January 24, 2026 • 40 mins
A GP is often the first port of call when you're feeling under the weather, but how do you choose the right one?
Dr Bryan Betty joins Tim Beveridge to discuss what to keep an eye out for, what to avoid, and whether or not you should do some internet research to help solve your illnesses.
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Speaker 1 (00:05):
You're listening to the Weekend Collective podcast from News Talks.
Speaker 2 (00:09):
I'd be there, but right now it is time for
the Health Hut. But we want your calls and participation
on eight hundred eighty ten eighty. Don't forget text nine
two nine two, and actually we're gonna have a chat
about well, you know, when you when you need to
be seen, you're not feeling too well, of course you're
not book a GP appointment. And talk of a family
(00:29):
GP in the past in New Zealand, I mean we
had a family GP growing up, the one person we
get in touch with having a regular porter call. It's
something I used to have recent until recently, but then
he retired and then now I sort of see just
whoever's available. But how important is it to have that
one person who knows all of your your issues I guess,
(00:53):
or at least all of your medical issues. In fact,
they might know all of your issues. God knows what
we share with our GPS and everything. But also if
it is it still important to have that one point
of contact or you know, does the digital change that
that everyone can have your story as long as they
hopped into the data. But also sometimes even before you
get there. You know, you might have actually consulted doctor Google.
(01:16):
Sometimes that's helpful, sometimes it might be a little bit alarming.
So we're gonna have a chat about doing your own
research as well, whether it makes you a more informed
patient or frankly a more difficult one. But to talk
about all these issues, he is well, he needs no introduction,
really is doctor Brian Betty help Brian? Hello?
Speaker 3 (01:34):
Oh hi Tim, really nice to be here.
Speaker 2 (01:37):
How common is the individual GP the family GP? How
much is that changing these days in terms of modern
medical practice that people just have the one person this
is who I see full stop.
Speaker 3 (01:53):
Yeah, look, I mean really good question, and yeah, things
have changed. I think that's due to workforce pressures, shortage
to GPS, and there is this thing that is happening
where people have seen different doctors. However, and I think
we do need to get back to this international research
across the world. And there's been some big studies on
the show that if you're with the same GP for
(02:15):
more than ten years, you've got less hospital admissions, less
emergency department at tendencies, and you actually live longer.
Speaker 2 (02:25):
So the same sentence I missed the start.
Speaker 3 (02:27):
If you what so if you see the same GP
for more than ten years. That is, you have your
own GP that you see, less hospital admissions, less emergency
department attendancies, and you actually live longer. Big, big studies
out of Norway and the UK show this, and it's
really really interesting and I can see why if you've
got complex medical problems, knowing your history, knowing the investigations,
(02:51):
knowing who you are is really really important in terms
of managing your condition. Going forward.
Speaker 2 (02:58):
There'll be a lot of people who So I had
a regular GP I saw and he retired, and I
now just sort of see who is available, which means
I've got less chance of living chance I've got living longer.
Oh my goodness.
Speaker 3 (03:12):
But look you tapped into something. We have a lot
more avenues now. So look, we do have chat, you know,
the Internet and chat GP and a whole lot of
other modalities that we work with. You know, Urgent care
is different to long term continuous care, a whole lot
of things. As a system, I think it's something we
do need to think about about how we provide care
and look, in an ideal world, I think I think
(03:34):
seeing the same GP is actually really important and most
of my colleagues would agree with that.
Speaker 2 (03:39):
Actually, because it cuts both ways, doesn't it, Because I imagine
the reward of being a GP. I mean, I'm not
going to get into the motivations for getting into that
occupation and staying in it, but I would imagine that
the reason one chooses to go into general practice is
also because you want to look out. I don't want
to use the word stable of people, but I've just
(04:01):
used it. I can't think of anying. But you want
to you want to have a relationship with people. You
don't want to be a bus stop. Where who have
we got today's you know, you know, in a constant
parade of people you don't know. That's an important part
of the job for you guys.
Speaker 3 (04:14):
Look at it as a really really important job for
most GPS. That continuity with the patient, knowing their history,
knowing their family, knowing where they come from, and their
history in terms of what's happened look at is a
really really important important part of general practice, and it's
one of the reasons a lot of general practitioners choose
to do what they do. So, look, there's no doubt
(04:36):
that that is a very very strong motivation and it's
actually rewarding to you know, knowing a person over a
period of time, knowing you there to help to give advice,
to help navigate what's a really really complex health system,
and you know, diagnose and help manage conditions is really
really important and I think we can't underestimate that. And
certainly for my colleagues, I know that's a big motivator
(04:59):
for what they do.
Speaker 2 (05:00):
Is it sort of a nostalgic notion that is unavoidably
going to become a little bit historical because even the
move we have now to encourage and enable more nurse
practitioners to see patients as well. And to be honest,
I mean I've had something I've been seeing in the
nurse at the practice for a little while ago, and
I probably know her better than any of the doctors.
Speaker 3 (05:22):
Look, look, that's the reality of what's happening. And look,
our nurse colleagues and nurse practitioners are highly skilled, highly
trained and actually a really really valuable part of primary
care and what we actually do. I think there is
still an absolute need for general practitioners or gps or
doctors who have a different skill based often to be
(05:42):
there to actually consult and back up. But yeah, look
I agree there are pressures for this concept of continuity
and seeing the same practitioner, but look, at the end
of the day, I go back to what I said.
The research sort of backs up that it's where we
should be going as a system. So as we get
more doctors into the system or gps into the system,
it's definitely something we should be driving. It's driving for
(06:04):
in terms of what we're delivering.
Speaker 2 (06:05):
How does it work in practice with you with how
many people in your practice?
Speaker 4 (06:09):
Is it?
Speaker 3 (06:10):
Yeah, so we've got about six or seven doctors are
all part time, and look, we allocate patients to each doctor,
so absolutely we all have our own patient base. But look,
if you ring up on a day that I'm not
there and it's an urgent problem, you'll be seen by
one of our colleagues. So we keep a certain proportion
of our appointments free for urgent problems, and we'll see
(06:32):
anyone's patient in those type of situations. But for continuous,
ongoing medical care, we actually will go for the same
doctor who knows you and knows your medical history. And
that's the way we operate practice.
Speaker 2 (06:47):
If I'm with Brian and Brand's not available and I
see Jill will Jill. How does that work in practice?
Fact will be different. But I imagine if I'm your patient,
it'd be just like Jill saw him that day and
here his notes, and God is a plan on the backside.
Speaker 3 (07:10):
Never happens to him.
Speaker 2 (07:13):
But do you try to assume I don't want to
say ownership, but do you try and assume continuity of relationship?
Speaker 3 (07:20):
Yeah, So look what happens in that situation is a
your practice management system, your computer system is really important.
So the notes will be there from the other doctor
seeing the patient. Those notes will have all your long
term conditions and long term medications on them, so we
know exactly what's going on there. And that doctor in
our practice will refer you back to me to see
(07:40):
me and book an appointment with me down the track
if it's a problem that needs following up, so they
won't follow up the problem, they'll make sure that it's
me that follows up the problem going forward. So yeah,
that's how we tend to work. Yeah, and we need
to create space for urgent problems that arise, but we
also need to have this acute, ongoing chronic care part
(08:01):
of what we do, so that that's the thing we
try and balance out.
Speaker 2 (08:05):
Is that One of the things many practices do, because
everyone's well often booked out, is that there'll be a thing. Look,
call us at seven point thirty and let us know
and we'll find an appointment because there are places set aside.
Speaker 3 (08:16):
Usually yeah yeah, so so generally that's why that happens,
because they're called on the day appointments, so they free
up x amount of appointments, may twenty percent of the
appointments for people who ring up on the day and say, look,
I've got a child with who's very sick with the
temperature and a sore throat. Could you please come in
and see me. So, yeah, we'll free out appoinments. And
in those situations, if your doctor's not available, you'll be
(08:38):
booked in with someone else or booked him with a
nurse to do an assessment and see what's going on.
Speaker 2 (08:42):
Gosh, we're only a whisper away from that dread of
those dread of three words manage my health. Let's not
go there. I should never mentioned it. Somebody texted it.
Somebody texted, dare I mentioned manage my health?
Speaker 4 (08:56):
Hey?
Speaker 2 (08:57):
Okay, what about so? I mean as every time someone
moves down one of the one of the issues is,
you know, we've got to find a new doctor. How
does one go about I mean, how much effort should
you go to finding the right doctor? And how would
you know who's who? You ask around them? And are
there some doctor patient relationships there's a certain how much
(09:21):
does it rely on some form of I'm putting this
very clumsily, but you know there are patients, there's a
certain chemistry, Some patients suit certain doctors and vice versa.
Speaker 3 (09:31):
Look, look if you're looking for another doctor. And look,
we know there's resource constraints. There's not enough gps often
a lot of areas, so we have to accept that. Okay, However,
there's three core things that I'd be looking at. One
is you're absolutely right to the way you relate to
your doctor is incredibly important. In fact, we know that
eighty percent of complaints come through poor communication. You know,
(09:54):
what's said is not what's heard, and there's issues that arise.
