March 22, 2026 • 40 mins
The popularity of Telehealth GP appointments skyrocketed during the pandemic, and it hasn't gone away since.
Just about every general practice now offers Telehealth appointments, generally as a less costly and more accessible alternative.
But this country has an increasingly urgent primary care crisis, with 50% of GPs planning to retire by 2035 - and Telehealth is just another tool to get more patients seen as GPs leave the workforce.
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Speaker 1 (00:05):
You're listening to the Weekend Collective podcast from News Talk SEDB.
Speaker 2 (00:13):
But you've burn not kill the use.
Speaker 3 (00:17):
Hey hey it's later on the time flow, but you've.
Speaker 4 (00:21):
Burn not tell the nest D day.
Speaker 1 (00:24):
You're gonna burn?
Speaker 5 (00:25):
This gone down?
Speaker 6 (00:25):
How's that down?
Speaker 2 (00:27):
Yes, welcome back. This is the Weekend Collective. I'm Tim Beveridge.
Nice to have your company. The number is eight hundred
and eighty ten eighty and we want your calls for
this hour. Chris, this is the Health Hub and what
we're going to have a chat about this hour.
Speaker 6 (00:41):
Before I introduced my esteemed guest.
Speaker 2 (00:44):
Is well, you know, obviously, look, time's changed, don't they,
and so is the way that we interact with the
health system. There's a change in popularity of telehealth and GP.
Telehealth GP appointments obviously became vogue during the pandemic. Everyone
was doing everything remotely, well a lot anyway, and it
hasn't really gone away since and just about every general
(01:04):
practice now offers a telehealth appointments or remote appointments at
least if I can put it that way generally, as
maybe perhaps are less costly or more accessible alternative.
Speaker 6 (01:14):
But also, you know this country, as you.
Speaker 2 (01:16):
Will reading the news is a primary health care crisis
going on, with fifty percent of gps planning to retire
by twenty thirty five, which will be after we've run
out of oil. Anyway, Sorry, I just shouldn't have said that.
It was this ridiculous comment anyway, But Tellorhealth's another tool
to get patients seen as gps leave the workforce. I
guess that it might be, or is it? I don't
(01:39):
know anyway, See, my guest is disagreeing with my script already,
which is fantastic. But also the question I've got is
how do you choose a GP? And there are a
couple of reasons for this question, Because you know, there's location, location.
Speaker 6 (01:52):
Location, You go somewhere in your neighborhood.
Speaker 2 (01:54):
Of course they're only five minutes away and it's convenient
or close to your kids' school might be another one.
Speaker 6 (01:59):
But of course there's the GP themselves.
Speaker 2 (02:02):
And how do you know if a GP is going
to be right for you? Because medicine's medicine, isn't it?
But how important is that specific relationship that you have
with your GP? And and also the reason I sort
of mentioned it was a conversation with a conversation with
a parent the other day about doctors who were in
a particular corporate type practice where they were under a
(02:24):
lot of pressure to get through so many appointments and
all that sort of thing, as opposed to you know,
the local GPHR owns its own practice and all that
sort of thing. So the different sort of practice do
you belong to a practice? Do you join a specific GP?
How do you choose it? Where do we go?
Speaker 6 (02:37):
What's happening?
Speaker 2 (02:38):
We're going around and round we go and where she stops?
Nobody knows and enjoining me to discuss that and give
us all the answers because it's a bit of a
no at all. Well, actually, John Cameron, you have to
sort of be a bit of a no at all
as a GP in a way.
Speaker 7 (02:55):
Don't you do you?
Speaker 2 (02:56):
I mean, because people want the reassurance that you know
what I mean if you were going.
Speaker 6 (03:00):
Not sure about that one?
Speaker 2 (03:02):
How often would a doctor say, well, I mean, a
good doctor say that quite du shouldn't they?
Speaker 6 (03:07):
How nice to see see general.
Speaker 7 (03:10):
Practice practices learn more and more about less and less
until they know absolutely something about everything, whereas my passions
colleagues lean more and more about sort of less less. Listen, listen, listen,
till absolutely everything about a small pitt. We're broad and
that we're broad with general as specialists.
Speaker 6 (03:25):
And that's because being a GP is the specialty. In fact,
do you do?
Speaker 5 (03:29):
You know?
Speaker 7 (03:30):
You do?
Speaker 2 (03:30):
You do your original degree M B C h B
and then what happens following that? As are you GP?
And then you go to specialize?
Speaker 7 (03:40):
Okay, so yeah, I get really up in arms. I'm
a specialist general practitioner. Yes, so did my medical degree.
The two years post registration, moved into general practice and
then undertook a long protracted voyage through to becoming a
a Fellow of the Royal New Zealand College of General Practitioners.
Speaker 2 (04:01):
So did you know that early on when you became
a doctor, you thought this is what I want to do.
Speaker 7 (04:06):
Yeah, I'm just curious and I started the fifth one
that I want to be a GP. Really?
Speaker 6 (04:10):
What was it? Was it?
Speaker 7 (04:11):
Ollie Johnson, great doctor, brilliant? Was my GP when I
was a kid, and he was a lovely man, beautiful,
Oh your GP. My GP when I was was a
we tacker and he drove a nice green e type
gen one of those.
Speaker 6 (04:25):
It's like my life what do I have to do.
Speaker 7 (04:28):
There's a personality that sold me on it and the
capability of the breadth of humanity that you deal with.
And so when you I hate it when people say
are just a GP. No, I'm a special generalist.
Speaker 6 (04:39):
Actually, can I let's get into that a bit more.
Speaker 2 (04:41):
But also one thing to go from, you know, liking
the family doctor who you saw and be inspired and
want an e type jag or whatever?
Speaker 6 (04:50):
Was that everything?
Speaker 2 (04:52):
How how much did the dream match up with the reality?
Was it sort of everything you expected to be and more?
Speaker 6 (04:57):
Or how different was it?
Speaker 7 (04:58):
And more?
Speaker 6 (04:59):
Yeah?
Speaker 7 (04:59):
And more wonderful? Yeah, you're talking about retirement. I theoretically
retired in August last year my practice. Okay, but I'm
maintaining my registration and I'm continuing doing bits and so
do you still are you on? Are you sort of
going going to the practice tomorrow? I'm doing sessions?
Speaker 2 (05:15):
And do you have the regulars who won't accept that
you've retired? It's like no, no, no, Johnsman doctor No.
Speaker 7 (05:20):
Because I did it hopefully gracefully by slowly pulling back
from the practice. So introducing people to the other members
of my practice who are brilliant GPS.
Speaker 6 (05:30):
That's a tough one for patients too, isn't it?
Speaker 7 (05:32):
That relationship And that comes back to what is a
general practition Well, and as.
Speaker 6 (05:36):
There's my intro, yeah, errors and admissions and expected of course.
Speaker 7 (05:41):
Yeah, and that's why I have it seems that Okay,
So we've got this great problem with primary care and
it's worldwide. It's not just in New Zealand. Everywhere around
the world is running show of general practitioners general practice.
Without general practice, our health system would fall over flat
on its face. Every dollar invested in general practice gives
you twelve to fourteen dollars return and saved healthcare costs.
(06:04):
So it sure beats a made way to walk with
and return to the public purse. But we're grossly underfunded,
we're grossly underresourced, and we've got to attract people into
general practice, which is the start. So people who get
there moan and growind about how bad it is. Now
busy there and all this go away. It's the most
brilliant job in the world. So let's get into it.
Speaker 2 (06:24):
How much has it changed for doctors heading into the
workforce now as GPS versus when you did it? Because
as I'm alluded to in my comments, so that there
are some more corporatized sort of practices where the doctors
are sort of I don't know the doctors even just
employees or shareholders or sort of.
Speaker 6 (06:40):
I don't know. How what are the different models for
general practice?
Speaker 7 (06:44):
For years, it was GPS working in an isolated room.
Even sometimes in a group practice, they just worked out
of one room and then they hadst yeah, very little
relationship with anyone else in the practice. That's changed significantly.
It's now becoming groups who own the practice. Like in
the practice which I've built up, that was sold to
(07:05):
two GPS, one receptionist to one nurse. So they formed
a little company and bought the place of me. So
GP ownership is still staying within general practice as a
money making ideas. It's a good coin, okay, So if
you owned the practice, yeah, it's great. Who can I
own a practice anyone? Really? It used to be like pharmacy,
you had to be registered in pharmacist to own a practice.
Speaker 2 (07:28):
The receptionist was in there because she's probably watched things
that revolve and going on this. If I could get
into this business, it'd be good. And all of a sudden,
like Hello, Yeah, so a small investment where you go.
General practice changed tremendously in the thirty eight forty years
that I have been doing it. We didn't know what
we didn't know back in the early days, working off
paper records, no electronics, not only seeing the pundits who
(07:48):
came in front of us. Now we're dealing much more
with population health who are in our population who have
enrolled with the practice. Now people can either enroll with
a GP or with a practice.
Speaker 7 (07:59):
So it's either or.
Speaker 2 (08:01):
And what's the most common scenario, all town, big town
does it or not?
Speaker 7 (08:06):
No, it's I much prefer the concept of when rolling
with the practice and sharing the practitioners within that practice,
so that you can share the providers, you can you
build a roll.
Speaker 2 (08:17):
Also, gps also have even within the specialty of general practice,
there are general there are gps who have a certain
special or expertise. I mean they'll be the ones like
in the practice that I've been at, there's the one.
There might be one or two who quite like to
cut things out, yeah, and others who are like nah,
I'll just like that. I'll send you down the corridor
(08:38):
to a colleague.
Speaker 7 (08:39):
Yeah. So it's fine, but it's coming back to general practice.
The most important thing is a relationship. So that I
used to play this game when had students coming through
the practice and we were using paper files and say,
pully out that paper file, tell me the name that's
on there, and I will tell you who their family is,
what other family members there are around there, the mother,
the sister, the father of the brother, the auntie, the uncle,
and what their health problems are, because you're not just
(09:01):
looking after an illness or a condition. You are trying
to be there as a health resource to the entire fun.
Speaker 2 (09:08):
Now, well, that's interesting because the reason I'm with the
practice that i'm with now is because Mum and dad
went there, even though that's not my hometowns, you know,
but where it was, I was within couey of their doctor,
and I quite liked, even though I don't know how
the confidence. I like the fact that they were aware
of my parents' medical history, which might have informed them
(09:28):
on the things that they want to question for me,
which actually is relevant, Isn't it totally relevant? But of
course if you go to your own.
Speaker 6 (09:34):
Medical practice, well that's that sort of elephant is not
in the room any longer, is it?
Speaker 7 (09:38):
And also if we got into episodic telehealth, so tellyhealth
through a practice where you know who the patient is.
Speaker 6 (09:44):
Really quite we need to define telehealth.
