The Good GP

In this episode of This Could Save Your Life podcast, Dr Catherine Bourke is joined by Dr Tessa McLean for an in-depth discussion on the clinical relevance of breast density and its reporting in breast cancer screening. Focusing on the recent rollout of breast density reporting through BreastScreen programs across several Australian states, and what this means for patients and general practitioners.They talked about the clinical relevance of breast density for both cancer risk and the diagnostic performance of mammography. The masking effect of dense breast tissue can lower mammography sensitivity, making early cancer detection more challenging. They explored how GPs can support patients who receive a dense breast notification, recommending the use of validated breast cancer risk assessment tools like iPrevent for individualised risk evaluation. While breast density is one factor, several points were raised about the importance of considering other risk factors including family history, genetic susceptibility, and lifestyle.Recommendations were provided for follow-up: women should consult their GP for assessment and discussion of additional screening if needed, guided by new Department of Health resources.Concluding with strategies for risk reduction, including exercise, maintaining a healthy weight, reducing alcohol intake, not smoking, and breastfeeding where possible.Link & Resources: Listen to our Episode: Breast cancer Awareness: Screening, prevention and risk factors: https://thegoodgp.com.au/episode/breast-cancer-awareness-screening-prevention-and-risk-factors/iPrevent Breast Cancer Risk Assessment Tool: https://www.breastcancertrials.org.au/breast-cancer-resources/iprevent/?utm_source=google&utm_medium=cpc&utm_campaign=comms-iprevent-leads-au&gad_source=1&gad_campaignid=23677845721&gbraid=0AAAAAqA0HjKMpgHSG_Y2EblNd_8Hrpfh_&gclid=Cj0KCQiA77DXBhCHARIsAHf2MNpl89YxFElLltP_yqM3AYRa3k63iYJ1n9rPcqX4SpFATpnD-qQlO40aAtLAEALw_wcBBreast density GP guidance tool: https://www.health.gov.au/our-work/breastscreen-australia-program/health-professionals/breast-density-information-for-gps?language=enThis Could Save Your Life Podcast is under The Good GP podcast, 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/networkIf you have any questions or would like to contact The Good GP, send an email to [email protected]. Visit www.thegoodgp.com.au for previous episodes and more information. You can also find us on our Instagram page: @thegoodgppodcast. Follow us for more updates!

In this episode of The Good GP, host Dr Ash Bowden is joined by Professor Rukshen Weerasooriya, Clinical Professor of Medicine at UWA and cardiac electrophysiologist, to discuss the updated management of atrial fibrillation (AF) and what this means for general practitioners.Professor Rukshen explains the recent introduction of pulsed field ablation, a non-thermal technique that has made AF ablation procedures faster and safer by reducing complications such as esophageal and nerve injury. This development has expanded the availability of ablation and changed practice guidelines, now recommending ablation earlier in a patient’s AF journey rather than as a last resort.Key risk factors and modifiable contributors to AF outcomes are discussed, including limiting alcohol, achieving weight loss (especially a 10% reduction for overweight patients), managing blood pressure, and treating sleep apnea. Also covering expected success rates, stressing that ablation is highly effective (up to 90% suppression in ideal patients) but not curative, and early referral to a cardiac electrophysiologist, ideally within the first year of diagnosis, maximises patient benefit. Highlighting the key investigations to organise before referral: ECG, echocardiogram (especially for left atrial size and ventricular function), and Holter monitoring.The broader significance of AF is addressed, with its rising prevalence, elevated stroke and heart failure risk, and the psychological burden on patients underscored as reasons to prioritise detection and early, proactive management.Links & Resources: 2024 Cardiac Society of Australia and New Zealand Expert Position StatementHEAD 2 TOES ManagementThe 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/networkIf you have any questions or would like to contact The Good GP, send an email to [email protected]. Visit www.thegoodgp.com.au for previous episodes and more information. You can also find us on our Instagram page: @thegoodgppodcast. Follow us for more updates!