So I mean, comfortable with the style of your GP
is really important. Your qualification of your GP, I think
is really important. People may not understand this, but look
for the qualification. So what's called a Fellow of the
College GP f RN z CGP at the end of
the name on hang.
Speaker 2 (10:12):
On, I'm going to write this downfr n z CGPP, right.
Speaker 3 (10:16):
It indicates the GP's done specialist training in general practice.
It's a three year training program. It's a very extensive
lot of exams, and most GPS and New Zealander fellows
of the College or training to be Fellows of the College.
So that's really really important to look for that qualification
to know that there's been extra training in general practice.
Speaker 2 (10:36):
How do you do that diplomatically without walking into their
surgery and going, hang on a minute, I just want
to where are your frames? What's this one here?
Speaker 3 (10:44):
Look, most most surgeries will have a list of their doctors,
and most will have their qualifications and what they've done,
and they'll actually say, look, I've done the fellowship, I've
done extra training in general practice, and I've got this
qualification and a it's a specialist qualification in general practice.
It's really really important to look for.
Speaker 2 (11:02):
That, actually, because we get into political art in a way,
don't we. But are you saying that if they haven't
got that, then what what are you looking for?
Speaker 3 (11:10):
Well, well, look, look looking for some postgraduates. So we
do have overseas, doctors who come in they will be
generally in the process of training through to that extra qualification.
In New Zealand we have registrars who are training to
get that qualification in practices, and we have doctors who
come in from places like the UK and their qualification
is slightly difference called MRI CGP. So again there'll be
(11:32):
letters behind their name that indicate they've done specialist training
in general practice. So you can generally said that on
the internet very very easily.
Speaker 2 (11:39):
What about so? So basically that's the first thing, check
the qualifications and I guess, look, I mean hopefully not
many people have to go to the doctor too frequently,
so you're not sort of trying trialing people every fortnight
or something else.
Speaker 5 (11:53):
What about it?
Speaker 2 (11:54):
If a doctors sort of do you have do you
sometimes as a doctor have a patient come in and
you might say, look, I actually really think one of
my colleagues might be I mean, how do you because
there must be times you like you and I you know,
you are looking for a style of communication obviously that
I'm not providing, but my colleague down the corridor I
think will be perfect for you. How do you say that?
Speaker 3 (12:16):
Exactly exactly how you just said it. I mean, I'll
be very honest with patients. If I think that's the
case and we're not sort of on the same wavelength,
I'll sort of say, look, and actually one of the
things we do need to do is recommend someone else.
So that's what you do. You recommend someone else to
see and look, I'll be very honest about it and say, look,
I don't think I'm sort of addressing your needs. All
the way we communicate, all the way we talk with
(12:37):
each other, So look, in that situation, I would have
no hesitation and recommending one of my colleagues to see them.
We do that all the time.
Speaker 2 (12:45):
Yeah, Look, we'd love your cause on this about how
have you gone about choosing a GP, because I think
it is as Brian's Brian Betty has said that the
research shows that people who have a consistent relationship with
the same GP over a period of I think it
was more than ten years, wasn't it, Brian, that's what
(13:05):
some of the research have a better life expectancy. So
what do you make of that? Eight hundred and eighty
ten eighty By the way, Brian happens to be a
GP as well, so if there's something you'd like to
ask him about, because your current GP is not cutting
the mustard. I say that completely mischievously. But if there
are anything, if there's anything you'd like to talk to
Brian about, then please do give us a call on
(13:26):
eight hundred and eighty ten eighty. He and I are
going to continue the conversation in just a moment, but
you can interrupt us by jumping on the blow right
now and the lines are open. It is twenty one
past four News talk edb Yes, welcome back now just
before we get back into the Health Hub with doctor
(13:48):
Brian Betty, just to update you on mart mung and
Ui and police have held an updated press conference. They
will not resume. Police will not resume work on the
malt mung and Ui slip recovery today. After they pause
work just before noon. They have plenty District Commander Superintendent
Tim Anderson says police were given reports from two geotechnical
experts about a crack near the site. More equipment and
(14:11):
experts we brought in to make the site safe to
work on again, and search efforts have also been hampered
by wind and rain. Today. Police say they are one
hundred percent committed to returning those families loved ones, and
we'll stay there until the job is done. So pretty
grim stuff in Mantmong and Ui. But there's the latest
on that police have will not resume work until they
(14:35):
can make that site safe. Right, let's get back to it.
We're talking about GPS, the importance of having a relationship
with your family or your own GP, and how important
that is. But how important is it to you to
have found the right GP and to have a relationship
with that GP or do you just see who you
can we can And we've taken some calls on this
(14:55):
as well with doctor Brian, Betty and Margaret.
Speaker 6 (14:58):
Hello, oh hello doctor, my doctor of the last thirty years.
Me that it's thirty oh, that I've got wrong. It
comes and goes, but he hasn't told me how I
can fix it. How can I fix my vay to go?
I'm eighty three, very fit and active.
Speaker 3 (15:16):
Yeah, look, that's really actually quite a difficult problem sometimes, Margaret.
And it's a lot of different causes at your age
for vertigo. One of the commonest causes is benign postural vertigo.
When you move your head or you stand up and
you can get dizzy or get vertigo. With that, there
(15:37):
can be a lot of other causes such as you
stand up and you get postural what we call low
blood pressure, and that can make you feel a bit
dizzy or unbalanced. And there's another a number of other
causes that that that can be part of that. So
I suppose it depends on the reason for it or
why it is occurring. There are some medications that can help.
Sometimes there's some simple procedures that can be done sometimes
(16:01):
to help. But actually, to be honest with you, sometimes
it is quite a difficul problem to address. So it
depends on the cause as to what you do about it.
But again, if you've got concerns and you may still
need to have a further chat to your GP about
that and about you.
Speaker 6 (16:19):
You might have it perhaps for most of the day
and we really I am steady and have to use
my walking stick even around the house, and then the
next day I'm fine.
Speaker 3 (16:28):
Yeah, And and look that that that is a lot
of what we do here as you get older, that
this this this fluctuation or this coming go in a
vertigo that can occur. So it may be that that
you know on those days where it occurs, it is
about just rest and taking it easy and not walking
to too much because you're you're danger as a fall
(16:48):
and that's something you don't want to do. Yeah, and
those days if you're okay, you're more active.
Speaker 6 (16:56):
Again exactly if I do have four.
Speaker 3 (17:00):
Yeah, yeah exactly. So so a lot of different reasons
for it occurring. And look, if you're concerned and you
do need to talk to your GPG and have another
chat about it. But again it comes down to probably
the reasons it's occurring.
Speaker 6 (17:12):
Okay, yes, I haven't worked that out, thank you doctor.
Speaker 2 (17:15):
Ok thanks Margaret, actually, because there's that farbeit for me
to say anything apart from I've learned the apply maneuver
from the odd bout of vertigo. And there are some
amazing machines as well. You see on the web where
people does anyone have one of those machines where they
pop you in and move you into position and then
(17:36):
swivel you and.
Speaker 3 (17:37):
Oh the tilt thing that is available at some of
the specialist clinics. That that is certainly available to try
and diagnose what's going on and try and fix it.
And there can be procedures that have done the hallpipe procedure,
which is about if it's due to this. It's a
bit complex, but there's little grains of sand that get
into the inner ear. You can do a procedure try
and shift those around and sort of resolve the vertigo.
(17:59):
So yeah, there's these tilt table things that can be
used depending on the cause of the vertigo. That's critical thing.
Speaker 2 (18:05):
Because a doctor would probably be quiet. I guess as
a patient gets older. If you're talking to a twenty
five year old about doing some maneuver, you know, some
exercises like the air ply maneuver, would you be more
nervous about teaching an older patient to do that sort
of stuff?
Speaker 3 (18:23):
Oh, look at look, it's very effective when it's done. Yeah,
and it depends on the ability of the patient to
actually do it. If they can do it at home,
you can, you can do things at home around this,
but depends on the ability the older person to actually
do it. So look, it often depends on age. A
whole lot of different things that come into play.
Speaker 2 (18:41):
Yeah. Yeah, so I didn't want to get outside my
area of actually, but that's actually funny enough raises that
the whole spectrum of doctor google because there is there
is a lot on b PPV or whatever you call it,
and ways to do it. But you've got to work
out which which side it's on, and if you get
that wrong, you.
Speaker 3 (19:01):
Look like doctor Google. I think's got its place. I
think Chat's got its place with us. You've got to
be very very careful about ninety percent of the information
is often slightly inaccurate, and although it can seem authoritative,
there can often be quite dramatic and accuracies in there,
which you do need to be very very careful about
because that can delay diagnosis or maybe put you down
(19:23):
the wrong track.
Speaker 2 (19:24):
Yeah right, let's take some more calls, shall we. Wendy Hello, Hello,
he's hello. You're with doctor Brian Betties down the line there,
and I'm with you. What would you like to talk about?
Speaker 5 (19:35):
Well, a few weeks ago, I think it was stocked
run with Francesca and I missed the end of the
answer to a question about the timing of taking your
blood bridge and medication to the think that did make
a difference. If my GP has told me it shouldn't
make any difference.
Speaker 2 (19:51):
Oh okay, Yeah, so.