Speaker 7 (09:46):
So telehealth is non we call it virtual. In other words,
you're not sitting in front of the client. Now, some
of that can be put out through your own practice
where that practice will know you, yeah, and they'll have
access to all of the information. Access to the information
is not really the big thing. It's I quite often
again with students, I'd say, why is this Your individual
got their ass in that chair today? Right? So and
(10:09):
technically end well, but it's not just the presenting complaints
the whole thing which brings them to you, so you
can actually formulate something for that will help them. When
you get on telehealth one to somebody who doesn't know you,
they simply either on the phone, which is not so good,
or even through a screen. It's really hard to develop
that relationship, to know that trust and you actually start
(10:30):
dealing with a condition rather than with an individual.
Speaker 2 (10:33):
Because as telehealth, I mean, can it be could you
be talking to doctors in different countries as well?
Speaker 7 (10:38):
Anywhere except for registration, it becomes a little tricky. We
you have to be registered in New Zealand to offer
that service.
Speaker 6 (10:44):
In New Zealand. Oh okay, right.
Speaker 7 (10:47):
Yeah, so you can't be a doctor registered in the
States and patients in New Zealand. Okay, the Medical Council
won't allow that.
Speaker 2 (10:53):
Are there many overseas doctors who are registered in other countries.
Speaker 7 (10:57):
Not that I know of, Okay, okay, So normally the
New Zealand registered doctors working in New Zealand in a
maybe not even in a practice. They're on a dial
up service.
Speaker 6 (11:06):
What's it I mean?
Speaker 2 (11:07):
Does it does it change the access to health or
does it simply mean you don't if you're get in
the car and drive across town.
Speaker 7 (11:12):
So in actual fact, tallyhealth is not beneficial to the provider,
to the GP. It's a huge potential bonus for the client.
In no words, if you're going to your dock, yeah,
you've got to stop doing what you're doing. You've got
to drive somewhere, you've got to part the car. You
sit in the waiting room and it's only for five minutes,
by the way, you never sit there for more than that.
You're right, okay, go away, go away.
Speaker 2 (11:33):
Well, actually, I tell you what has a little hint.
I mean you can end up waiting, but I always
think that turning up on time does help.
Speaker 7 (11:39):
No first appointment after lunch. Don't tell anywhere. This is
just between you and me.
Speaker 6 (11:44):
Okay, what time's lunch?
Speaker 7 (11:46):
Just we'll find out what time lunches and take the
first appointment as never take the first appointment of the day,
and never the last appointment. First pointment of the day.
We rode, drove over the cat. The children are going, oh,
we're horrible, And the last appointment of the day. You're
absolutely shared. So you don't want to spend any time
with this punter. So at the first appointment at lunch,
you've arrived, you've cleared the morning, you've had your lunch,
you settled down to go bag on time. You don't
tell anyone that, but that's the way.
Speaker 6 (12:07):
Okay, there you go.
Speaker 7 (12:08):
People never booked after lunch, No first one after lunch. No,
that's I'm saying never. But so I can't do it,
all right, so you can do it.
Speaker 2 (12:15):
How do we get onto this, Well, actually it's all
about accessing healthcare, but also in choosing that GP.
Speaker 7 (12:22):
But yeah, it's excessing healthcare. If you're known to the
practice and I have a phone conversation of video conversation
with you that jimally weez quite well. So I know
who you are, what's going on with you, and you
can go okay, I can't look down your ears or
probe and poke and stick. No, you can't do that online,
and so you have to do something. Even before the pandemic,
I did a little survey within my practice, and I
(12:43):
reckon that around twenty five percent of the patients who
crossed my door actually needed to see me face to
face in person.
Speaker 6 (12:49):
How is there a generational sort of thing on telehealth?
I got it, Matt. If I want to see the doctor,
I think I want to walk into this. I want
them to see me.
Speaker 2 (12:58):
Even there's a I saw a specialist the other day,
and I know that there are a couple of things
she wouldn't have picked up if I had been on camera.
And it wasn't about a particular health condition. It was
just about the treatment options and helping me make a
choice on something absolutely, And I don't think she would
have got that if she hadn't been talking to me
in person.
Speaker 7 (13:17):
Now my console starts as I go and get you
from the waiting room. I'm looking around the waiting room.
I'm looking at you. I'm looking as you get up,
I'm looking at how you're dressed. I'm looking at how
you walk down the corridor. I'm already starting to formulate
what might be going on.
Speaker 6 (13:29):
Now.
Speaker 7 (13:29):
If you miss out on that and just see in
front of a screen, you'll miss that. So virtual care
within the practice I think works well. Virtual care to
someone whom you've got no relationship with, you've never seen before,
you've got no idea of the quality or anything else
like that. I'm not quite so sold on that. Yes,
it can solve a problem. And if that's all the
access to health care you've got, then we have to
(13:51):
live with it and try and make it as good
as we can.
Speaker 2 (13:53):
Okay, Looking before we go to the cause, how would
you advise someone on choosing a practice or a doctor? Yep,
and be going because just you know the family connection
with our practice, you know where the practice I go
to a bunch of reasons. I might be deciding to
look at a new doctor.
Speaker 6 (14:14):
Where would I? How would I?
Speaker 7 (14:15):
How would you do it? Okay?
Speaker 2 (14:17):
Because I tell you should I offer the dumb thing.
I'm going to look locally. First question, absolutely and beyond that,
I don't know right.
Speaker 7 (14:24):
So first we have to acknowledge that there are places
in New Zealand we don't have that choice because yeah,
they're overwhelmed. They're not taking registrations and that's the problem
we have to fix. Okay, so you're in a new area.
First thing I do is go and talk to local pharmacist.
Speaker 6 (14:40):
That is a great I don't have a chestion. God,
that's good.
Speaker 7 (14:43):
Look, I'm new to the area I'm thinking about. The
pharmacist knows everybody and everything, right, so they might be
able to give you a pointers of saying, well, you know,
for you, this might be a good one to have
worked at. First, it should be a fellow of the
Royal College of General Practitioners, so a fully qualified practitioner.
(15:04):
They should be at the They have to be what
we call Foundation standard, accredited and possibly even a higher
quality regime which is called Cornerstone to practice itself. So
you're looking at for a quality practice. You're looking at
a busy practice that probably has got a few doctors around.
Speaker 6 (15:21):
Do practices differ in the length of appointment time they give?
Speaker 7 (15:25):
That's a standard fifteen minute basically it is.
Speaker 2 (15:28):
It's nobody decreed that we could solve help there in
the conversation, because the conversation I heard from this person
was that this doctor was under pressure, christ that the
practice that introduced was ten minute appointments, So that would
be yeah, that would be a flag. How long are
your appointment times?
Speaker 7 (15:44):
Exactly? Yeah, what's wait for the appointment with you? Yep?
And when you when you do sign up, go and
source them out, go and sit in the waiting room
for a bit and have a look around. See what's
going on this open country. Okay, and what about.
Speaker 6 (15:57):
Female versus male?
Speaker 7 (15:59):
And it's bullshit? No, no, not no, this is one
of my beefs.
Speaker 6 (16:03):
No, no, no, I haven't got a beef for that.
I don't mind a female or a male.
Speaker 2 (16:08):
But there'll be people somebody saying, Okay, the typical I'm
gonna say, the typical bloke is middle age, just like well,
I don't want to a prostate checked by a woman
or funny enough, they might not want to check by
a bloke.
Speaker 6 (16:17):
I don't know why, but people have.
Speaker 7 (16:19):
Got much narrow fingers. So look at the quality of
the provider, not the gender of the provider. Yes, And
I get really up and names. I've known some really
really good female docs. I know some female docks. I
don't go for and in vice averse with males. So
look at the quality and leave the gender at the door.
We leave the gender at the door when you're walking
through my consulting room.
Speaker 2 (16:39):
Do you find that people do have a strange predilection
for saying, oh, I've got to get this test, and
i'd rather see a male or a female.
Speaker 7 (16:46):
That's fine, you can you can meet that. You've got
that mixed with them the practice. When I left my practice,
I was the only male in the practice with five
other female doctors, so they had to try and find
another male to welcome. Aaron. You're doing a great job,
but he's just coming and he's the token male in
our practice.
Speaker 2 (17:00):
Now, Yeah, I've always thought it's a somewhat I'm not
sure if it's a paradox that for some reason, if
men want they're going to have their prostate checked, they
would rather a man do it, And which is anyway,
I can't get my head around it.
Speaker 7 (17:13):
But quality, go for quality. Just look at the quality
of the clinician. That's what you're after.
Speaker 5 (17:18):
Yeah.
Speaker 7 (17:18):
Yeah, and I had a health interaction this week and
it was with a specist or partist colleague of mine.
It took an hour.
Speaker 6 (17:28):
Yeah, I would love.
Speaker 7 (17:29):
To have an hour with a new patient because you
really make fine. I got paid six hundred and fifty
dollars for it. So that's the other side of it.
Speaker 2 (17:36):
Actually, that suggestion of the pharmacist is a great one.
I think that that's if you're going to take one
little bit of because it's so obvious because pharmacists, I mean,
obviously pharmacy has changed as well with the chemists warehouse
and all those sorts of things. But if you're lucky
to have a pharmacist who has a relationship with the community,
go and chat with them. That's that's brilland device.
Speaker 6 (17:58):
John, you congratulations, thank you can go home now.
Speaker 2 (18:01):
No, no, no, don't move anywhere. We're going to take
some calls one hundred and eighty ten to eighty. Look
your questions for John as well, But also how did
you go about finding your GP? Did you just inherit
it through family or relationships and connections. But if you've
moved to a new neighborhood, new town, new city, whatever,
how did you go about it? Did you ask around?
I mean if you're at the school. Maybe you ask
some of the parents that you know when you're at the.
Speaker 6 (18:21):
Pickup, who's your GP?
Speaker 7 (18:23):
What are they like?
Speaker 6 (18:24):
Actually that's not a bad idea either.
Speaker 7 (18:26):
But you'll be getting at one.
Speaker 3 (18:27):
Ah.
Speaker 6 (18:28):
Yes, the pharmacist he see everything.
Speaker 5 (18:31):
Yeah.
Speaker 2 (18:32):
Must be difficult for pharmacists to go on a blind date,
wouldn't it, because you meet someone and you go, oh,
I don't think we can go on. I've sent you
prescriptions anyway.
Speaker 7 (18:39):
I don't know.
Speaker 6 (18:40):
That was a random thought from me. Twenty five.
Speaker 2 (18:42):
That's what I do from time to time for a
stream of consciousness. Twenty five past four News Talk z B. Yes,
News Talk z B with Tim Beverage talking about choosing
your GP and we actually you would love to know
from those of you who are quite comfortable with telehealth
and just getting on the on the zoom call or
the equivalent of it now anyway, and hello.
Speaker 8 (19:05):
Good afternoon, Tim and the doctor. I just turned on
the radio to hear the doctor say nowadays we treat
the whole person rather than its a disease. How I
wish that was the case when I was thirty four.
I'm now nearly eighty nine, and after ending up in
the Cute Medical in Dunedin for the third time to
(19:28):
three specialists stood at the end of my bed, debating
what was wrong with me, as if I wasn't there
so being me. The next when I got the chance,
I said to him, I said exactly what that doctor said,
that I wish they'd treat the whole person instead of
just a disease.