In this episode of The Good GP, host Dr Kristiana Pederick welcomes Dr Justin Ng, a specialist cardiologist and electrophysiologist specialising in the diagnosis and management of arrhythmias. They discuss common presentations of bradycardia and how to distinguish between physiological and pathological low heart rates.Dr Justin highlights red flags in the presentation, investigation, and general management of bradyarrhythmia, as well as the uses and limitations of wearable tracking devices, such as smartwatches.They explore typical presentations of bradycardia, including syncope, near-syncope, reduced exercise tolerance, and cognitive decline in older adults. Dr Justin emphasises the importance of clinical context when distinguishing between physiological and pathological bradycardia, taking into account the patient's age, fitness level, symptoms, and the circumstances in which a low heart rate is identified.They also discuss management principles, including reserving pacemaker implantation for symptomatic or irreversible cases. The importance of taking a thorough patient history and correlating symptoms with documented bradycardia is emphasised to help determine the urgency of management and guide further investigations.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/networkIf you have any questions or would like to contact The Good GP, send an email to [email protected]. Visit www.thegoodgp.com.au for previous episodes and more information. You can also find us on our Instagram page: @thegoodgppodcast. Follow us for more updates!

In this episode of The Good GP, Dr Krystyna de Lange speaks with Dr Steph Daly, GP with a special interest in aged care and dementia, about the introduction of plasma biomarkers, specifically the p-Tau 217 blood test for Alzheimer’s disease. They explore what the p-Tau 217 test measures, its reliability, and its role in primary care.Dr Steph Daly outlines that the test shows high positive and negative predictive value for Alzheimer’s pathology when used in the appropriate, symptomatic patient group, typically those over 55 presenting with clear cognitive or memory symptoms. Discussing the practical process for GPs to request the test, expected costs, and considerations for both urban and rural settings.They emphasise the need for pre-test counselling, careful patient selection, and the importance of structured clinical assessment to ensure meaningful use of the test. The application of this biomarker in asymptomatic individuals is not recommended at present, due to limited clinical utility and potential psychological harm.Listeners are encouraged to approach the test thoughtfully, seek additional education, and use it initially in patients where clinical suspicion of Alzheimer’s disease is already high.Links & Resources: Prognostic Value of Blood-Based P-Tau217 Levels for Progression to Cognitive Impairment study: https://jamanetwork.com/journals/jama/article-abstract/2851720The Nun Study: Insights from 30 years of aging and dementia research: https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.14626Link to webinar and information on biomarker study currently being carried out in Australia: https://www.australiandementianetwork.org.au/improved-extended-study-blood-based-biomarkers-for-alzheimers-disease-in-primary-care-project/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/networkIf you have any questions or would like to contact The Good GP, send an email to [email protected]. Visit www.thegoodgp.com.au for previous episodes and more information. You can also find us on our Instagram page: @thegoodgppodcast. Follow us for more updates!

In this episode of The Good GP, host Dr Krystyna De Lange speaks with Dr David Leitinger, a GP with a special interest in addiction medicine, about the practical use of naltrexone for managing alcohol use disorder (AUD).Dr Leitinger explains how naltrexone, an opioid antagonist, disrupts the endorphin-mediated reward of alcohol consumption, helping patients gradually reduce intake and unlearn habitual drinking behaviours. He highlights that naltrexone can be prescribed while patients are still drinking, not only during abstinence, and discusses flexible prescribing methods including daily dosing and the “Sinclair Method” of targeted dosing prior to drinking.Important considerations covered include contraindications such as concurrent opioid use and the approach to temporary cessation if opioid analgesia is needed. Dr Leitinger reassures that naltrexone is generally safe in patients with liver disease and recommends baseline and follow-up LFTs, though testing should not be a barrier to therapy.A case study illustrates practical patient outcomes, expectations, and follow-up. Strategies for supporting patients through lapses and individualising success measures are discussed, as well as where naltrexone fits alongside other first-line options like acamprosate. The value of harm reduction and ongoing patient support in primary care is emphasised.Link & Resources: AJGP article on naltrexone in alcohol use disorder: https://www1.racgp.org.au/ajgp/2026/january-february/naltrexoneCommunity Access to Pharmacotherapy for Alcohol (CAPA) EOI Form: https://forms.cloud.microsoft/Pages/ResponsePage.aspx?id=xMYIFZVfdU-KZ5mS34Mn6CJfQHBGKCREk2C2wuYgdyNUM0IzSDc4WTVXMkNGT1VXWkYxMlNGQ0FIVy4u&origin=QRCodeA 2-step reduction in WHO alcohol risk drinking levels (rather than abstinence) for harm reduction: https://pmc.ncbi.nlm.nih.gov/articles/PMC12739655/ Stronger evidence for the effectiveness of naltrexone: https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2727384The 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/networkIf you have any questions or would like to contact The Good GP, send an email to [email protected]. Visit www.thegoodgp.com.au for previous episodes and more information. You can also find us on our Instagram page: @thegoodgppodcast. Follow us for more updates!