Speaker 3 (19:55):
It depends on the blood pressure medication you're on. Sometimes
you know it should make a difference occasion. It does,
and it depends entirely on your blood pressure medication and
what type of medication you're on, and whether what we
call long acting or there's a shorter half life. So
there's a number of things that come into play. Everyone's
(20:16):
slightly different with this, Wendy. So again it's something that
you discuss with your GP, but it will depend on
the medications that you're on.
Speaker 5 (20:24):
Oh well, it was I caught the missed the most
of your reply when someone else was talking about the
same topic. But I'll just yeah, just keep weighing up.
Speaker 3 (20:36):
What I think the important thing to say though. It's
really really important to take your blood pressure medications you
are on blood pressure. Stopping and starting them is quite
a can be a dangerous thing sometimes.
Speaker 2 (20:49):
Can I can I ask sort of on Wendy's behalf
if she's got some confusion about timing of medication that
she's on, does she need to actually go see her
doctor or can she actually leave them? Because sometimes there
are bits of advice it's like, oh no, no, don't
tell her to take it, swyan Z. Does someone need
to make an appointment for something that they've mean?
Speaker 3 (21:11):
I know, yeah, it's it's very individual what happens here,
So it depends on a range of things and medications
are on the range of problems that the patient may
have as to whether you'd want to see them about that,
as to whether there's something else going on or not
or not is a simple thing that could be worked
on through you know, I don't want to mention manager
(21:32):
by health, but through a telephone call or the internet
or whatever. And you know that's a different topic. But
I mean, it sometimes can be dealt with with a
phone call or a simple contact with the practice or
the practice nurse. But if it's more complex than that,
we'll often ask you to come in and see you
because it can be a range of other things that
are may be going on.
Speaker 2 (21:49):
So it wouldn't hurt just to call and leave a
message for the nurse saying I've got this question and
then take it from there. So you don't to make
an appointment.
Speaker 3 (21:57):
No, speak to the nurse in the first instance, because
I'll often what we call triarche the situation and say, look,
you do need to see the GP over this, or
look here the piece of advice i'd give you at
the moment and see how that goes excellent.
Speaker 2 (22:08):
My gosh, it does highlight how medical practice is changing
in a way, because there'd be a time when somebody
have a question, we like pick up the phone, go
and have an appointment, et cetera. Whereas now you've got
nurses triaging.
Speaker 3 (22:18):
And yeah, there's a whole lot of different things that
are happening.
Speaker 7 (22:21):
You know.
Speaker 3 (22:21):
I think our nurses do a fantastic job. They do
a lot of this type of thing now, and we've
got nurse practitioners who take on a lot of responsibility.
So yeah, the world has changed. Absolutely.
Speaker 2 (22:33):
Just one quick question without mentioning those three words, just
the ability to book online? Is that a problem in
a way because in the days of receptionists taking the call,
recognizing a name and like, oh, they want their fifth
appointment this week, it's online booking and does it it's
(22:56):
great efficiency, But does it make it difficult for practices
to actually manage their books in terms of seeing people
who they need to see when they need to see them.
Speaker 3 (23:04):
Look, I think what you've tapped into is possibly one
of the hidden problems sometimes. I think the majority of
our patients who book into our clinic would actually be
triarched by the nurse often or speak to the receptionist.
A small percentage of our patients do book online and
they'll select the doctor they want to book online, so
they will book through own doctor. And often that's if
(23:25):
it's a chronic, on going problem. But if it's a
cut problem, they'll often talk for the practice.
Speaker 2 (23:29):
Yeah, okay, right, it's probably something that's going to evolve
over time as more people becomes yeah, digitally right. Let's
go to Helen. Hello, Helen, Hello.
Speaker 8 (23:41):
Oh hello, sorry, Hi, Hi, thank you. I'm just a
querious of the doctor. I've gotten a ralded down my
right leg and into my foot. It's sort of low
to medium and it gets worse winter. I was prescribed
(24:03):
nor flex for it. Is there anything else I can
do to alleviate it?
Speaker 3 (24:10):
Good? Good question, Helen, And yeah, a difficult problem. Again
comes down to what's causing the problem. Often that sort
of pain or that neuralgic pain down the leg comes
from the back. It's a compressed nerve in the back.
Norflex is one of the medications we use. Look, there
are other medications. There's some medication called pre gablin, a
(24:32):
medication called na triplene, which is specifically for what we
call neuropathic pain. That is pain caused by nerves. So
again there's a lot of different reasons why that pain
can occur. But there are some other options that are
more long term that can be of use in the situation.
So yeah, yeah, so there are.
Speaker 8 (24:51):
Some options table.
Speaker 3 (24:56):
Well, again it depends on exactly the cause, but there
is one called pregablin which is used for neuropropathic pain,
and there's another one called nor tripling that's used for
neuropathic pain. There's a number of other medications as well.
There's a range of them. Those are probably the commonest.
Speaker 8 (25:14):
Okay, oh, okay, and there's walking, good exercise.
Speaker 3 (25:18):
Look one hundred percent. Okay, So put aside medication absolutely
certainly if it's coming from the back, mobility and walking
one hundred percent is something you should be trying to do.
Speaker 2 (25:29):
Okay, Hey, thanks so much for your call, Helen. We'll
take a quick moment back with Dr Brian Betty and
just to check this his news talk z B the
Health Hub. It's twenty three and a half minutes to
five News Talks be with Tim Beverage, John Hello, and
Brian Betty. Should I say John Hello? Where you go?
Speaker 9 (25:51):
Right? I've got arthritis of beliefs. Yep, right, huh they
they give me this this pool were here?
Speaker 2 (26:07):
Oxy codeine, right, and what's your question?
Speaker 10 (26:13):
It makes me constipated?
Speaker 2 (26:16):
Oh yeah, okay, yep right, so.
Speaker 3 (26:21):
Yeah, yeah, so oxycodine is a opiate. It's used for
severe pain when you've got you know, quite severe arthritis,
if either waiting for a knee knee knee replacement, or
if you can't have one for a variety of reasons.
But its main side effect is actually constipation. It's a
well known side effect and generally you need to take
(26:44):
a laxative for something to alleviate the constipation when you
are taking oxycodine like that. So it's something you do
need to talk to your doctor about and it's something
you do need to get get some medication probably to
sort that out because there's no way of avoiding that
when it happens. Important to have lots of fruit and
vegetables in your diet, lots of fluids in your diet,
(27:06):
but you do need medication in this situation.
Speaker 11 (27:09):
Water.
Speaker 2 (27:11):
Have you got water?
Speaker 3 (27:12):
Definitely? So drinking is very important.
Speaker 10 (27:14):
Yeah yeah, but now I'm too old to have a
knee replacement. Yeah, I need two of them because on
seventy five, so they don't reckon i'd recover from it.
So I've been, I've been and had the injections and
(27:36):
the knees yep, yep, you know what they are, what
they called.
Speaker 3 (27:40):
Yeah, the quarter zone injections, the stereotygqrt.
Speaker 10 (27:44):
Zone injections and the knees, and they help. They help for.
Speaker 9 (27:51):
Three to four days, five days, yeah, yeah, maybe maybe
a wee bit longer.
Speaker 10 (27:58):
You're not allowed to have them too often.
Speaker 2 (28:01):
No, that's right, of course, that's really tough. So I
would would somebody have to be on a long term
laxative as well to go with that pain.
Speaker 3 (28:11):
Yeah, Look in John's situation, which is very very difficult
if you can't have the operation, and pain relief becomes
really really important, and you often move into the opioids
to do that. Yeah, long term lexative becomes something that's
often required. Yeah, to keep the bells moving.
Speaker 2 (28:30):
The age thing would be a clinical decision, I guess,
wouldn't would just just be like your seventy five bad luck?
Speaker 3 (28:35):
Well no, no, so it depends on Look, it's a
clinical decision, depend on what other sort of what we
call comorbidities or other things that are going on as
to why you couldn't have the operation. So yeah, look,
it's it's it's a range of factors come into play
in terms of a decision to do an operation or not.
So if there's a substantial risk, they'll say no, and
it does have to be managed with pain relief and
(28:58):
that's tough medication often.
Speaker 2 (29:00):
Yeah, okay, Hey, thanks for your call. John. I'm sorry
I'm to deal with that. That's a real challenge. God.
That sounds so you've mystic and everything, but that sounds
really tough. Tony. Hello, you're good.
Speaker 12 (29:13):
Austinon, gentlemen, thanks for your time. I'll try and be
fairly brief. I have had none feet now for five
six years. I've been tested for diabetes, which I don't have,
and it only comes on at night when I'm in bed,
and sometimes I get horrendous cramps. But the minute I
get up and walk and run, especially put the pressure
on and running, it kills us straight away. I don't
(29:34):
have it in the daytime, but at night it's just
it's neuropathy obviously what I've got. But I've been tested.
I've even had my brain scan. I thought was something
wrong with my motor skills or something. But anyway, have
you got any any suggestions that what it could be
that would cause them?
Speaker 3 (29:54):
Look, look, that's a really, really again difficult problem, Tony,
that you're describing. Yeah, I mean, look, I mean there's
three three I supposed or two big causes. One is circulation,
that is that is blood circulation to the lower legs.
