. The additional burden of living with a chronic...
Careful foot assessment is an important part of GPs' comprehensive care of people with diabetes.
Diabetes has long been associated with increased risk of foot ulceration and lower extremity amputation.
Dr Jonathan Cohen presents a timely update on the pharmacotherapy of glycaemic control and other factors that modify cardiovascular risk for people with type 2 diabetes. Metformin is...
Patients with diabetes have a high cardiovascular risk. In addition to achieving good glycaemic control, cardiovascular risk reduction is a vital component of management.
General practice is all about listening to our patients as they tell us the story of their health. Dr Chris Pearce discusses the impact that both computers and evidence-based medicine...
The doctor-patient relationship is crucial to the practice of medicine and yet the rise of science in the 19th and 20th centuries shifted doctors’ focus away from the patient toward...