Speaker 2 (19:47):
And believe me, was it because they'd forgotten that there
was a human being who could actually hear what they
were discussing, and you would have run.
Speaker 8 (19:53):
It was terrible. It was terrible, and it slowed things
down for me because I was frightened to speak. But anyway,
eventually they after acting the point between two specialist, Professor Stewart,
my specialist, doctor Dixon, and doctor Dixon won and I
(20:15):
went home to the year from hell until my hair,
my skin turned dark brown, by passed fro amn Indian. Oh,
she got nervous disorders. She's got Edison's disease.
Speaker 6 (20:27):
So how are you? I'm not sure what to ask you.
Speaker 5 (20:30):
Now.
Speaker 6 (20:30):
That was a while ago, wasn't it. But really I'm June.
Speaker 8 (20:36):
I was thirty four when they finally diagnosed me, and
I don't believe me that I was very close to dying.
They're very lucky I didn't die on them.
Speaker 7 (20:45):
Well, same diseases, John Fitzyer Kennedy.
Speaker 6 (20:47):
What is Edison's disease?
Speaker 7 (20:48):
It's a primary adrenal band failure.
Speaker 2 (20:51):
Okay, Well, I mean, look, I think and it would
have been uncomfortable to be discussed like you just sort
of slab, but at least there were three of them
trying to find the answer.
Speaker 7 (21:01):
You go somewhere else and do that exactly.
Speaker 6 (21:05):
Have changed on that respect, I would hope, I would hope. Yeah,
thanks for your call. Anne Alison.
Speaker 9 (21:10):
Hello, Hello, Just about the finger prick print test for
you for the kidneys. You don't go to your doctor
for that, do you?
Speaker 7 (21:18):
What's the finger prict test for kidneys? Help me out
on that one.
Speaker 9 (21:22):
Well, it's on semi shark one night where you can
go along and you can go to this thing and
you have your finger practice to test with you, and
I little thing comes and shows your number and then
it's got a problem. Then you go back to your
doctor from there. So if you just go you don't
have an ordinary blood test, that would they kept your kidneys.
That would be the best way to do it rather
having the finger practice, wouldn't it Okay?
Speaker 7 (21:41):
First thing, it's much more accurate to have it done
through a formal lab, and secondly it enters your clinical
record in a meaningful way so that we can follow
the trend. So yeah, point of care. Testing can be
very important if you're lying in the hospital being about
to die and we want to know exactly what's wrong
with you. But for general stuff, yeah, maybe not.
Speaker 9 (21:59):
And just when the blood tests, when you go to
your doctor, they know what to tack on that you don't.
You're not up to you to tell them what to
do there. They know what to teck, don't they. The
more you teck, the more they pay.
Speaker 7 (22:12):
No, not at all or for testing. It's all covered
by the government.
Speaker 9 (22:16):
So right, that doesn't matter to two. They're not cost anymore.
Speaker 7 (22:22):
That ties into something somebody said to me.
Speaker 2 (22:25):
Somebody said, you can refer yourself for a blood test
or something like that, and when and what circumstances would
you do that, because I would have thought the hyper
hypochondract would take everything and.
Speaker 7 (22:35):
Then they pay for it. So if you do that,
you self pay.
Speaker 2 (22:38):
Oh, so if it's not referred, like you can come
in here and get tested for x y Z or
eights head if you want, but you're paying for it
unless you've got to referral from your GP.
Speaker 7 (22:47):
And then how are you going to deal with the
result because the lab won't take ownership.
Speaker 2 (22:50):
That's why I put it up because I thought something's
missing from the story.
Speaker 7 (22:53):
So firstly, why are you doing the test? There's a
good rule of mens that you should never do a
test that you don't know what the answer is going
to be. So you're doing a test to test a hypothesis.
You go hunting, you will end up with so many
read hearings that you're.
Speaker 6 (23:04):
In And I'm hearing Jack Nicholson saying you can't handle
the truth. Well, I've got to be a GP sort
of a quivalent.
Speaker 2 (23:12):
Actually, just before we go to our next caller, I'm
reminded by regularly there's been a bit of talk about
COVID and flus and stuff like that, just as a
public health sort of awareness thing. What's the flu jab
sort of season? As are we into it one April?
Speaker 7 (23:28):
The vaccine? So this little hint, if you talk to
your practice, they probably have got the vaccines in. Yeah,
they might have, but we can't start claiming it off
the government till one April, so sometimes we just I
couldn't say that, okay, right and put the invoice through
slightly later. That's good. So yes, it's only a few days.
I know it's only a few days. So yes, is
the flu vaccine starts in one April, and it's a
(23:49):
good idea if you're in the eligibility group for COVID.
There is a new COVID vaccine around as well, which
will cover the legs and as.
Speaker 2 (23:54):
The new one, the new strains are in now. And
what about the one where they say, remember there's there's
the one where you get the free one and or
you can get the super duper one and pay thirdy
not for COVID.
Speaker 7 (24:04):
I think, no, that's wasn't okay. Yes, So so look,
if you want to do that, fine, it's not going
to give you really that much additional benefit. It is
a theoretical benefit, but whether it works out in practice.
Speaker 2 (24:16):
It I was just wondering if it was the pharmaceutical
or qualm, would you like would you like would you
like fries with that?
Speaker 7 (24:20):
Would you like size fries?
Speaker 2 (24:22):
Actually the good group, but one one side effect of
having done talkback right throughout the COVID thing is. I
do have a couple of vaccinologists on speed dive, well
one in particular, and I talked.
Speaker 6 (24:33):
Yes, that's the one.
Speaker 2 (24:36):
God, she is fantastic, Harris, and she's the I just
love the fact that her name is very close to
whipping off.
Speaker 7 (24:44):
It's it's called the whole thing off.
Speaker 6 (24:49):
Yeah either right. Oh gosh, we're random today, aren't we?
Uh as we as? I love it? Yes, but yes, Windy,
Hello here, Hi guys here.
Speaker 5 (25:04):
I have an unusual sort of query here. I have
this mobile lump that sort of moves around the left
hand side of my body. It seems about the size
of a small walnut, quite firm, and I can feel
it under the bottom of my ribs right down from
a hip area, and it appears randomly. If I cut
(25:25):
my shoe laces this sort of bend over. It's sort
of I can feel it then and I have to
get on my hands and knees, you know, for it
to move off where I can't feel it. It's not painful,
So I was wondering what.
Speaker 4 (25:37):
It could be.
Speaker 7 (25:38):
And it's blow the level of the skins, as you
can tell.
Speaker 5 (25:41):
Yeah, yeah, quite sort of.
Speaker 7 (25:44):
Any shown it to your dock.
Speaker 5 (25:47):
No, I haven't checked it out.
Speaker 6 (25:48):
No an idea, Yeah, it would be. Yeah, how come
you haven't been to the doctor about it yet?
Speaker 5 (25:56):
Oh, I don't know. A funny thing about three four
months ago, I woke up really really ill, you know,
and I have I had a raucus calf and tickley
throws and my breathing was really hampered and yeah, and
(26:17):
I was wheezing a lot, runny nose, no energy, feeling tired,
and I thought it might have been COVID, but it was.
I had a test and it wasn't COVID, And then
I went to the emergency doctor and I found out
me blood pressure really dropped quite low to about one
hundred and six thirty five blood blood oxygen was ninety
two or something. So whether it was, I haven't had
(26:41):
it since then, So whether it might have been a.
Speaker 7 (26:45):
Movie, no things related to that. But if you've got
a lump anywhere, come and show it to us. Yeah,
we'll sort of what it is, and if it differ
in doubt, we'll do some testing to find out what
it is. If it's safe, we leave it bee if
it's not, we remove it. And we sought it for you,
so it'd be fronting about showing things and not all.
Speaker 5 (27:04):
When I got to I can't feel it. You know,
it doesn't appear, you know, I sort of do a
weird sort of movement or something.
Speaker 7 (27:11):
Can we do the weird sort of movements? We don't
mind you, Yeah, we don't mind you doing all those
things in the concert room.
Speaker 2 (27:16):
Okay, fine, thank okay, thanks, cheers. Do you get things
that move around a bit that sort of you know,
can be here here and there or unusual?
Speaker 7 (27:25):
That's how unusual?
Speaker 6 (27:26):
Okay?
Speaker 7 (27:29):
Right?
Speaker 6 (27:29):
Oh wait, one hundred and eighty ten eighty, let's go
to tell you what.
Speaker 2 (27:33):
Let's go to the break. We've got a couple of
speed lines. So if you want to come through and
I have a chat with John Cameron. But in particular,
i'd love to know how you would go or how
you did go about choosing your GP. And John's made
a very I think a golden suggestion is go and
talk to the local pharmacist. Possibly not at the chemist warehouse,
(27:53):
because I'm not sure who knows who knows, but yeh,
go and talk to the local pharmacist and just say,
in which GPS do you like?
Speaker 6 (27:59):
How would you ask?
Speaker 7 (28:00):
What would you say, I'm new to the area, I'm
looking to find a GP. Can you give me some
hunters on who I could be looking for?
Speaker 6 (28:07):
Okay, good, simple, that's not There's an art to asking question,
isn't there? And that was it? Okay?
Speaker 3 (28:13):
Right?
Speaker 2 (28:13):
It's twenty two minutes to five News Talk zed B.
I'm with doctor John Cameron and we're talking about choosing gps.
What do you look for? And actually the other question
just before we go to our next caller, John, was
we are you having a conversation off here about you know,
there's the gps who are great at the common touch
and you feel a certain connection. But then there might
be the one who maybe isn't exactly the most charming individual,
(28:36):
but it might be a diagnosedtician for the ages.
Speaker 6 (28:38):
So where do you go?
Speaker 7 (28:39):
You try and get both of those together, and what
you'll find is that certain patients will gravitate towards certain
members of the practice. There are people who in my
old practice who wouldn't come near me with a barge
pole because we just didn't match.
Speaker 2 (28:51):
That's an argument for joining the practice too, isn't it?
Because doctors, somebody might say, I've got a tricky case.
I might take it down to my friend, might take
it down to.
Speaker 6 (28:57):
Dave and have a chat. See what he reckons.
Speaker 7 (28:59):
Always doing that?
Speaker 6 (29:00):
They're always always doing stuff right.
Speaker 4 (29:01):
Peter, Hello, Yeah, h I turnin doctor John. I had
a bad fall going for an x ray on to
two wrists that I'd fallen on or a couple of
months ago. I got an x ray from the from
the fall there and they said I've gotarthritis and the
(29:23):
two thumbs and one finger. I'm just wondering. I've also
had a chronic knee for years and years and years,
and all of a sudden that's all come up, and
I'm wondering if if by the fall it's upset my
knee also. And I'm just wondering you might be able
(29:43):
to offer me something for the for the f riders
and these thumbs instead of just taking penadole.
Speaker 7 (29:51):
So yeah, So quite often you when you have a four,
you'll tickle up a joint and it lecked up. And
quite often if you damage one side of the body,
the other side of lecked up. As you're taking compensating
for it. By what you're saying, I'm assuming that what
you've got as a form of threat, it's called osteoarthritis,
which is where the nice smooth joint catch cartilage wears away.