The second one is new neuropathy where the nerves start
to get damaged and start to cause problems. And often
(30:16):
diabetes causes that. And you've just mentioned you've been tested
for diabetes.
Speaker 4 (30:20):
There's things like.
Speaker 3 (30:21):
Nerve nerve compressions that can do it as well, but
if it's in both feet, it tends to be circulation
or nerves that are causing the problem. So yeah, getting
up and walking around absolutely the right thing to do.
You know, where the medication, Where the medications can help
sometimes is the other question. But again it depends on
the circumstance. Are the medical problems, what's actually going on?
(30:43):
And it, yeah, can be quite a complex problem to
sort out.
Speaker 12 (30:47):
Have you heard of this before? And people have patience
that you've had on your you know that you're built Yeah.
Speaker 3 (30:53):
No, Look look, yeah, absolutely with this this this neuropathic
pain type problem. Yeah, so it does happen. We do
see it, as we said, we often see it associated
with diabetes in particular. Yeah, but there's that can happen
for other reasons alreadiopathically, and so yeah, it can be
quite quite complex to sort out sometimes.
Speaker 2 (31:13):
Thanks, thanks for your time.
Speaker 3 (31:16):
Yeah, thanks, Tony.
Speaker 2 (31:17):
Is there anything to do with the often sighted the
expression restless leg syndrome when you lie down, your legs
and your feet must behave and then you're fine and.
Speaker 3 (31:24):
Yeah, yeah, look, look that is a syndrome that what
Tony's describing sounds slightly different to be honest, in terms
of what he's talking about and what's going on. So yeah,
it can be sometimes quite difficult to work out.
Speaker 2 (31:37):
Okay, right, let's go to Lynette. Hello. Hello, Hello.
Speaker 13 (31:42):
I was diagnosed last year with congestive art failure, which
really annoys me because I'm only in my late sixties,
so I cannot do things like hiking or tramping, running
a bike and that kind of thing can I do
(32:08):
to help my heart. I've also got atual problation, which
I'm waiting for an ablation for that.
Speaker 9 (32:18):
Yeah, yeah, perhaps.
Speaker 13 (32:22):
Really not be back.
Speaker 3 (32:24):
Sure, sure. So Look, sometimes the actual pibrillation contributes to
the heart failure, that is where the heart isn't pumping
the blood through the body as well as it should.
There's a range of reasons why it occurs, but sometimes
AF so getting the ablation and getting the af sorted,
I think is a is a really positive thing to do. Look,
you've asked the question what else can you do? There's
(32:44):
there's three main main main things to think about. One
is the medication you're taking. Medication is incredibly important with
congest for cardiac failure and the range of very new
medications we have, so medication is important. Look, exercise is important,
trying to walk as much as possible and just doing
this aerobic exercises just does help the heart and does
(33:07):
help the circulation, so it's and important things to do.
Making sure you don't have too much salt in the
diet again is important, so salt can make it worse
and sometimes depend on what's going on. Not drinking too
much fluid during the day so you go into what
we call fluid overload. So that you look that there's
(33:28):
a range of things. Medication is critically important in these situations.
But as I said when I started ablation, it is
probably a very good thing to do as well.
Speaker 2 (33:38):
Okay, best wishes for that, actually, Brian, just a question
when people get diagnosed with things like congest of heart
failure and even how you mentioned aerobic activity, do they
how much can people trust the way they feel when
they are getting some exercises if they're concerned with the
diagnosis is because it's alarming.
Speaker 3 (34:00):
Yeah, look at is alarming, and I think it does
cause anxiety, and it's something you need to talk about
with your doctors as to the degree that you've got
a problem. But look, even if it's severe, any type
of exercise is often good. So even if it's just
I was, you know, tell you to people, just walking
to the front gate and back again a couple of
times a day just does help. Any aerobic exercise does help.
Speaker 2 (34:21):
So does your body normally tell you what's enough? In
other words, does.
Speaker 3 (34:25):
Will look it often will? Yeah, it often will. It'll
think I'm exhausted and tired. But the more you do that,
the more you sort of find you can do a
little bit extra every day or every two and you
just start to extend that a little bit and if
you do that, it does actually tend to improve things.
So everyone's different with this, and this is the issue
with this tim but as a general principle, any type
(34:46):
of aerobic exits and we're not talking about running a
marathon or going to the gym. Often we're just talking
about walking to the gate or walking to the shop
and back. And if you can manage it. So your
body will often tell you what you can and can't do,
but you should just try and keep a little bit
going right.
Speaker 2 (35:00):
Look, tell you what we will take a quick break.
We'll try and squeeze in a call or two more.
In just a moment, we were doctor Bran Betty, this
is the health up on new Talk News Talks. It'd
be it's eleven minutes to five news Talk, does it be? Indeed,
try and squeze a couple more course with doctor Bryan Betty.
And it's Jeff Hello.
Speaker 11 (35:20):
Hi, Hi, are you good?
Speaker 9 (35:21):
Good good?
Speaker 11 (35:23):
I am about fourteen years ago. I won't dwirl too
much on stuff. I had a leg crushed in an accident.
Since seeing the leg's always played up a bit. But
now I've developed really bad varied exprains it and becoming
very painful. And one of two things. One is there
anything I can do at the moment to try and
(35:44):
leave that pain? And secondly, do you think that would
still qualify for ACC?
Speaker 9 (35:51):
Uh?
Speaker 3 (35:52):
Yeah, really good, really really good question. First in you know,
what can you do to relieve it? I mean there's
three things. Really if you've developed bericus veins. One medication
can sometimes be useful in terms of the but the
mainstay of treatment is often when they're painful, elevating legs
or the other thing is wearing compression stockings or what
(36:13):
we call teddys stockings, which you can get from the
chemist or through your doctor, and they compress the veins
and actually reduce the pain when you walk around because
your legs tend to swell up and that's what causes
the pain. The question about ACC absolutely in this situation,
an application should be put through to ACC to say
if it's secondary to the injury, they will accept it.
(36:36):
Your doctor will put through an application. ACC will then
look at that and decide whether they accept that or not.
So it's worth putting an application in these situations. If
they do accept it, good. If they don't, then they
don't think it's related. You go through the normal channels,
so certainly worth putting in a claim what we call
a claim.
Speaker 2 (36:54):
And an appeal. Actually, be honest, you.
Speaker 11 (37:00):
Can almost fay straight to the appeals.
Speaker 2 (37:03):
You do you need you would they do it under
the existing claim in terms of just the administrative side, Brian,
Would it be the useful to have the original number
and all that or.
Speaker 3 (37:12):
Yeah, Look, they'll look at the claim history. So they
do quite a thing. They look at the claim history.
They look at the original industry and the last often
ask an occupational specialist if they think the injury could
produce this problem, and if they do, it's accepted. If
they don't think it's the case, they won't accept it.
Speaker 11 (37:29):
It was the companies that I was working for at
the time were privately insured, so that never never helps.
Speaker 3 (37:36):
Yeah, yeah, yeah, yeah, but look, it's worth talking to
you to doctor about a claim if in this situation.
Speaker 11 (37:43):
Cool, Well, I think I'll go to a doctor that's
at least dealt with acc for while rather than the
woman they can to appoint me to.
Speaker 2 (37:54):
Okay, we've got about a minute or so, we'll see
actually receiveing squeeze, Wendy, because it's a it's a thing
about managing getting specialists on the same page. Wendy, Hello, Hi, minute,
I'll try to breathe.
Speaker 7 (38:07):
Okay, So you done knows the GCA six months ago,
and so I'm under a rheumatologist, under a doctor. I
just feel that this one's giving me pearls. This one's
giving me pearls gone from a person that never taken
a pill in the life. So I've got a little
ice cream container full of them there.
Speaker 13 (38:28):
Okay, you know, just simple.
Speaker 7 (38:31):
Things like I'm on chresterral tablets, but I'm having horrendous prench.
I'm growing a bed from the premious time. There's just
a whole lot of shit.
Speaker 2 (38:42):
Gun's okay, that's oh gosh. I think actually, when I
said in a minute, we might have a problem with
that one. But I guess if she's with a bunch
of specialists, how do you sort of get an overview
of what medication's right if I can summarize.
Speaker 3 (38:55):
Because often that's what you often that's what your GPS for.
And going back to our original conversation, Ton, this is
why you need someone who knows your history and knows
what's going on, because often that's where we intervene. Will
either talk to the specialist or look at adjustment because
often specialists to deal with individual things. The GP deals
with a whole lot and has got the oversight. So
that's often why you do need continuity in terms of
(39:18):
the GP you've seen.
Speaker 2 (39:19):
Well, that does help sort of tie a little bar
around it. Although I'm really sorry we didn't have more
time to talk to you Wendy about your properm Hey, Brian,
thank you so much for your time, so I thank you.
Great to have you on that, Brian, Betty doctor. He's
the chair of General Practice New Zealand. And yeah, don't
forget look for that certificate fr n z CGP. That's
the starting point if you're looking for a new GP. Anyway,
(39:40):
we'll be back with smart Money next.
Speaker 4 (39:42):
Catch you soon.
Speaker 1 (40:13):
For more from the Weekend Collective, listen live to News
Talk zedbe weekends from three pm, or follow the podcast
on iHeartRadio.
You're listening to the Weekend Collective podcast from News Talks.
