Deep Breath In: a podcast for GPs
Tackling primary care’s everyday challenges
Life in primary care can be complex. Deep Breath In explores the highs and lows of being a GP, offering a space to reflect on the grey areas of general practice.

Deep Breath In

This week the panel are joined by Michael Brady, the national advisor for LGBT Health to discuss why your patient’s queerness might matter to you, and how to practice inclusively, as well as an interview with Lisa Power MBE,  a British sexual health and LGBT rights campaigner. Have a listen to hear Michael Brady answering your questions, agony aunt style!

Inclusive Practice

The mental health of athletes has been in the spotlight throughout this summer, as high-profile athletes such as Naomi Osaka and Simone Biles have spoken out about the importance of prioritizing their physical, and especially their mental, well-being.

In this episode, host Dr. Giselle Aerni, MD is joined by AMSSM Past Presidents Dr. Cindy Chang, MD and Dr. Margot Putukian, MD to discuss the AMSSM Position Statement on Mental Health Issues and Psychological Factors in Athletes, which Dr. Aerni also co-authored.

In this 33-minute conversation, they address the following topics:
The importance of a position statement on the mental health of athletes and the novel aspects addressed in the document
The team-based approach to mental health care and why it’s a crucial component for the well-being of athletes
How the acceptance of mental health issues has evolved in recent years and the impact social media has on those perceptions
The impact of the COVID-19 pandemic on athletes’ mental health and how it reinforces the need for conversations about this vital issue

Resources:
Mental health issues and psychological factors in athletes: detection, management, effect on performance and prevention: American Medical Society for Sports Medicine Position Statement (https://bjsm.bmj.com/content/54/4/216.full)
Madam Athlete Podcast (https://madamathlete.com/)

The Importance of Mental Health in Athletes with Two AMSSM Past Presidents EP #483

Musculoskeletal (MSK) pain and osteoarthritis are clinically common in general practice, but with the new draft NICE guideline on osteoarthritis (published in April 2022) recommending a move away from pharmacological treatments and instead promoting self-management, some GPs have been left wondering how best to manage MSK pain going forwards . In this week’s episode, Dr. Imran Sajid talks to us about the importance of educating patients on what arthritis really is – moving away from the term “wear and tear” – and of taking a thorough history of a patient’s pain journey in consultations. He also gives practical advice on how we might approach non-pharmacological management of MSK pain with our patients. 


Our guest:

Imran Sajid is a GP with a special interest in MSK medicine. He is the clinical lead in MSK & Diagnostics for NHS North West London, an adjunct lecturer in Health Policy  at the University of Global Health Equity, as well as being a qualified personal trainer.


Further reading:

‘Osteoarthritis: assessment and management, draft for consultation, April 2022’. NICE. 2022. https://www.nice.org.uk/guidance/gid-ng10127/documents/draft-guideline

‘The tear, flare, and repair model of osteoarthritis’. BMJ 2022;377:o1028. https://www.bmj.com/content/377/bmj.o1028

Musculoskeletal pain and osteoarthritis with Imran Sajid

In general practice, it can often feel like a lot is changing beyond our grasp. On top of this, the pandemic has left many healthcare professionals self-reflecting on their careers and lives, and trying to work out what they really want going forward. 

This week, we speak to Claire Kaye about her role as a coach for doctors. Claire talks to us about the benefits of coaching, including helping to get rid of internal & external noise, shaping the mindset, and coping better with change. She also offers advice on the best ways to approach coaching in order to achieve a positive outcome. 

Our guest:
Claire Kaye, formerly a GP, is an executive coach. She specialises in career development. 
Instagram: @drclairekayecoaching 
LinkedIn: @drclairekaye 
Website: www.drclairekaye.com

Coaching with Claire Kaye

Reproductive coercion may feel like something that we don’t see very often in general practice, but a 2022 poll carried out for BBC Radio 4 of 1,060 UK women between the ages of 18 and 44 found that half of them had experienced some form of reproductive coercion. This week, we speak to returning guest Annabel Sowemimo about the various forms that reproductive coercion can take, and who might be at risk of experiencing it. We discuss how we, as GPs, can identify these patients, and, once we’ve done so, how we might be able to help them. Later on, we talk to our BMJ columnist, John Launer, about how narrative medicine approaches can help to reach a better & more satisfying resolution to a consultation “puzzle” for you and for the patient.