(30:12):
Now that tends not to be a whole body approach
where and like the inflammatory arthritis is like rheumatoid arthritis,
where there's an active destructive process that goes on on
specific joints around your body. So, firstly, most important things
to keep as mobile as you can. Secondly, paracetamol is
a reasonable thing that will help take away some of
the pain. It won't work so much on the stiffness,
(30:32):
but using it, using it, using it for your wrists
and fingers. You just got to keep using it. Paracetamol
is good. Anti inflammatory medicines can be there, but they've
got some risks associated with them, and so we try
and hold off those as much as we can. But
most important things keep things moving, keep moving moving.
Speaker 10 (30:48):
Yep.
Speaker 4 (30:49):
Okay, thanks you very much.
Speaker 6 (30:52):
Yeah, good on you. Thanks for calling cat.
Speaker 7 (30:54):
Hello.
Speaker 3 (30:56):
Oh my goodness, I don't even know where to start.
Speaker 5 (30:58):
Hi.
Speaker 3 (31:02):
So, my teen year old three months ago was diagnosed
with scoliosis. We've been seeing a my fascial my facial
that make pensions. Okay, So he was he was sixty
three degrees he's now at seventy after three months, so
(31:22):
that's not working. What the not all? Almost for?
Speaker 7 (31:27):
What?
Speaker 3 (31:28):
What what do I do with Mike?
Speaker 5 (31:29):
Yeah?
Speaker 3 (31:30):
I know, sorry, very.
Speaker 7 (31:32):
Well. Normally, normally scoliosis is something that is developed from
birth rather than something which accelerates as they get older. Okay,
have you he.
Speaker 3 (31:40):
Had he had he had lung surgery, keyhole surgery when
he was one. And they are producing that they have
next nerd.
Speaker 7 (31:48):
That is I wouldn't believe that one. It's on. Have
you seen have you seen an orthopedic surgeon on this matter?
Speaker 3 (31:56):
Yes? Yes, yes, yes, and so now waiting to get
in to see start it.
Speaker 7 (32:02):
Yep, yep. That's almost certainly the way that you go.
And with a scoliosis, exercise generally doesn't do a hell
of lot. They can try sometimes some corseting so to
try and realign things up and as a last at surgery,
but it's a long slide process and it does take time,
and I apologize for that, but it's generally takes time
(32:23):
because there is a long term process. It's not something
that you're going to arrive one day and get fixed
the next day, So there will be a time fact.
Speaker 3 (32:30):
Yeah, absolutely okay.
Speaker 7 (32:33):
So you're on the right track, okay. And from the mobility,
physio osteopathy, all of that sort of thing, that's if
it's a true bone scoliosis, that's not going to make
that much of a difference because it's a bone process
that's causing the problem. And I think it's very unlikely.
Speaker 3 (32:50):
I'm not understanding what that means. What does that mean.
Speaker 7 (32:53):
So it's the way the bones are built, not necessarily
the muscles and and anything else. Okay, okay, okay, So yeah.
Speaker 3 (33:00):
So that's the fact that he's gone from sixty two
percent to seventy percent in three months.
Speaker 7 (33:06):
I don't I don't think that is that should be
super worrying for you. But when you're doing these things,
if it's measured on an X ray, quite often there's
a whole lot of rotational things that go on on
X rays that will give you false reading. So we
can say it's averaging out around that I think would
be very unlikely, and I can be you know, I
can be corrected on us. I think it's very unlikely
that things are going to catastrophically go bad for you
(33:27):
and for your young man.
Speaker 11 (33:28):
Okay, thank you.
Speaker 6 (33:30):
O, thanks thanks for your call Carlton.
Speaker 11 (33:34):
Hello, hello doctor John. You mentioned earlier about making a
doctor's appointment. I've been helping out the local amateur theater
and the rule of summers you don't go to the
first performance and you don't go to the last performance.
Pick one in the middle about lunch time.
Speaker 7 (33:53):
It's about right. We call it the U shaped curve.
So when you first got out a medical school, you're
absolutely dangerous, right because you've got no knowledge. And as
you get to my a you come and back up
the other side of that you shape curve and it's
really good. You really have to know when to get
off the curve. So you're right, that middle is really
good where you've got a lot of experience, a lot
(34:14):
of knowledge, and you're putting it to good use. I
agree with you totally.
Speaker 11 (34:17):
I believe in dance they call it meddle for diddle.
But my eighty four year old neighbor, he's very fit,
sixty k bike rides, osteos riders in his ankles. Is
there anything he can get any sort of support through
his ankles because standing is his problem.
Speaker 7 (34:36):
So and when you're talking about nostriothritis to remove the pain,
you stop movement. So if we stop the movement, the
pain would go away. But if you stop movement, you
put a whole lot of secondary disability into the process.
And so it's that constant balancing of trying to keep
as active as you can, to keep the joint moving,
to keep the rest of the body accommodating the stiffness
and a joint, trying not to lock it up. So
(34:58):
being mobile again and cycling brilliant for ankle's knees and
heaps really good. You're not weight bearing, you're not thumping
down on the pavement, you're actually getting things moving, and
keeping that non weight bearing movements really important.
Speaker 11 (35:13):
Just another funny aside, the only time he's fallen off
his bike is when the bike was stopped.
Speaker 2 (35:19):
Well, especially if you're wearing the bicycle clips. It's one
of the reasons I haven't thought about getting those because
I thought I'll be the guy who forgets, who pull
up to the lights and go help.
Speaker 6 (35:30):
Which could be quite dangerous if you fall into the path.
Speaker 2 (35:33):
So yeah, actually, but just before we go to the
break and we'll come back with a quick call from Sally,
I think somebody texted saying I work as a pharmacist,
and unfortunately we aren't ethically or maybe even legally able
to recommend GPS to the public. I did mine just
before we go to John on that. I've did my
own research on that, and actually the code of practice
for pharmacists it looks to me from what I read,
(35:55):
is that it's actually part of the thing that you
facilitate access to professional services so long as you don't
have a specific relationship and get a financial benefiting stunt.
Speaker 7 (36:05):
Nothing's in writing, so and you're just asking, you know,
if you were seeing someone in the area and you
know who I am, what would you suggest. So it's
it's nothing legal, it's nothing binding, there's no kickback on it,
and you're not certainly not directing to your own sifts.
That's a really potentially increasing risk in healthcare at the
(36:25):
moment is self referrals to within the same group.
Speaker 2 (36:28):
In fact, one of the that says here the pharmacist
recognizes patient's health status, abilities, cultural and social needs, and
provides or facilitates access to professional services delivered by the
pharmacist or other appropriate services. Sounds cot off. Sounds like
that's covet it off for me. It's always good to
go to the you know, to the actual the.
Speaker 7 (36:47):
Fountain of knowledge that the web chat JBT pushed me
in that direction.
Speaker 6 (36:51):
But I'm actually at the Pharmacy Council dot org dot
in z website.
Speaker 2 (36:54):
So in my defense, it is what's the time. It's
ten to ten to five, time flies as news talks
that be with Dr John Cameron and time for one
quick call. We've got about two minutes, Matt, Matt, that's you. Yeah, Hello,
(37:16):
you're on air. What would you like to talk about?
Speaker 11 (37:19):
Oh?
Speaker 10 (37:19):
I was just wanting to talk about my IBS.
Speaker 6 (37:23):
Yeah ib Yes did you say.
Speaker 7 (37:26):
Yeah, IBS edible syndrome.
Speaker 10 (37:29):
Ye, yes, that's right. So I was just, I guess
asking a question. So I go into the office and
it's it's just like a nine to five Monday to Friday.
It seems I have IBS and then as soon as
I get home for the weekends, no more IBS. Like,
I don't know what it.
Speaker 7 (37:49):
Is, but there's your answer. Don't go to the office.
Speaker 5 (37:52):
That's not an option.
Speaker 1 (37:54):
I know a mortgage.
Speaker 10 (37:56):
I've got kents to feed, you.
Speaker 7 (37:57):
Know, yeah, I know you'd look. Is there anything When
we talk about ib seretral bell syndrome, we always try
and look for a dietary processing around it and the
classic ones what we call fodmap, which is a where
we try and avoid forermendable sugars in your diet. Have
you been able to find something within your diet that's
different between home and work.
Speaker 5 (38:19):
No.
Speaker 10 (38:19):
I thought it might have been the coffees, but then
I stopped drinking coffee at work and same thing.
Speaker 6 (38:26):
It's just a formal diagnosis you've had of that. Or
is a self diagnosis of IBS?
Speaker 3 (38:31):
Ah?
Speaker 10 (38:32):
Yeah, it's a self diagnosis, that's for sure.
Speaker 2 (38:35):
It's yeah, okay, well so IBS.
Speaker 7 (38:40):
There's no diagnostic test for IBS. It's a diagnosis of exclusion.
We've excluded everything else. We really don't understand about understand
much about gut motility and the microbiota as much as
we would really like to. One thing you can try
is fod mapping. It's from the Monash University. Go Monash
University fodmap. Give that a go. And it's hard to
(39:01):
do that diet, but that will soon tell you whether
it's likely to be IBS or not. But also get
a clinical diagnosis to rule out the things which it
might be. And there are other things that can cause symptoms,
symptoms five years, intermittent diarrhea, constipation, grumbley, abdominal pain, pooping, farting,
it's and so there are very many things that can.
Speaker 6 (39:17):
Some people would say that sums up my yeah.
Speaker 7 (39:22):
So either try the mo Nash five map, or go
and see your doc and talk about putting on the
table and see if you can come up with a
diagnostic process for you.
Speaker 2 (39:29):
Thanks for your call, Matt, and good luck with that. Hey,
so we got about just with about a minute remaining. Really,
so if people are thinking that they that they're that
they're going to look for another doctor and then arrived
in New Town. So talking to your local pharmacist, I
mean I talking to I mean people that you know,
talking to people have the most common interface with medical practices.
(39:49):
I guess, wouldn't it.
Speaker 7 (39:50):
Yeah, it's all around that and taking them for a test, right. Yeah. Hey, look,
I'm new to the area. I'm thinking of joining the practice,
so I just thought to come along and see how
you are. Pay the money, take a consoplet. You'll get
a little bit of health advice from it, and you'll
soon work out.
Speaker 6 (40:05):
Well, you've always got something you want to ask about anyway,
haven't you.
Speaker 7 (40:07):
Oh god you yeah. Yeah. The people who stay away
from us since we dragged them in to say, look,
what's time we actually saw you. The list comes out.
Speaker 2 (40:14):
Yeah, excellent. Hey John, thank you so much for your time. Again,
we always appreciate you coming on the show.
Speaker 7 (40:19):
It's a pleasure.
Speaker 2 (40:20):
Great stuff that is doctor John Cameron. We'll be back
next with Smart Money Rupert Carlo and we're going to
talk about, you know, what the investment sort of landscape
looks like with everything that's going on so nationally so
and your key We saber I one hundred eighteen eighty
after five for the Smart Money back soon.