Speaker 2 (00:09):
I'd be there, but right now it is time for
the Health Hut. But we want your calls and participation
on eight hundred eighty ten eighty. Don't forget text nine
two nine two, and actually we're gonna have a chat
about well, you know, when you when you need to
be seen, you're not feeling too well, of course you're
not book a GP appointment. And talk of a family
(00:29):
GP in the past in New Zealand, I mean we
had a family GP growing up, the one person we
get in touch with having a regular porter call. It's
something I used to have recent until recently, but then
he retired and then now I sort of see just
whoever's available. But how important is it to have that
one person who knows all of your your issues I guess,
(00:53):
or at least all of your medical issues. In fact,
they might know all of your issues. God knows what
we share with our GPS and everything. But also if
it is it still important to have that one point
of contact or you know, does the digital change that
that everyone can have your story as long as they
hopped into the data. But also sometimes even before you
get there. You know, you might have actually consulted doctor Google.
(01:16):
Sometimes that's helpful, sometimes it might be a little bit alarming.
So we're gonna have a chat about doing your own
research as well, whether it makes you a more informed
patient or frankly a more difficult one. But to talk
about all these issues, he is well, he needs no introduction,
really is doctor Brian Betty help Brian? Hello?
Speaker 3 (01:34):
Oh hi Tim, really nice to be here.
Speaker 2 (01:37):
How common is the individual GP the family GP? How
much is that changing these days in terms of modern
medical practice that people just have the one person this
is who I see full stop.
Speaker 3 (01:53):
Yeah, look, I mean really good question, and yeah, things
have changed. I think that's due to workforce pressures, shortage
to GPS, and there is this thing that is happening
where people have seen different doctors. However, and I think
we do need to get back to this international research
across the world. And there's been some big studies on
the show that if you're with the same GP for
(02:15):
more than ten years, you've got less hospital admissions, less
emergency department at tendencies, and you actually live longer.
Speaker 2 (02:25):
So the same sentence I missed the start.
Speaker 3 (02:27):
If you what so if you see the same GP
for more than ten years. That is, you have your
own GP that you see, less hospital admissions, less emergency
department attendancies, and you actually live longer. Big, big studies
out of Norway and the UK show this, and it's
really really interesting and I can see why if you've
got complex medical problems, knowing your history, knowing the investigations,
(02:51):
knowing who you are is really really important in terms
of managing your condition. Going forward.
Speaker 2 (02:58):
There'll be a lot of people who So I had
a regular GP I saw and he retired, and I
now just sort of see who is available, which means
I've got less chance of living chance I've got living longer.
Oh my goodness.
Speaker 3 (03:12):
But look you tapped into something. We have a lot
more avenues now. So look, we do have chat, you know,
the Internet and chat GP and a whole lot of
other modalities that we work with. You know, Urgent care
is different to long term continuous care, a whole lot
of things. As a system, I think it's something we
do need to think about about how we provide care
and look, in an ideal world, I think I think
(03:34):
seeing the same GP is actually really important and most
of my colleagues would agree with that.
Speaker 2 (03:39):
Actually, because it cuts both ways, doesn't it, Because I imagine
the reward of being a GP. I mean, I'm not
going to get into the motivations for getting into that
occupation and staying in it, but I would imagine that
the reason one chooses to go into general practice is
also because you want to look out. I don't want
to use the word stable of people, but I've just
(04:01):
used it. I can't think of anying. But you want
to you want to have a relationship with people. You
don't want to be a bus stop. Where who have
we got today's you know, you know, in a constant
parade of people you don't know. That's an important part
of the job for you guys.
Speaker 3 (04:14):
Look at it as a really really important job for
most GPS. That continuity with the patient, knowing their history,
knowing their family, knowing where they come from, and their
history in terms of what's happened look at is a
really really important important part of general practice, and it's
one of the reasons a lot of general practitioners choose
to do what they do. So, look, there's no doubt
(04:36):
that that is a very very strong motivation and it's
actually rewarding to you know, knowing a person over a
period of time, knowing you there to help to give advice,
to help navigate what's a really really complex health system,
and you know, diagnose and help manage conditions is really
really important and I think we can't underestimate that. And
certainly for my colleagues, I know that's a big motivator
(04:59):
for what they do.
Speaker 2 (05:00):
Is it sort of a nostalgic notion that is unavoidably
going to become a little bit historical because even the
move we have now to encourage and enable more nurse
practitioners to see patients as well. And to be honest,
I mean I've had something I've been seeing in the
nurse at the practice for a little while ago, and
I probably know her better than any of the doctors.
Speaker 3 (05:22):
Look, look, that's the reality of what's happening. And look,
our nurse colleagues and nurse practitioners are highly skilled, highly
trained and actually a really really valuable part of primary
care and what we actually do. I think there is
still an absolute need for general practitioners or gps or
doctors who have a different skill based often to be
(05:42):
there to actually consult and back up. But yeah, look
I agree there are pressures for this concept of continuity
and seeing the same practitioner, but look, at the end
of the day, I go back to what I said.
The research sort of backs up that it's where we
should be going as a system. So as we get
more doctors into the system or gps into the system,
it's definitely something we should be driving. It's driving for
(06:04):
in terms of what we're delivering.
Speaker 2 (06:05):
How does it work in practice with you with how
many people in your practice?
Speaker 4 (06:09):
Is it?
Speaker 3 (06:10):
Yeah, so we've got about six or seven doctors are
all part time, and look, we allocate patients to each doctor,
so absolutely we all have our own patient base. But look,
if you ring up on a day that I'm not
there and it's an urgent problem, you'll be seen by
one of our colleagues. So we keep a certain proportion
of our appointments free for urgent problems, and we'll see
(06:32):
anyone's patient in those type of situations. But for continuous,
ongoing medical care, we actually will go for the same
doctor who knows you and knows your medical history. And
that's the way we operate practice.
Speaker 2 (06:47):
If I'm with Brian and Brand's not available and I
see Jill will Jill. How does that work in practice?
Fact will be different. But I imagine if I'm your patient,
it'd be just like Jill saw him that day and
here his notes, and God is a plan on the backside.
Speaker 3 (07:10):
Never happens to him.
Speaker 2 (07:13):
But do you try to assume I don't want to
say ownership, but do you try and assume continuity of relationship?
Speaker 3 (07:20):
Yeah, So look what happens in that situation is a
your practice management system, your computer system is really important.
So the notes will be there from the other doctor
seeing the patient. Those notes will have all your long
term conditions and long term medications on them, so we
know exactly what's going on there. And that doctor in
our practice will refer you back to me to see
(07:40):
me and book an appointment with me down the track
if it's a problem that needs following up, so they
won't follow up the problem, they'll make sure that it's
me that follows up the problem going forward. So yeah,
that's how we tend to work. Yeah, and we need
to create space for urgent problems that arise, but we
also need to have this acute, ongoing chronic care part
(08:01):
of what we do, so that that's the thing we
try and balance out.
Speaker 2 (08:05):
Is that One of the things many practices do, because
everyone's well often booked out, is that there'll be a thing. Look,
call us at seven point thirty and let us know
and we'll find an appointment because there are places set aside.
Speaker 3 (08:16):
Usually yeah yeah, so so generally that's why that happens,
because they're called on the day appointments, so they free
up x amount of appointments, may twenty percent of the
appointments for people who ring up on the day and say, look,
I've got a child with who's very sick with the
temperature and a sore throat. Could you please come in
and see me. So, yeah, we'll free out appoinments. And
in those situations, if your doctor's not available, you'll be
(08:38):
booked in with someone else or booked him with a
nurse to do an assessment and see what's going on.
Speaker 2 (08:42):
Gosh, we're only a whisper away from that dread of
those dread of three words manage my health. Let's not
go there. I should never mentioned it. Somebody texted it.
Somebody texted, dare I mentioned manage my health?
Speaker 4 (08:56):
Hey?
Speaker 2 (08:57):
Okay, what about so? I mean as every time someone
moves down one of the one of the issues is,
you know, we've got to find a new doctor. How
does one go about I mean, how much effort should
you go to finding the right doctor? And how would
you know who's who? You ask around them? And are
there some doctor patient relationships there's a certain how much
(09:21):
does it rely on some form of I'm putting this
very clumsily, but you know there are patients, there's a
certain chemistry, Some patients suit certain doctors and vice versa.
Speaker 3 (09:31):
Look, look if you're looking for another doctor. And look,
we know there's resource constraints. There's not enough gps often
a lot of areas, so we have to accept that. Okay, However,
there's three core things that I'd be looking at. One
is you're absolutely right to the way you relate to
your doctor is incredibly important. In fact, we know that
eighty percent of complaints come through poor communication. You know,
(09:54):
what's said is not what's heard, and there's issues that arise.
So I mean, comfortable with the style of your GP
is really important. Your qualification of your GP, I think
is really important. People may not understand this, but look
for the qualification. So what's called a Fellow of the
College GP f RN z CGP at the end of
the name on hang.
Speaker 2 (10:12):
On, I'm going to write this downfr n z CGPP, right.
Speaker 3 (10:16):
It indicates the GP's done specialist training in general practice.