Speaker 1 (40:44):
For more from the Weekend Collective, listen live to News
Talk zed be weekends from three pm, or follow the
podcast on iHeartRadio
You're listening to the Weekend Collective podcast from News Talk SEDB.
Speaker 2 (00:13):
But you've burn not kill the use.
Speaker 3 (00:17):
Hey hey it's later on the time flow, but you've.
Speaker 4 (00:21):
Burn not tell the nest D day.
Speaker 1 (00:24):
You're gonna burn?
Speaker 5 (00:25):
This gone down?
Speaker 6 (00:25):
How's that down?
Speaker 2 (00:27):
Yes, welcome back. This is the Weekend Collective. I'm Tim Beveridge.
Nice to have your company. The number is eight hundred
and eighty ten eighty and we want your calls for
this hour. Chris, this is the Health Hub and what
we're going to have a chat about this hour.
Speaker 6 (00:41):
Before I introduced my esteemed guest.
Speaker 2 (00:44):
Is well, you know, obviously, look, time's changed, don't they,
and so is the way that we interact with the
health system. There's a change in popularity of telehealth and GP.
Telehealth GP appointments obviously became vogue during the pandemic. Everyone
was doing everything remotely, well a lot anyway, and it
hasn't really gone away since and just about every general
(01:04):
practice now offers a telehealth appointments or remote appointments at
least if I can put it that way generally, as
maybe perhaps are less costly or more accessible alternative.
Speaker 6 (01:14):
But also, you know this country, as you.
Speaker 2 (01:16):
Will reading the news is a primary health care crisis
going on, with fifty percent of gps planning to retire
by twenty thirty five, which will be after we've run
out of oil. Anyway, Sorry, I just shouldn't have said that.
It was this ridiculous comment anyway, But Tellorhealth's another tool
to get patients seen as gps leave the workforce. I
guess that it might be, or is it? I don't
(01:39):
know anyway, See, my guest is disagreeing with my script already,
which is fantastic. But also the question I've got is
how do you choose a GP? And there are a
couple of reasons for this question, Because you know, there's location, location.
Speaker 6 (01:52):
Location, You go somewhere in your neighborhood.
Speaker 2 (01:54):
Of course they're only five minutes away and it's convenient
or close to your kids' school might be another one.
Speaker 6 (01:59):
But of course there's the GP themselves.
Speaker 2 (02:02):
And how do you know if a GP is going
to be right for you? Because medicine's medicine, isn't it?
But how important is that specific relationship that you have
with your GP? And and also the reason I sort
of mentioned it was a conversation with a conversation with
a parent the other day about doctors who were in
a particular corporate type practice where they were under a
(02:24):
lot of pressure to get through so many appointments and
all that sort of thing, as opposed to you know,
the local GPHR owns its own practice and all that
sort of thing. So the different sort of practice do
you belong to a practice? Do you join a specific GP?
How do you choose it? Where do we go?
Speaker 6 (02:37):
What's happening?
Speaker 2 (02:38):
We're going around and round we go and where she stops?
Nobody knows and enjoining me to discuss that and give
us all the answers because it's a bit of a
no at all. Well, actually, John Cameron, you have to
sort of be a bit of a no at all
as a GP in a way.
Speaker 7 (02:55):
Don't you do you?
Speaker 2 (02:56):
I mean, because people want the reassurance that you know
what I mean if you were going.
Speaker 6 (03:00):
Not sure about that one?
Speaker 2 (03:02):
How often would a doctor say, well, I mean, a
good doctor say that quite du shouldn't they?
Speaker 6 (03:07):
How nice to see see general.
Speaker 7 (03:10):
Practice practices learn more and more about less and less
until they know absolutely something about everything, whereas my passions
colleagues lean more and more about sort of less less. Listen, listen, listen,
till absolutely everything about a small pitt. We're broad and
that we're broad with general as specialists.
Speaker 6 (03:25):
And that's because being a GP is the specialty. In fact,
do you do?
Speaker 5 (03:29):
You know?
Speaker 7 (03:30):
You do?
Speaker 2 (03:30):
You do your original degree M B C h B
and then what happens following that? As are you GP?
And then you go to specialize?
Speaker 7 (03:40):
Okay, so yeah, I get really up in arms. I'm
a specialist general practitioner. Yes, so did my medical degree.
The two years post registration, moved into general practice and
then undertook a long protracted voyage through to becoming a
a Fellow of the Royal New Zealand College of General Practitioners.
Speaker 2 (04:01):
So did you know that early on when you became
a doctor, you thought this is what I want to do.
Speaker 7 (04:06):
Yeah, I'm just curious and I started the fifth one
that I want to be a GP. Really?
Speaker 6 (04:10):
What was it? Was it?
Speaker 7 (04:11):
Ollie Johnson, great doctor, brilliant? Was my GP when I
was a kid, and he was a lovely man, beautiful,
Oh your GP. My GP when I was was a
we tacker and he drove a nice green e type
gen one of those.
Speaker 6 (04:25):
It's like my life what do I have to do.
Speaker 7 (04:28):
There's a personality that sold me on it and the
capability of the breadth of humanity that you deal with.
And so when you I hate it when people say
are just a GP. No, I'm a special generalist.
Speaker 6 (04:39):
Actually, can I let's get into that a bit more.
Speaker 2 (04:41):
But also one thing to go from, you know, liking
the family doctor who you saw and be inspired and
want an e type jag or whatever?
Speaker 6 (04:50):
Was that everything?
Speaker 2 (04:52):
How how much did the dream match up with the reality?
Was it sort of everything you expected to be and more?
Speaker 6 (04:57):
Or how different was it?
Speaker 7 (04:58):
And more?
Speaker 6 (04:59):
Yeah?
Speaker 7 (04:59):
And more wonderful? Yeah, you're talking about retirement. I theoretically
retired in August last year my practice. Okay, but I'm
maintaining my registration and I'm continuing doing bits and so
do you still are you on? Are you sort of
going going to the practice tomorrow? I'm doing sessions?
Speaker 2 (05:15):
And do you have the regulars who won't accept that
you've retired? It's like no, no, no, Johnsman doctor No.
Speaker 7 (05:20):
Because I did it hopefully gracefully by slowly pulling back
from the practice. So introducing people to the other members
of my practice who are brilliant GPS.
Speaker 6 (05:30):
That's a tough one for patients too, isn't it?
Speaker 7 (05:32):
That relationship And that comes back to what is a
general practition Well, and as.
Speaker 6 (05:36):
There's my intro, yeah, errors and admissions and expected of course.
Speaker 7 (05:41):
Yeah, and that's why I have it seems that Okay,
So we've got this great problem with primary care and
it's worldwide. It's not just in New Zealand. Everywhere around
the world is running show of general practitioners general practice.
Without general practice, our health system would fall over flat
on its face. Every dollar invested in general practice gives
you twelve to fourteen dollars return and saved healthcare costs.
(06:04):
So it sure beats a made way to walk with
and return to the public purse. But we're grossly underfunded,
we're grossly underresourced, and we've got to attract people into
general practice, which is the start. So people who get
there moan and growind about how bad it is. Now
busy there and all this go away. It's the most
brilliant job in the world. So let's get into it.
Speaker 2 (06:24):
How much has it changed for doctors heading into the
workforce now as GPS versus when you did it? Because
as I'm alluded to in my comments, so that there
are some more corporatized sort of practices where the doctors
are sort of I don't know the doctors even just
employees or shareholders or sort of.
Speaker 6 (06:40):
I don't know. How what are the different models for
general practice?
Speaker 7 (06:44):
For years, it was GPS working in an isolated room.
Even sometimes in a group practice, they just worked out
of one room and then they hadst yeah, very little
relationship with anyone else in the practice. That's changed significantly.
It's now becoming groups who own the practice. Like in
the practice which I've built up, that was sold to
(07:05):
two GPS, one receptionist to one nurse. So they formed
a little company and bought the place of me. So
GP ownership is still staying within general practice as a
money making ideas. It's a good coin, okay, So if
you owned the practice, yeah, it's great. Who can I
own a practice anyone? Really? It used to be like pharmacy,
you had to be registered in pharmacist to own a practice.
Speaker 2 (07:28):
The receptionist was in there because she's probably watched things
that revolve and going on this. If I could get
into this business, it'd be good. And all of a sudden,
like Hello, Yeah, so a small investment where you go.
General practice changed tremendously in the thirty eight forty years
that I have been doing it. We didn't know what
we didn't know back in the early days, working off
paper records, no electronics, not only seeing the pundits who
(07:48):
came in front of us. Now we're dealing much more
with population health who are in our population who have
enrolled with the practice. Now people can either enroll with
a GP or with a practice.
Speaker 7 (07:59):
So it's either or.
Speaker 2 (08:01):
And what's the most common scenario, all town, big town
does it or not?
Speaker 7 (08:06):
No, it's I much prefer the concept of when rolling
with the practice and sharing the practitioners within that practice,
so that you can share the providers, you can you
build a roll.
Speaker 2 (08:17):
Also, gps also have even within the specialty of general practice,
there are general there are gps who have a certain
special or expertise. I mean they'll be the ones like
in the practice that I've been at, there's the one.
There might be one or two who quite like to
cut things out, yeah, and others who are like nah,
I'll just like that. I'll send you down the corridor
(08:38):
to a colleague.
Speaker 7 (08:39):
Yeah. So it's fine, but it's coming back to general practice.
The most important thing is a relationship. So that I
used to play this game when had students coming through
the practice and we were using paper files and say,
pully out that paper file, tell me the name that's
on there, and I will tell you who their family is,
what other family members there are around there, the mother,
the sister, the father of the brother, the auntie, the uncle,
and what their health problems are, because you're not just
(09:01):
looking after an illness or a condition. You are trying
to be there as a health resource to the entire fun.
Speaker 2 (09:08):
Now, well, that's interesting because the reason I'm with the
practice that i'm with now is because Mum and dad
went there, even though that's not my hometowns, you know,
but where it was, I was within couey of their doctor,
and I quite liked, even though I don't know how
the confidence. I like the fact that they were aware
of my parents' medical history, which might have informed them
(09:28):
on the things that they want to question for me,
which actually is relevant, Isn't it totally relevant? But of
course if you go to your own.
Speaker 6 (09:34):
Medical practice, well that's that sort of elephant is not
in the room any longer, is it?
Speaker 7 (09:38):
And also if we got into episodic telehealth, so tellyhealth
through a practice where you know who the patient is.
Speaker 6 (09:44):
Really quite we need to define telehealth.
Speaker 7 (09:46):
So telehealth is non we call it virtual. In other words,
you're not sitting in front of the client. Now, some
of that can be put out through your own practice
where that practice will know you, yeah, and they'll have
access to all of the information. Access to the information
is not really the big thing. It's I quite often
again with students, I'd say, why is this Your individual
got their ass in that chair today? Right? So and
(10:09):
technically end well, but it's not just the presenting complaints
the whole thing which brings them to you, so you
can actually formulate something for that will help them. When
you get on telehealth one to somebody who doesn't know you,
they simply either on the phone, which is not so good,
or even through a screen. It's really hard to develop
that relationship, to know that trust and you actually start
(10:30):
dealing with a condition rather than with an individual.
Speaker 2 (10:33):
Because as telehealth, I mean, can it be could you
be talking to doctors in different countries as well?
Speaker 7 (10:38):
Anywhere except for registration, it becomes a little tricky. We
you have to be registered in New Zealand to offer
that service.
Speaker 6 (10:44):
In New Zealand. Oh okay, right.
Speaker 7 (10:47):
Yeah, so you can't be a doctor registered in the
States and patients in New Zealand. Okay, the Medical Council
won't allow that.
Speaker 2 (10:53):
Are there many overseas doctors who are registered in other countries.
Speaker 7 (10:57):
Not that I know of, Okay, okay, So normally the
New Zealand registered doctors working in New Zealand in a
maybe not even in a practice. They're on a dial
up service.
Speaker 6 (11:06):
What's it I mean?
Speaker 2 (11:07):
Does it does it change the access to health or
does it simply mean you don't if you're get in
the car and drive across town.
Speaker 7 (11:12):
So in actual fact, tallyhealth is not beneficial to the provider,
to the GP. It's a huge potential bonus for the client.
In no words, if you're going to your dock, yeah,
you've got to stop doing what you're doing. You've got
to drive somewhere, you've got to part the car. You
sit in the waiting room and it's only for five minutes,
by the way, you never sit there for more than that.
You're right, okay, go away, go away.
Speaker 2 (11:33):
Well, actually, I tell you what has a little hint.
I mean you can end up waiting, but I always
think that turning up on time does help.
Speaker 7 (11:39):
No first appointment after lunch. Don't tell anywhere. This is
just between you and me.
Speaker 6 (11:44):
Okay, what time's lunch?
Speaker 7 (11:46):
Just we'll find out what time lunches and take the
first appointment as never take the first appointment of the day,
and never the last appointment. First pointment of the day.
We rode, drove over the cat. The children are going, oh,
we're horrible, And the last appointment of the day. You're
absolutely shared. So you don't want to spend any time
with this punter. So at the first appointment at lunch,
you've arrived, you've cleared the morning, you've had your lunch,
you settled down to go bag on time. You don't
tell anyone that, but that's the way.
Speaker 6 (12:07):
Okay, there you go.
Speaker 7 (12:08):
People never booked after lunch, No first one after lunch. No,
that's I'm saying never. But so I can't do it,
all right, so you can do it.
Speaker 2 (12:15):
How do we get onto this, Well, actually it's all
about accessing healthcare, but also in choosing that GP.
Speaker 7 (12:22):
But yeah, it's excessing healthcare. If you're known to the
practice and I have a phone conversation of video conversation
with you that jimally weez quite well. So I know
who you are, what's going on with you, and you
can go okay, I can't look down your ears or
probe and poke and stick. No, you can't do that online,
and so you have to do something. Even before the pandemic,
I did a little survey within my practice, and I
(12:43):
reckon that around twenty five percent of the patients who
crossed my door actually needed to see me face to
face in person.
Speaker 6 (12:49):
How is there a generational sort of thing on telehealth?
I got it, Matt. If I want to see the doctor,
I think I want to walk into this. I want
them to see me.
Speaker 2 (12:58):
Even there's a I saw a specialist the other day,
and I know that there are a couple of things
she wouldn't have picked up if I had been on camera.
And it wasn't about a particular health condition. It was
just about the treatment options and helping me make a
choice on something absolutely, And I don't think she would
have got that if she hadn't been talking to me
in person.
Speaker 7 (13:17):
Now my console starts as I go and get you
from the waiting room. I'm looking around the waiting room.
I'm looking at you. I'm looking as you get up,
I'm looking at how you're dressed. I'm looking at how
you walk down the corridor. I'm already starting to formulate
what might be going on.
Speaker 6 (13:29):
Now.
Speaker 7 (13:29):
If you miss out on that and just see in
front of a screen, you'll miss that. So virtual care
within the practice I think works well. Virtual care to
someone whom you've got no relationship with, you've never seen before,
you've got no idea of the quality or anything else
like that. I'm not quite so sold on that. Yes,
it can solve a problem. And if that's all the
access to health care you've got, then we have to
(13:51):
live with it and try and make it as good
as we can.
Speaker 2 (13:53):
Okay, Looking before we go to the cause, how would
you advise someone on choosing a practice or a doctor? Yep,
and be going because just you know the family connection
with our practice, you know where the practice I go
to a bunch of reasons. I might be deciding to
look at a new doctor.
Speaker 6 (14:14):
Where would I? How would I?
Speaker 7 (14:15):
How would you do it? Okay?
Speaker 2 (14:17):
Because I tell you should I offer the dumb thing.
I'm going to look locally. First question, absolutely and beyond that,
I don't know right.
Speaker 7 (14:24):
So first we have to acknowledge that there are places
in New Zealand we don't have that choice because yeah,
they're overwhelmed. They're not taking registrations and that's the problem
we have to fix. Okay, so you're in a new area.
First thing I do is go and talk to local pharmacist.
Speaker 6 (14:40):
That is a great I don't have a chestion. God,
that's good.
Speaker 7 (14:43):
Look, I'm new to the area I'm thinking about. The
pharmacist knows everybody and everything, right, so they might be
able to give you a pointers of saying, well, you know,
for you, this might be a good one to have
worked at. First, it should be a fellow of the
Royal College of General Practitioners, so a fully qualified practitioner.
(15:04):
They should be at the They have to be what
we call Foundation standard, accredited and possibly even a higher
quality regime which is called Cornerstone to practice itself. So
you're looking at for a quality practice. You're looking at
a busy practice that probably has got a few doctors around.
Speaker 6 (15:21):
Do practices differ in the length of appointment time they give?
Speaker 7 (15:25):
That's a standard fifteen minute basically it is.
Speaker 2 (15:28):
It's nobody decreed that we could solve help there in
the conversation, because the conversation I heard from this person
was that this doctor was under pressure, christ that the
practice that introduced was ten minute appointments, So that would
be yeah, that would be a flag. How long are
your appointment times?
Speaker 7 (15:44):
Exactly? Yeah, what's wait for the appointment with you? Yep?
And when you when you do sign up, go and
source them out, go and sit in the waiting room
for a bit and have a look around. See what's
going on this open country. Okay, and what about.
Speaker 6 (15:57):
Female versus male?
Speaker 7 (15:59):
And it's bullshit? No, no, not no, this is one
of my beefs.
Speaker 6 (16:03):
No, no, no, I haven't got a beef for that.
I don't mind a female or a male.
Speaker 2 (16:08):
But there'll be people somebody saying, Okay, the typical I'm
gonna say, the typical bloke is middle age, just like well,
I don't want to a prostate checked by a woman
or funny enough, they might not want to check by
a bloke.
Speaker 6 (16:17):
I don't know why, but people have.
Speaker 7 (16:19):
Got much narrow fingers. So look at the quality of
the provider, not the gender of the provider. Yes, And
I get really up and names. I've known some really
really good female docs. I know some female docks. I
don't go for and in vice averse with males. So
look at the quality and leave the gender at the door.
We leave the gender at the door when you're walking
through my consulting room.
Speaker 2 (16:39):
Do you find that people do have a strange predilection
for saying, oh, I've got to get this test, and
i'd rather see a male or a female.
Speaker 7 (16:46):
That's fine, you can you can meet that. You've got
that mixed with them the practice. When I left my practice,
I was the only male in the practice with five
other female doctors, so they had to try and find
another male to welcome. Aaron. You're doing a great job,
but he's just coming and he's the token male in
our practice.
Speaker 2 (17:00):
Now, Yeah, I've always thought it's a somewhat I'm not
sure if it's a paradox that for some reason, if
men want they're going to have their prostate checked, they
would rather a man do it, And which is anyway,
I can't get my head around it.
Speaker 7 (17:13):
But quality, go for quality. Just look at the quality
of the clinician. That's what you're after.
Speaker 5 (17:18):
Yeah.
Speaker 7 (17:18):
Yeah, and I had a health interaction this week and
it was with a specist or partist colleague of mine.
It took an hour.
Speaker 6 (17:28):
Yeah, I would love.
Speaker 7 (17:29):
To have an hour with a new patient because you
really make fine. I got paid six hundred and fifty
dollars for it. So that's the other side of it.
Speaker 2 (17:36):
Actually, that suggestion of the pharmacist is a great one.
I think that that's if you're going to take one
little bit of because it's so obvious because pharmacists, I mean,
obviously pharmacy has changed as well with the chemists warehouse
and all those sorts of things. But if you're lucky
to have a pharmacist who has a relationship with the community,
go and chat with them. That's that's brilland device.
Speaker 6 (17:58):
John, you congratulations, thank you can go home now.
Speaker 2 (18:01):
No, no, no, don't move anywhere. We're going to take
some calls one hundred and eighty ten to eighty. Look
your questions for John as well, But also how did
you go about finding your GP? Did you just inherit
it through family or relationships and connections. But if you've
moved to a new neighborhood, new town, new city, whatever,
how did you go about it? Did you ask around?
I mean if you're at the school. Maybe you ask
some of the parents that you know when you're at the.
Speaker 6 (18:21):
Pickup, who's your GP?
Speaker 7 (18:23):
What are they like?
Speaker 6 (18:24):
Actually that's not a bad idea either.
Speaker 7 (18:26):
But you'll be getting at one.
Speaker 3 (18:27):
Ah.
Speaker 6 (18:28):
Yes, the pharmacist he see everything.
Speaker 5 (18:31):
Yeah.
Speaker 2 (18:32):
Must be difficult for pharmacists to go on a blind date,
wouldn't it, because you meet someone and you go, oh,
I don't think we can go on. I've sent you
prescriptions anyway.
Speaker 7 (18:39):
I don't know.
Speaker 6 (18:40):
That was a random thought from me. Twenty five.
Speaker 2 (18:42):
That's what I do from time to time for a
stream of consciousness. Twenty five past four News Talk z B. Yes,
News Talk z B with Tim Beverage talking about choosing
your GP and we actually you would love to know
from those of you who are quite comfortable with telehealth
and just getting on the on the zoom call or
the equivalent of it now anyway, and hello.
Speaker 8 (19:05):
Good afternoon, Tim and the doctor. I just turned on
the radio to hear the doctor say nowadays we treat
the whole person rather than its a disease. How I
wish that was the case when I was thirty four.
I'm now nearly eighty nine, and after ending up in
the Cute Medical in Dunedin for the third time to
(19:28):
three specialists stood at the end of my bed, debating
what was wrong with me, as if I wasn't there
so being me. The next when I got the chance,
I said to him, I said exactly what that doctor said,
that I wish they'd treat the whole person instead of
just a disease.
Speaker 2 (19:47):
And believe me, was it because they'd forgotten that there
was a human being who could actually hear what they
were discussing, and you would have run.