It's a three year training program. It's a very extensive
lot of exams, and most GPS and New Zealander fellows
of the College or training to be Fellows of the College.
So that's really really important to look for that qualification
to know that there's been extra training in general practice.
Speaker 2 (10:36):
How do you do that diplomatically without walking into their
surgery and going, hang on a minute, I just want
to where are your frames? What's this one here?
Speaker 3 (10:44):
Look, most most surgeries will have a list of their doctors,
and most will have their qualifications and what they've done,
and they'll actually say, look, I've done the fellowship, I've
done extra training in general practice, and I've got this
qualification and a it's a specialist qualification in general practice.
It's really really important to look for.
Speaker 2 (11:02):
That, actually, because we get into political art in a way,
don't we. But are you saying that if they haven't
got that, then what what are you looking for?
Speaker 3 (11:10):
Well, well, look, look looking for some postgraduates. So we
do have overseas, doctors who come in they will be
generally in the process of training through to that extra qualification.
In New Zealand we have registrars who are training to
get that qualification in practices, and we have doctors who
come in from places like the UK and their qualification
is slightly difference called MRI CGP. So again there'll be
(11:32):
letters behind their name that indicate they've done specialist training
in general practice. So you can generally said that on
the internet very very easily.
Speaker 2 (11:39):
What about so? So basically that's the first thing, check
the qualifications and I guess, look, I mean hopefully not
many people have to go to the doctor too frequently,
so you're not sort of trying trialing people every fortnight
or something else.
Speaker 5 (11:53):
What about it?
Speaker 2 (11:54):
If a doctors sort of do you have do you
sometimes as a doctor have a patient come in and
you might say, look, I actually really think one of
my colleagues might be I mean, how do you because
there must be times you like you and I you know,
you are looking for a style of communication obviously that
I'm not providing, but my colleague down the corridor I
think will be perfect for you. How do you say that?
Speaker 3 (12:16):
Exactly exactly how you just said it. I mean, I'll
be very honest with patients. If I think that's the
case and we're not sort of on the same wavelength,
I'll sort of say, look, and actually one of the
things we do need to do is recommend someone else.
So that's what you do. You recommend someone else to
see and look, I'll be very honest about it and say, look,
I don't think I'm sort of addressing your needs. All
the way we communicate, all the way we talk with
(12:37):
each other, So look, in that situation, I would have
no hesitation and recommending one of my colleagues to see them.
We do that all the time.
Speaker 2 (12:45):
Yeah, Look, we'd love your cause on this about how
have you gone about choosing a GP, because I think
it is as Brian's Brian Betty has said that the
research shows that people who have a consistent relationship with
the same GP over a period of I think it
was more than ten years, wasn't it, Brian, that's what
(13:05):
some of the research have a better life expectancy. So
what do you make of that? Eight hundred and eighty
ten eighty By the way, Brian happens to be a
GP as well, so if there's something you'd like to
ask him about, because your current GP is not cutting
the mustard. I say that completely mischievously. But if there
are anything, if there's anything you'd like to talk to
Brian about, then please do give us a call on
(13:26):
eight hundred and eighty ten eighty. He and I are
going to continue the conversation in just a moment, but
you can interrupt us by jumping on the blow right
now and the lines are open. It is twenty one
past four News talk edb Yes, welcome back now just
before we get back into the Health Hub with doctor
(13:48):
Brian Betty, just to update you on mart mung and
Ui and police have held an updated press conference. They
will not resume. Police will not resume work on the
malt mung and Ui slip recovery today. After they pause
work just before noon. They have plenty District Commander Superintendent
Tim Anderson says police were given reports from two geotechnical
experts about a crack near the site. More equipment and
(14:11):
experts we brought in to make the site safe to
work on again, and search efforts have also been hampered
by wind and rain. Today. Police say they are one
hundred percent committed to returning those families loved ones, and
we'll stay there until the job is done. So pretty
grim stuff in Mantmong and Ui. But there's the latest
on that police have will not resume work until they
(14:35):
can make that site safe. Right, let's get back to it.
We're talking about GPS, the importance of having a relationship
with your family or your own GP, and how important
that is. But how important is it to you to
have found the right GP and to have a relationship
with that GP or do you just see who you
can we can And we've taken some calls on this
(14:55):
as well with doctor Brian, Betty and Margaret.
Speaker 6 (14:58):
Hello, oh hello doctor, my doctor of the last thirty years.
Me that it's thirty oh, that I've got wrong. It
comes and goes, but he hasn't told me how I
can fix it. How can I fix my vay to go?
I'm eighty three, very fit and active.
Speaker 3 (15:16):
Yeah, look, that's really actually quite a difficult problem sometimes, Margaret.
And it's a lot of different causes at your age
for vertigo. One of the commonest causes is benign postural vertigo.
When you move your head or you stand up and
you can get dizzy or get vertigo. With that, there
(15:37):
can be a lot of other causes such as you
stand up and you get postural what we call low
blood pressure, and that can make you feel a bit
dizzy or unbalanced. And there's another a number of other
causes that that that can be part of that. So
I suppose it depends on the reason for it or
why it is occurring. There are some medications that can help.
Sometimes there's some simple procedures that can be done sometimes
(16:01):
to help. But actually, to be honest with you, sometimes
it is quite a difficul problem to address. So it
depends on the cause as to what you do about it.
But again, if you've got concerns and you may still
need to have a further chat to your GP about
that and about you.
Speaker 6 (16:19):
You might have it perhaps for most of the day
and we really I am steady and have to use
my walking stick even around the house, and then the
next day I'm fine.
Speaker 3 (16:28):
Yeah, And and look that that that is a lot
of what we do here as you get older, that
this this this fluctuation or this coming go in a
vertigo that can occur. So it may be that that
you know on those days where it occurs, it is
about just rest and taking it easy and not walking
to too much because you're you're danger as a fall
(16:48):
and that's something you don't want to do. Yeah, and
those days if you're okay, you're more active.
Speaker 6 (16:56):
Again exactly if I do have four.
Speaker 3 (17:00):
Yeah, yeah exactly. So so a lot of different reasons
for it occurring. And look, if you're concerned and you
do need to talk to your GPG and have another
chat about it. But again it comes down to probably
the reasons it's occurring.
Speaker 6 (17:12):
Okay, yes, I haven't worked that out, thank you doctor.
Speaker 2 (17:15):
Ok thanks Margaret, actually, because there's that farbeit for me
to say anything apart from I've learned the apply maneuver
from the odd bout of vertigo. And there are some
amazing machines as well. You see on the web where
people does anyone have one of those machines where they
pop you in and move you into position and then
(17:36):
swivel you and.
Speaker 3 (17:37):
Oh the tilt thing that is available at some of
the specialist clinics. That that is certainly available to try
and diagnose what's going on and try and fix it.
And there can be procedures that have done the hallpipe procedure,
which is about if it's due to this. It's a
bit complex, but there's little grains of sand that get
into the inner ear. You can do a procedure try
and shift those around and sort of resolve the vertigo.
(17:59):
So yeah, there's these tilt table things that can be
used depending on the cause of the vertigo. That's critical thing.
Speaker 2 (18:05):
Because a doctor would probably be quiet. I guess as
a patient gets older. If you're talking to a twenty
five year old about doing some maneuver, you know, some
exercises like the air ply maneuver, would you be more
nervous about teaching an older patient to do that sort
of stuff?
Speaker 3 (18:23):
Oh, look at look, it's very effective when it's done. Yeah,
and it depends on the ability of the patient to
actually do it. If they can do it at home,
you can, you can do things at home around this,
but depends on the ability the older person to actually
do it. So look, it often depends on age. A
whole lot of different things that come into play.
Speaker 2 (18:41):
Yeah. Yeah, so I didn't want to get outside my
area of actually, but that's actually funny enough raises that
the whole spectrum of doctor google because there is there
is a lot on b PPV or whatever you call it,
and ways to do it. But you've got to work
out which which side it's on, and if you get
that wrong, you.
Speaker 3 (19:01):
Look like doctor Google. I think's got its place. I
think Chat's got its place with us. You've got to
be very very careful about ninety percent of the information
is often slightly inaccurate, and although it can seem authoritative,
there can often be quite dramatic and accuracies in there,
which you do need to be very very careful about
because that can delay diagnosis or maybe put you down
(19:23):
the wrong track.
Speaker 2 (19:24):
Yeah right, let's take some more calls, shall we. Wendy Hello, Hello,
he's hello. You're with doctor Brian Betties down the line there,
and I'm with you. What would you like to talk about?
Speaker 5 (19:35):
Well, a few weeks ago, I think it was stocked
run with Francesca and I missed the end of the
answer to a question about the timing of taking your
blood bridge and medication to the think that did make
a difference. If my GP has told me it shouldn't
make any difference.
Speaker 2 (19:51):
Oh okay, Yeah, so.
Speaker 3 (19:55):
It depends on the blood pressure medication you're on. Sometimes
you know it should make a difference occasion. It does,
and it depends entirely on your blood pressure medication and
what type of medication you're on, and whether what we
call long acting or there's a shorter half life. So
there's a number of things that come into play. Everyone's
(20:16):
slightly different with this, Wendy. So again it's something that
you discuss with your GP, but it will depend on
the medications that you're on.