Speaker 8 (19:53):
It was terrible. It was terrible, and it slowed things
down for me because I was frightened to speak. But anyway,
eventually they after acting the point between two specialist, Professor Stewart,
my specialist, doctor Dixon, and doctor Dixon won and I
(20:15):
went home to the year from hell until my hair,
my skin turned dark brown, by passed fro amn Indian. Oh,
she got nervous disorders. She's got Edison's disease.
Speaker 6 (20:27):
So how are you? I'm not sure what to ask you.
Speaker 5 (20:30):
Now.
Speaker 6 (20:30):
That was a while ago, wasn't it. But really I'm June.
Speaker 8 (20:36):
I was thirty four when they finally diagnosed me, and
I don't believe me that I was very close to dying.
They're very lucky I didn't die on them.
Speaker 7 (20:45):
Well, same diseases, John Fitzyer Kennedy.
Speaker 6 (20:47):
What is Edison's disease?
Speaker 7 (20:48):
It's a primary adrenal band failure.
Speaker 2 (20:51):
Okay, Well, I mean, look, I think and it would
have been uncomfortable to be discussed like you just sort
of slab, but at least there were three of them
trying to find the answer.
Speaker 7 (21:01):
You go somewhere else and do that exactly.
Speaker 6 (21:05):
Have changed on that respect, I would hope, I would hope. Yeah,
thanks for your call. Anne Alison.
Speaker 9 (21:10):
Hello, Hello, Just about the finger prick print test for
you for the kidneys. You don't go to your doctor
for that, do you?
Speaker 7 (21:18):
What's the finger prict test for kidneys? Help me out
on that one.
Speaker 9 (21:22):
Well, it's on semi shark one night where you can
go along and you can go to this thing and
you have your finger practice to test with you, and
I little thing comes and shows your number and then
it's got a problem. Then you go back to your
doctor from there. So if you just go you don't
have an ordinary blood test, that would they kept your kidneys.
That would be the best way to do it rather
having the finger practice, wouldn't it Okay?
Speaker 7 (21:41):
First thing, it's much more accurate to have it done
through a formal lab, and secondly it enters your clinical
record in a meaningful way so that we can follow
the trend. So yeah, point of care. Testing can be
very important if you're lying in the hospital being about
to die and we want to know exactly what's wrong
with you. But for general stuff, yeah, maybe not.
Speaker 9 (21:59):
And just when the blood tests, when you go to
your doctor, they know what to tack on that you don't.
You're not up to you to tell them what to
do there. They know what to teck, don't they. The
more you teck, the more they pay.
Speaker 7 (22:12):
No, not at all or for testing. It's all covered
by the government.
Speaker 9 (22:16):
So right, that doesn't matter to two. They're not cost anymore.
Speaker 7 (22:22):
That ties into something somebody said to me.
Speaker 2 (22:25):
Somebody said, you can refer yourself for a blood test
or something like that, and when and what circumstances would
you do that, because I would have thought the hyper
hypochondract would take everything and.
Speaker 7 (22:35):
Then they pay for it. So if you do that,
you self pay.
Speaker 2 (22:38):
Oh, so if it's not referred, like you can come
in here and get tested for x y Z or
eights head if you want, but you're paying for it
unless you've got to referral from your GP.
Speaker 7 (22:47):
And then how are you going to deal with the
result because the lab won't take ownership.
Speaker 2 (22:50):
That's why I put it up because I thought something's
missing from the story.
Speaker 7 (22:53):
So firstly, why are you doing the test? There's a
good rule of mens that you should never do a
test that you don't know what the answer is going
to be. So you're doing a test to test a hypothesis.
You go hunting, you will end up with so many
read hearings that you're.
Speaker 6 (23:04):
In And I'm hearing Jack Nicholson saying you can't handle
the truth. Well, I've got to be a GP sort
of a quivalent.
Speaker 2 (23:12):
Actually, just before we go to our next caller, I'm
reminded by regularly there's been a bit of talk about
COVID and flus and stuff like that, just as a
public health sort of awareness thing. What's the flu jab
sort of season? As are we into it one April?
Speaker 7 (23:28):
The vaccine? So this little hint, if you talk to
your practice, they probably have got the vaccines in. Yeah,
they might have, but we can't start claiming it off
the government till one April, so sometimes we just I
couldn't say that, okay, right and put the invoice through
slightly later. That's good. So yes, it's only a few days.
I know it's only a few days. So yes, is
the flu vaccine starts in one April, and it's a
(23:49):
good idea if you're in the eligibility group for COVID.
There is a new COVID vaccine around as well, which
will cover the legs and as.
Speaker 2 (23:54):
The new one, the new strains are in now. And
what about the one where they say, remember there's there's
the one where you get the free one and or
you can get the super duper one and pay thirdy
not for COVID.
Speaker 7 (24:04):
I think, no, that's wasn't okay. Yes, So so look,
if you want to do that, fine, it's not going
to give you really that much additional benefit. It is
a theoretical benefit, but whether it works out in practice.
Speaker 2 (24:16):
It I was just wondering if it was the pharmaceutical
or qualm, would you like would you like would you
like fries with that?
Speaker 7 (24:20):
Would you like size fries?
Speaker 2 (24:22):
Actually the good group, but one one side effect of
having done talkback right throughout the COVID thing is. I
do have a couple of vaccinologists on speed dive, well
one in particular, and I talked.
Speaker 6 (24:33):
Yes, that's the one.
Speaker 2 (24:36):
God, she is fantastic, Harris, and she's the I just
love the fact that her name is very close to
whipping off.
Speaker 7 (24:44):
It's it's called the whole thing off.
Speaker 6 (24:49):
Yeah either right. Oh gosh, we're random today, aren't we?
Uh as we as? I love it? Yes, but yes, Windy,
Hello here, Hi guys here.
Speaker 5 (25:04):
I have an unusual sort of query here. I have
this mobile lump that sort of moves around the left
hand side of my body. It seems about the size
of a small walnut, quite firm, and I can feel
it under the bottom of my ribs right down from
a hip area, and it appears randomly. If I cut
(25:25):
my shoe laces this sort of bend over. It's sort
of I can feel it then and I have to
get on my hands and knees, you know, for it
to move off where I can't feel it. It's not painful,
So I was wondering what.
Speaker 4 (25:37):
It could be.
Speaker 7 (25:38):
And it's blow the level of the skins, as you
can tell.
Speaker 5 (25:41):
Yeah, yeah, quite sort of.
Speaker 7 (25:44):
Any shown it to your dock.
Speaker 5 (25:47):
No, I haven't checked it out.
Speaker 6 (25:48):
No an idea, Yeah, it would be. Yeah, how come
you haven't been to the doctor about it yet?
Speaker 5 (25:56):
Oh, I don't know. A funny thing about three four
months ago, I woke up really really ill, you know,
and I have I had a raucus calf and tickley
throws and my breathing was really hampered and yeah, and
(26:17):
I was wheezing a lot, runny nose, no energy, feeling tired,
and I thought it might have been COVID, but it was.
I had a test and it wasn't COVID, And then
I went to the emergency doctor and I found out
me blood pressure really dropped quite low to about one
hundred and six thirty five blood blood oxygen was ninety
two or something. So whether it was, I haven't had
(26:41):
it since then, So whether it might have been a.
Speaker 7 (26:45):
Movie, no things related to that. But if you've got
a lump anywhere, come and show it to us. Yeah,
we'll sort of what it is, and if it differ
in doubt, we'll do some testing to find out what
it is. If it's safe, we leave it bee if
it's not, we remove it. And we sought it for you,
so it'd be fronting about showing things and not all.
Speaker 5 (27:04):
When I got to I can't feel it. You know,
it doesn't appear, you know, I sort of do a
weird sort of movement or something.
Speaker 7 (27:11):
Can we do the weird sort of movements? We don't
mind you, Yeah, we don't mind you doing all those
things in the concert room.
Speaker 2 (27:16):
Okay, fine, thank okay, thanks, cheers. Do you get things
that move around a bit that sort of you know,
can be here here and there or unusual?
Speaker 7 (27:25):
That's how unusual?
Speaker 6 (27:26):
Okay?
Speaker 7 (27:29):
Right?
Speaker 6 (27:29):
Oh wait, one hundred and eighty ten eighty, let's go
to tell you what.
Speaker 2 (27:33):
Let's go to the break. We've got a couple of
speed lines. So if you want to come through and
I have a chat with John Cameron. But in particular,
i'd love to know how you would go or how
you did go about choosing your GP. And John's made
a very I think a golden suggestion is go and
talk to the local pharmacist. Possibly not at the chemist warehouse,
(27:53):
because I'm not sure who knows who knows, but yeh,
go and talk to the local pharmacist and just say,
in which GPS do you like?
Speaker 6 (27:59):
How would you ask?
Speaker 7 (28:00):
What would you say, I'm new to the area, I'm
looking to find a GP. Can you give me some
hunters on who I could be looking for?
Speaker 6 (28:07):
Okay, good, simple, that's not There's an art to asking question,
isn't there? And that was it? Okay?
Speaker 3 (28:13):
Right?
Speaker 2 (28:13):
It's twenty two minutes to five News Talk zed B.
I'm with doctor John Cameron and we're talking about choosing gps.
What do you look for? And actually the other question
just before we go to our next caller, John, was
we are you having a conversation off here about you know,
there's the gps who are great at the common touch
and you feel a certain connection. But then there might
be the one who maybe isn't exactly the most charming individual,
(28:36):
but it might be a diagnosedtician for the ages.
Speaker 6 (28:38):
So where do you go?
Speaker 7 (28:39):
You try and get both of those together, and what
you'll find is that certain patients will gravitate towards certain
members of the practice. There are people who in my
old practice who wouldn't come near me with a barge
pole because we just didn't match.
Speaker 2 (28:51):
That's an argument for joining the practice too, isn't it?
Because doctors, somebody might say, I've got a tricky case.
I might take it down to my friend, might take
it down to.
Speaker 6 (28:57):
Dave and have a chat. See what he reckons.
Speaker 7 (28:59):
Always doing that?
Speaker 6 (29:00):
They're always always doing stuff right.
Speaker 4 (29:01):
Peter, Hello, Yeah, h I turnin doctor John. I had
a bad fall going for an x ray on to
two wrists that I'd fallen on or a couple of
months ago. I got an x ray from the from
the fall there and they said I've gotarthritis and the
(29:23):
two thumbs and one finger. I'm just wondering. I've also
had a chronic knee for years and years and years,
and all of a sudden that's all come up, and
I'm wondering if if by the fall it's upset my
knee also. And I'm just wondering you might be able
(29:43):
to offer me something for the for the f riders
and these thumbs instead of just taking penadole.
Speaker 7 (29:51):
So yeah, So quite often you when you have a four,
you'll tickle up a joint and it lecked up. And
quite often if you damage one side of the body,
the other side of lecked up. As you're taking compensating
for it. By what you're saying, I'm assuming that what
you've got as a form of threat, it's called osteoarthritis,
which is where the nice smooth joint catch cartilage wears away.
(30:12):
Now that tends not to be a whole body approach
where and like the inflammatory arthritis is like rheumatoid arthritis,
where there's an active destructive process that goes on on
specific joints around your body. So, firstly, most important things
to keep as mobile as you can. Secondly, paracetamol is
a reasonable thing that will help take away some of
the pain. It won't work so much on the stiffness,
(30:32):
but using it, using it, using it for your wrists
and fingers. You just got to keep using it. Paracetamol
is good. Anti inflammatory medicines can be there, but they've
got some risks associated with them, and so we try
and hold off those as much as we can. But
most important things keep things moving, keep moving moving.
Speaker 10 (30:48):
Yep.
Speaker 4 (30:49):
Okay, thanks you very much.
Speaker 6 (30:52):
Yeah, good on you. Thanks for calling cat.
Speaker 7 (30:54):
Hello.
Speaker 3 (30:56):
Oh my goodness, I don't even know where to start.
Speaker 5 (30:58):
Hi.
Speaker 3 (31:02):
So, my teen year old three months ago was diagnosed
with scoliosis. We've been seeing a my fascial my facial
that make pensions. Okay, So he was he was sixty
three degrees he's now at seventy after three months, so
(31:22):
that's not working. What the not all? Almost for?
Speaker 7 (31:27):
What?
Speaker 3 (31:28):
What what do I do with Mike?
Speaker 5 (31:29):
Yeah?
Speaker 3 (31:30):
I know, sorry, very.
Speaker 7 (31:32):
Well. Normally, normally scoliosis is something that is developed from
birth rather than something which accelerates as they get older. Okay,
have you he.
Speaker 3 (31:40):
Had he had he had lung surgery, keyhole surgery when
he was one. And they are producing that they have
next nerd.
Speaker 7 (31:48):
That is I wouldn't believe that one. It's on. Have
you seen have you seen an orthopedic surgeon on this matter?
Speaker 3 (31:56):
Yes? Yes, yes, yes, and so now waiting to get
in to see start it.
Speaker 7 (32:02):
Yep, yep. That's almost certainly the way that you go.
And with a scoliosis, exercise generally doesn't do a hell
of lot. They can try sometimes some corseting so to
try and realign things up and as a last at surgery,
but it's a long slide process and it does take time,
and I apologize for that, but it's generally takes time
(32:23):
because there is a long term process. It's not something
that you're going to arrive one day and get fixed
the next day, So there will be a time fact.
Speaker 3 (32:30):
Yeah, absolutely okay.
Speaker 7 (32:33):
So you're on the right track, okay. And from the mobility,
physio osteopathy, all of that sort of thing, that's if
it's a true bone scoliosis, that's not going to make
that much of a difference because it's a bone process
that's causing the problem. And I think it's very unlikely.
Speaker 3 (32:50):
I'm not understanding what that means. What does that mean.
Speaker 7 (32:53):
So it's the way the bones are built, not necessarily
the muscles and and anything else. Okay, okay, okay, So yeah.
Speaker 3 (33:00):
So that's the fact that he's gone from sixty two
percent to seventy percent in three months.
Speaker 7 (33:06):
I don't I don't think that is that should be
super worrying for you. But when you're doing these things,
if it's measured on an X ray, quite often there's
a whole lot of rotational things that go on on
X rays that will give you false reading. So we
can say it's averaging out around that I think would
be very unlikely, and I can be you know, I
can be corrected on us. I think it's very unlikely
that things are going to catastrophically go bad for you
(33:27):
and for your young man.
Speaker 11 (33:28):
Okay, thank you.
Speaker 6 (33:30):
O, thanks thanks for your call Carlton.
Speaker 11 (33:34):
Hello, hello doctor John. You mentioned earlier about making a
doctor's appointment. I've been helping out the local amateur theater
and the rule of summers you don't go to the
first performance and you don't go to the last performance.
Pick one in the middle about lunch time.
Speaker 7 (33:53):
It's about right. We call it the U shaped curve.
So when you first got out a medical school, you're
absolutely dangerous, right because you've got no knowledge. And as
you get to my a you come and back up
the other side of that you shape curve and it's
really good. You really have to know when to get
off the curve. So you're right, that middle is really
good where you've got a lot of experience, a lot
(34:14):
of knowledge, and you're putting it to good use. I
agree with you totally.
Speaker 11 (34:17):
I believe in dance they call it meddle for diddle.
But my eighty four year old neighbor, he's very fit,
sixty k bike rides, osteos riders in his ankles. Is
there anything he can get any sort of support through
his ankles because standing is his problem.
Speaker 7 (34:36):
So and when you're talking about nostriothritis to remove the pain,
you stop movement. So if we stop the movement, the
pain would go away. But if you stop movement, you
put a whole lot of secondary disability into the process.
And so it's that constant balancing of trying to keep
as active as you can, to keep the joint moving,
to keep the rest of the body accommodating the stiffness
and a joint, trying not to lock it up. So
(34:58):
being mobile again and cycling brilliant for ankle's knees and
heaps really good. You're not weight bearing, you're not thumping
down on the pavement, you're actually getting things moving, and
keeping that non weight bearing movements really important.
Speaker 11 (35:13):
Just another funny aside, the only time he's fallen off
his bike is when the bike was stopped.
Speaker 2 (35:19):
Well, especially if you're wearing the bicycle clips. It's one
of the reasons I haven't thought about getting those because
I thought I'll be the guy who forgets, who pull
up to the lights and go help.
Speaker 6 (35:30):
Which could be quite dangerous if you fall into the path.
Speaker 2 (35:33):
So yeah, actually, but just before we go to the
break and we'll come back with a quick call from Sally,
I think somebody texted saying I work as a pharmacist,
and unfortunately we aren't ethically or maybe even legally able
to recommend GPS to the public. I did mine just
before we go to John on that. I've did my
own research on that, and actually the code of practice
for pharmacists it looks to me from what I read,
(35:55):
is that it's actually part of the thing that you
facilitate access to professional services so long as you don't
have a specific relationship and get a financial benefiting stunt.
Speaker 7 (36:05):
Nothing's in writing, so and you're just asking, you know,
if you were seeing someone in the area and you
know who I am, what would you suggest. So it's
it's nothing legal, it's nothing binding, there's no kickback on it,
and you're not certainly not directing to your own sifts.
That's a really potentially increasing risk in healthcare at the
(36:25):
moment is self referrals to within the same group.
Speaker 2 (36:28):
In fact, one of the that says here the pharmacist
recognizes patient's health status, abilities, cultural and social needs, and
provides or facilitates access to professional services delivered by the
pharmacist or other appropriate services. Sounds cot off. Sounds like
that's covet it off for me. It's always good to
go to the you know, to the actual the.
Speaker 7 (36:47):
Fountain of knowledge that the web chat JBT pushed me
in that direction.
Speaker 6 (36:51):
But I'm actually at the Pharmacy Council dot org dot
in z website.
Speaker 2 (36:54):
So in my defense, it is what's the time. It's
ten to ten to five, time flies as news talks
that be with Dr John Cameron and time for one
quick call. We've got about two minutes, Matt, Matt, that's you. Yeah, Hello,
(37:16):
you're on air. What would you like to talk about?
Speaker 11 (37:19):
Oh?
Speaker 10 (37:19):
I was just wanting to talk about my IBS.
Speaker 6 (37:23):
Yeah ib Yes did you say.
Speaker 7 (37:26):
Yeah, IBS edible syndrome.
Speaker 10 (37:29):
Ye, yes, that's right. So I was just, I guess
asking a question. So I go into the office and
it's it's just like a nine to five Monday to Friday.
It seems I have IBS and then as soon as
I get home for the weekends, no more IBS. Like,
I don't know what it.
Speaker 7 (37:49):
Is, but there's your answer. Don't go to the office.
Speaker 5 (37:52):
That's not an option.
Speaker 1 (37:54):
I know a mortgage.
Speaker 10 (37:56):
I've got kents to feed, you.
Speaker 7 (37:57):
Know, yeah, I know you'd look. Is there anything When
we talk about ib seretral bell syndrome, we always try
and look for a dietary processing around it and the
classic ones what we call fodmap, which is a where
we try and avoid forermendable sugars in your diet. Have
you been able to find something within your diet that's
different between home and work.
Speaker 5 (38:19):
No.
Speaker 10 (38:19):
I thought it might have been the coffees, but then
I stopped drinking coffee at work and same thing.
Speaker 6 (38:26):
It's just a formal diagnosis you've had of that. Or
is a self diagnosis of IBS?
Speaker 3 (38:31):
Ah?
Speaker 10 (38:32):
Yeah, it's a self diagnosis, that's for sure.
Speaker 2 (38:35):
It's yeah, okay, well so IBS.
Speaker 7 (38:40):
There's no diagnostic test for IBS. It's a diagnosis of exclusion.
We've excluded everything else. We really don't understand about understand
much about gut motility and the microbiota as much as
we would really like to. One thing you can try
is fod mapping. It's from the Monash University. Go Monash
University fodmap. Give that a go. And it's hard to
(39:01):
do that diet, but that will soon tell you whether
it's likely to be IBS or not. But also get
a clinical diagnosis to rule out the things which it
might be. And there are other things that can cause symptoms,
symptoms five years, intermittent diarrhea, constipation, grumbley, abdominal pain, pooping, farting,
it's and so there are very many things that can.
Speaker 6 (39:17):
Some people would say that sums up my yeah.
Speaker 7 (39:22):
So either try the mo Nash five map, or go
and see your doc and talk about putting on the
table and see if you can come up with a
diagnostic process for you.
Speaker 2 (39:29):
Thanks for your call, Matt, and good luck with that. Hey,
so we got about just with about a minute remaining. Really,
so if people are thinking that they that they're that
they're going to look for another doctor and then arrived
in New Town. So talking to your local pharmacist, I
mean I talking to I mean people that you know,
talking to people have the most common interface with medical practices.
(39:49):
I guess, wouldn't it.
Speaker 7 (39:50):
Yeah, it's all around that and taking them for a test, right. Yeah. Hey, look,
I'm new to the area. I'm thinking of joining the practice,
so I just thought to come along and see how
you are. Pay the money, take a consoplet. You'll get
a little bit of health advice from it, and you'll
soon work out.
Speaker 6 (40:05):
Well, you've always got something you want to ask about anyway,
haven't you.
Speaker 7 (40:07):
Oh god you yeah. Yeah. The people who stay away
from us since we dragged them in to say, look,
what's time we actually saw you. The list comes out.
Speaker 2 (40:14):
Yeah, excellent. Hey John, thank you so much for your time. Again,
we always appreciate you coming on the show.
Speaker 7 (40:19):
It's a pleasure.
Speaker 2 (40:20):
Great stuff that is doctor John Cameron. We'll be back
next with Smart Money Rupert Carlo and we're going to
talk about, you know, what the investment sort of landscape
looks like with everything that's going on so nationally so
and your key We saber I one hundred eighteen eighty
after five for the Smart Money back soon.
Speaker 1 (40:44):
For more from the Weekend Collective, listen live to News
Talk zed be weekends from three pm, or follow the
podcast on iHeartRadio
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