Speaker 5 (20:24):
Oh well, it was I caught the missed the most
of your reply when someone else was talking about the
same topic. But I'll just yeah, just keep weighing up.
Speaker 3 (20:36):
What I think the important thing to say though. It's
really really important to take your blood pressure medications you
are on blood pressure. Stopping and starting them is quite
a can be a dangerous thing sometimes.
Speaker 2 (20:49):
Can I can I ask sort of on Wendy's behalf
if she's got some confusion about timing of medication that
she's on, does she need to actually go see her
doctor or can she actually leave them? Because sometimes there
are bits of advice it's like, oh no, no, don't
tell her to take it, swyan Z. Does someone need
to make an appointment for something that they've mean?
Speaker 3 (21:11):
I know, yeah, it's it's very individual what happens here,
So it depends on a range of things and medications
are on the range of problems that the patient may
have as to whether you'd want to see them about that,
as to whether there's something else going on or not
or not is a simple thing that could be worked
on through you know, I don't want to mention manager
(21:32):
by health, but through a telephone call or the internet
or whatever. And you know that's a different topic. But
I mean, it sometimes can be dealt with with a
phone call or a simple contact with the practice or
the practice nurse. But if it's more complex than that,
we'll often ask you to come in and see you
because it can be a range of other things that
are may be going on.
Speaker 2 (21:49):
So it wouldn't hurt just to call and leave a
message for the nurse saying I've got this question and
then take it from there. So you don't to make
an appointment.
Speaker 3 (21:57):
No, speak to the nurse in the first instance, because
I'll often what we call triarche the situation and say, look,
you do need to see the GP over this, or
look here the piece of advice i'd give you at
the moment and see how that goes excellent.
Speaker 2 (22:08):
My gosh, it does highlight how medical practice is changing
in a way, because there'd be a time when somebody
have a question, we like pick up the phone, go
and have an appointment, et cetera. Whereas now you've got
nurses triaging.
Speaker 3 (22:18):
And yeah, there's a whole lot of different things that
are happening.
Speaker 7 (22:21):
You know.
Speaker 3 (22:21):
I think our nurses do a fantastic job. They do
a lot of this type of thing now, and we've
got nurse practitioners who take on a lot of responsibility.
So yeah, the world has changed. Absolutely.
Speaker 2 (22:33):
Just one quick question without mentioning those three words, just
the ability to book online? Is that a problem in
a way because in the days of receptionists taking the call,
recognizing a name and like, oh, they want their fifth
appointment this week, it's online booking and does it it's
(22:56):
great efficiency, But does it make it difficult for practices
to actually manage their books in terms of seeing people
who they need to see when they need to see them.
Speaker 3 (23:04):
Look, I think what you've tapped into is possibly one
of the hidden problems sometimes. I think the majority of
our patients who book into our clinic would actually be
triarched by the nurse often or speak to the receptionist.
A small percentage of our patients do book online and
they'll select the doctor they want to book online, so
they will book through own doctor. And often that's if
(23:25):
it's a chronic, on going problem. But if it's a
cut problem, they'll often talk for the practice.
Speaker 2 (23:29):
Yeah, okay, right, it's probably something that's going to evolve
over time as more people becomes yeah, digitally right. Let's
go to Helen. Hello, Helen, Hello.
Speaker 8 (23:41):
Oh hello, sorry, Hi, Hi, thank you. I'm just a
querious of the doctor. I've gotten a ralded down my
right leg and into my foot. It's sort of low
to medium and it gets worse winter. I was prescribed
(24:03):
nor flex for it. Is there anything else I can
do to alleviate it?
Speaker 3 (24:10):
Good? Good question, Helen, And yeah, a difficult problem. Again
comes down to what's causing the problem. Often that sort
of pain or that neuralgic pain down the leg comes
from the back. It's a compressed nerve in the back.
Norflex is one of the medications we use. Look, there
are other medications. There's some medication called pre gablin, a
(24:32):
medication called na triplene, which is specifically for what we
call neuropathic pain. That is pain caused by nerves. So
again there's a lot of different reasons why that pain
can occur. But there are some other options that are
more long term that can be of use in the situation.
So yeah, yeah, so there are.
Speaker 8 (24:51):
Some options table.
Speaker 3 (24:56):
Well, again it depends on exactly the cause, but there
is one called pregablin which is used for neuropropathic pain,
and there's another one called nor tripling that's used for
neuropathic pain. There's a number of other medications as well.
There's a range of them. Those are probably the commonest.
Speaker 8 (25:14):
Okay, oh, okay, and there's walking, good exercise.
Speaker 3 (25:18):
Look one hundred percent. Okay, So put aside medication absolutely
certainly if it's coming from the back, mobility and walking
one hundred percent is something you should be trying to do.
Speaker 2 (25:29):
Okay, Hey, thanks so much for your call, Helen. We'll
take a quick moment back with Dr Brian Betty and
just to check this his news talk z B the
Health Hub. It's twenty three and a half minutes to
five News Talks be with Tim Beverage, John Hello, and
Brian Betty. Should I say John Hello? Where you go?
Speaker 9 (25:51):
Right? I've got arthritis of beliefs. Yep, right, huh they
they give me this this pool were here?
Speaker 2 (26:07):
Oxy codeine, right, and what's your question?
Speaker 10 (26:13):
It makes me constipated?
Speaker 2 (26:16):
Oh yeah, okay, yep right, so.
Speaker 3 (26:21):
Yeah, yeah, so oxycodine is a opiate. It's used for
severe pain when you've got you know, quite severe arthritis,
if either waiting for a knee knee knee replacement, or
if you can't have one for a variety of reasons.
But its main side effect is actually constipation. It's a
well known side effect and generally you need to take
(26:44):
a laxative for something to alleviate the constipation when you
are taking oxycodine like that. So it's something you do
need to talk to your doctor about and it's something
you do need to get get some medication probably to
sort that out because there's no way of avoiding that
when it happens. Important to have lots of fruit and
vegetables in your diet, lots of fluids in your diet,
(27:06):
but you do need medication in this situation.
Speaker 11 (27:09):
Water.
Speaker 2 (27:11):
Have you got water?
Speaker 3 (27:12):
Definitely? So drinking is very important.
Speaker 10 (27:14):
Yeah yeah, but now I'm too old to have a
knee replacement. Yeah, I need two of them because on
seventy five, so they don't reckon i'd recover from it.
So I've been, I've been and had the injections and
(27:36):
the knees yep, yep, you know what they are, what
they called.
Speaker 3 (27:40):
Yeah, the quarter zone injections, the stereotygqrt.
Speaker 10 (27:44):
Zone injections and the knees, and they help. They help for.
Speaker 9 (27:51):
Three to four days, five days, yeah, yeah, maybe maybe
a wee bit longer.
Speaker 10 (27:58):
You're not allowed to have them too often.
Speaker 2 (28:01):
No, that's right, of course, that's really tough. So I
would would somebody have to be on a long term
laxative as well to go with that pain.
Speaker 3 (28:11):
Yeah, Look in John's situation, which is very very difficult
if you can't have the operation, and pain relief becomes
really really important, and you often move into the opioids
to do that. Yeah, long term lexative becomes something that's
often required. Yeah, to keep the bells moving.
Speaker 2 (28:30):
The age thing would be a clinical decision, I guess,
wouldn't would just just be like your seventy five bad luck?
Speaker 3 (28:35):
Well no, no, so it depends on Look, it's a
clinical decision, depend on what other sort of what we
call comorbidities or other things that are going on as
to why you couldn't have the operation. So yeah, look,
it's it's it's a range of factors come into play
in terms of a decision to do an operation or not.
So if there's a substantial risk, they'll say no, and
it does have to be managed with pain relief and
(28:58):
that's tough medication often.
Speaker 2 (29:00):
Yeah, okay, Hey, thanks for your call. John. I'm sorry
I'm to deal with that. That's a real challenge. God.
That sounds so you've mystic and everything, but that sounds
really tough. Tony. Hello, you're good.
Speaker 12 (29:13):
Austinon, gentlemen, thanks for your time. I'll try and be
fairly brief. I have had none feet now for five
six years. I've been tested for diabetes, which I don't have,
and it only comes on at night when I'm in bed,
and sometimes I get horrendous cramps. But the minute I
get up and walk and run, especially put the pressure
on and running, it kills us straight away. I don't
(29:34):
have it in the daytime, but at night it's just
it's neuropathy obviously what I've got. But I've been tested.
I've even had my brain scan. I thought was something
wrong with my motor skills or something. But anyway, have
you got any any suggestions that what it could be
that would cause them?
Speaker 3 (29:54):
Look, look, that's a really, really again difficult problem, Tony,
that you're describing. Yeah, I mean, look, I mean there's
three three I supposed or two big causes. One is circulation,
that is that is blood circulation to the lower legs.
The second one is new neuropathy where the nerves start
to get damaged and start to cause problems. And often
(30:16):
diabetes causes that. And you've just mentioned you've been tested
for diabetes.
Speaker 4 (30:20):
There's things like.
Speaker 3 (30:21):
Nerve nerve compressions that can do it as well, but
if it's in both feet, it tends to be circulation
or nerves that are causing the problem. So yeah, getting
up and walking around absolutely the right thing to do.
You know, where the medication, Where the medications can help
sometimes is the other question. But again it depends on
the circumstance. Are the medical problems, what's actually going on?
(30:43):
And it, yeah, can be quite a complex problem to
sort out.
Speaker 12 (30:47):
Have you heard of this before? And people have patience
that you've had on your you know that you're built Yeah.
Speaker 3 (30:53):
No, Look look, yeah, absolutely with this this this neuropathic
pain type problem. Yeah, so it does happen. We do
see it, as we said, we often see it associated
with diabetes in particular. Yeah, but there's that can happen
for other reasons alreadiopathically, and so yeah, it can be
quite quite complex to sort out sometimes.
Speaker 2 (31:13):
Thanks, thanks for your time.
Speaker 3 (31:16):
Yeah, thanks, Tony.
Speaker 2 (31:17):
Is there anything to do with the often sighted the
expression restless leg syndrome when you lie down, your legs
and your feet must behave and then you're fine and.
Speaker 3 (31:24):
Yeah, yeah, look, look that is a syndrome that what
Tony's describing sounds slightly different to be honest, in terms
of what he's talking about and what's going on. So yeah,
it can be sometimes quite difficult to work out.
Speaker 2 (31:37):
Okay, right, let's go to Lynette. Hello. Hello, Hello.
Speaker 13 (31:42):
I was diagnosed last year with congestive art failure, which
really annoys me because I'm only in my late sixties,
so I cannot do things like hiking or tramping, running
a bike and that kind of thing can I do
(32:08):
to help my heart. I've also got atual problation, which
I'm waiting for an ablation for that.
Speaker 9 (32:18):
Yeah, yeah, perhaps.
Speaker 13 (32:22):
Really not be back.
Speaker 3 (32:24):
Sure, sure. So Look, sometimes the actual pibrillation contributes to
the heart failure, that is where the heart isn't pumping
the blood through the body as well as it should.
There's a range of reasons why it occurs, but sometimes
AF so getting the ablation and getting the af sorted,
I think is a is a really positive thing to do. Look,
you've asked the question what else can you do? There's
(32:44):
there's three main main main things to think about. One
is the medication you're taking. Medication is incredibly important with
congest for cardiac failure and the range of very new
medications we have, so medication is important. Look, exercise is important,
trying to walk as much as possible and just doing
this aerobic exercises just does help the heart and does
(33:07):
help the circulation, so it's and important things to do.
Making sure you don't have too much salt in the
diet again is important, so salt can make it worse
and sometimes depend on what's going on. Not drinking too
much fluid during the day so you go into what
we call fluid overload. So that you look that there's
(33:28):
a range of things. Medication is critically important in these situations.
But as I said when I started ablation, it is
probably a very good thing to do as well.
Speaker 2 (33:38):
Okay, best wishes for that, actually, Brian, just a question
when people get diagnosed with things like congest of heart
failure and even how you mentioned aerobic activity, do they
how much can people trust the way they feel when
they are getting some exercises if they're concerned with the
diagnosis is because it's alarming.
Speaker 3 (34:00):
Yeah, look at is alarming, and I think it does
cause anxiety, and it's something you need to talk about
with your doctors as to the degree that you've got
a problem. But look, even if it's severe, any type
of exercise is often good. So even if it's just
I was, you know, tell you to people, just walking
to the front gate and back again a couple of
times a day just does help. Any aerobic exercise does help.
Speaker 2 (34:21):
So does your body normally tell you what's enough? In
other words, does.
Speaker 3 (34:25):
Will look it often will? Yeah, it often will. It'll
think I'm exhausted and tired. But the more you do that,
the more you sort of find you can do a
little bit extra every day or every two and you
just start to extend that a little bit and if
you do that, it does actually tend to improve things.
So everyone's different with this, and this is the issue
with this tim but as a general principle, any type
(34:46):
of aerobic exits and we're not talking about running a
marathon or going to the gym. Often we're just talking
about walking to the gate or walking to the shop
and back. And if you can manage it. So your
body will often tell you what you can and can't do,
but you should just try and keep a little bit
going right.
Speaker 2 (35:00):
Look, tell you what we will take a quick break.
We'll try and squeeze in a call or two more.
In just a moment, we were doctor Bran Betty, this
is the health up on new Talk News Talks. It'd
be it's eleven minutes to five news Talk, does it be? Indeed,
try and squeze a couple more course with doctor Bryan Betty.
And it's Jeff Hello.
Speaker 11 (35:20):
Hi, Hi, are you good?
Speaker 9 (35:21):
Good good?
Speaker 11 (35:23):
I am about fourteen years ago. I won't dwirl too
much on stuff. I had a leg crushed in an accident.
Since seeing the leg's always played up a bit. But
now I've developed really bad varied exprains it and becoming
very painful. And one of two things. One is there
anything I can do at the moment to try and
(35:44):
leave that pain? And secondly, do you think that would
still qualify for ACC?
Speaker 9 (35:51):
Uh?
Speaker 3 (35:52):
Yeah, really good, really really good question. First in you know,
what can you do to relieve it? I mean there's
three things. Really if you've developed bericus veins. One medication
can sometimes be useful in terms of the but the
mainstay of treatment is often when they're painful, elevating legs
or the other thing is wearing compression stockings or what
(36:13):
we call teddys stockings, which you can get from the
chemist or through your doctor, and they compress the veins
and actually reduce the pain when you walk around because
your legs tend to swell up and that's what causes
the pain. The question about ACC absolutely in this situation,
an application should be put through to ACC to say
if it's secondary to the injury, they will accept it.
(36:36):
Your doctor will put through an application. ACC will then
look at that and decide whether they accept that or not.
So it's worth putting an application in these situations. If
they do accept it, good. If they don't, then they
don't think it's related. You go through the normal channels,
so certainly worth putting in a claim what we call
a claim.
Speaker 2 (36:54):
And an appeal. Actually, be honest, you.
Speaker 11 (37:00):
Can almost fay straight to the appeals.
Speaker 2 (37:03):
You do you need you would they do it under
the existing claim in terms of just the administrative side, Brian,
Would it be the useful to have the original number
and all that or.
Speaker 3 (37:12):
Yeah, Look, they'll look at the claim history. So they
do quite a thing. They look at the claim history.
They look at the original industry and the last often
ask an occupational specialist if they think the injury could
produce this problem, and if they do, it's accepted. If
they don't think it's the case, they won't accept it.
Speaker 11 (37:29):
It was the companies that I was working for at
the time were privately insured, so that never never helps.
Speaker 3 (37:36):
Yeah, yeah, yeah, yeah, but look, it's worth talking to
you to doctor about a claim if in this situation.
Speaker 11 (37:43):
Cool, Well, I think I'll go to a doctor that's
at least dealt with acc for while rather than the
woman they can to appoint me to.
Speaker 2 (37:54):
Okay, we've got about a minute or so, we'll see
actually receiveing squeeze, Wendy, because it's a it's a thing
about managing getting specialists on the same page. Wendy, Hello, Hi, minute,
I'll try to breathe.
Speaker 7 (38:07):
Okay, So you done knows the GCA six months ago,
and so I'm under a rheumatologist, under a doctor. I
just feel that this one's giving me pearls. This one's
giving me pearls gone from a person that never taken
a pill in the life. So I've got a little
ice cream container full of them there.
Speaker 13 (38:28):
Okay, you know, just simple.
Speaker 7 (38:31):
Things like I'm on chresterral tablets, but I'm having horrendous prench.
I'm growing a bed from the premious time. There's just
a whole lot of shit.
Speaker 2 (38:42):
Gun's okay, that's oh gosh. I think actually, when I
said in a minute, we might have a problem with
that one. But I guess if she's with a bunch
of specialists, how do you sort of get an overview
of what medication's right if I can summarize.
Speaker 3 (38:55):
Because often that's what you often that's what your GPS for.
And going back to our original conversation, Ton, this is
why you need someone who knows your history and knows
what's going on, because often that's where we intervene. Will
either talk to the specialist or look at adjustment because
often specialists to deal with individual things. The GP deals
with a whole lot and has got the oversight. So
that's often why you do need continuity in terms of
(39:18):
the GP you've seen.
Speaker 2 (39:19):
Well, that does help sort of tie a little bar
around it. Although I'm really sorry we didn't have more
time to talk to you Wendy about your properm Hey, Brian,
thank you so much for your time, so I thank you.
Great to have you on that, Brian, Betty doctor. He's
the chair of General Practice New Zealand. And yeah, don't
forget look for that certificate fr n z CGP. That's
the starting point if you're looking for a new GP. Anyway,
(39:40):
we'll be back with smart Money next.
Speaker 4 (39:42):
Catch you soon.
Speaker 1 (40:13):
For more from the Weekend Collective, listen live to News
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Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
Fudd Around And Find Out
UConn basketball star Azzi Fudd brings her championship swag to iHeart Women’s Sports with Fudd Around and Find Out, a weekly podcast that takes fans along for the ride as Azzi spends her final year of college trying to reclaim the National Championship and prepare to be a first round WNBA draft pick. Ever wonder what it’s like to be a world-class athlete in the public spotlight while still managing schoolwork, friendships and family time? It’s time to Fudd Around and Find Out!