Our guests:

Annabel Sowemimo is a community sexual health registrar, based in Leicester. She is also a PhD candidate at King’s College London, and is the co-founder of the charity Reproductive Justice Initiative.

John Launer is a GP educator, working for Health Education England. He is also a freelance educator and writer, as well as being a columnist for ‘The BMJ’.


Further reading:

‘How to recognise and respond to reproductive coercion’. BMJ 2022;378:e069043. https://www.bmj.com/content/378/bmj-2021-069043

‘John Launer: The art of paying attention’. BMJ 2022;378:o2294. https://www.bmj.com/content/378/bmj.o2294

‘Careful, kind care is our compass out of the pandemic fog’. BMJ 2022;379:e073444. https://www.bmj.com/content/379/bmj-2022-073444

Reproductive coercion and narrative medicine with Annabel Sowemimo and John Launer

How long would it take GPs to enact all of the guideline recommendations that they might be expected too? Far more GP hours than exist in any healthcare system, but as medicine has turned its attention to primary prevention, and expanded the populations whose health we seek to improve, those guidelines are taking up more and more time.

A recent analysis in The BMJ has proposed the concept of “Time Needed to Treat” and implores guideline makers to take account consultation time as a precious, finite, resource when thinking about their recommendations.

In this episode of Deep Breath In, we’re joined by Minna Johansson, family doctor and director Global Center for Sustainable Healthcare, who co-authored that analysis to talk about how the concept has gone down, and what it might mean for rethinking what primary care is supposed to do.

Reading list:
Guidelines should consider clinicians’ time needed to treat
https://www.bmj.com/content/380/bmj-2022-072953

Time needed to treat, with Minna Johansson

The theory that depression is caused by serotonin deficiency has become embedded in our practice over the years, and can be a persuasive explanation of the condition for patients considering starting antidepressants. We talk to Tony Kendrick about the evidence (or lack thereof) to support this hypothesis, and what that means for the efficacy of antidepressants, particularly SSRIs. Later on, we speak to Mark Horowitz to discuss how to come off antidepressants safely, and manage withdrawal symptoms, and how to advise and support our patients as they gradually reduce, then stop, their medication. 


Our guests:

Tony Kendrick is a retired GP, and NICE committee member for the 2022 guideline update on depression in adults. He is also a professor of Primary Medical Care at the University of Southampton.

Mark Horowitz is a training psychiatrist, working as a clinical research fellow at North East NHS Trust, and as an honorary clinical research fellow at UCL, he is also the co-founder of outro.com.


Further reading:

‘Antidepressants and the serotonin hypothesis of depression’. BMJ 2022;378:o1993 https://www.bmj.com/content/378/bmj.o1993

‘Stopping antidepressants’. Royal College of Psychiatrists. 2020. https://www.rcpsych.ac.uk/mental-health/treatments-and-wellbeing/stopping-antidepressants

Antidepressant withdrawal with Tony Kendrick and Mark Horowitz

This week, we're going to be returning to a guest we heard from a while ago - Claire Kaye. 

Claire was a GP before deciding to become a coach, and we found her way of thinking through our wants and needs so useful, we decided to invite her back. 

This week we're going to be talking about that holding onto that feeling of excitement you had at the beginning of your career, a feeling that's difficult to hold onto, as the pressures on general practice mount.

Our guest:
Claire Kaye, formerly a GP, is an executive coach. She specialises in career development.
Instagram: @drclairekayecoaching
LinkedIn: @drclairekaye
Website: www.drclairekaye.com

Getting the joy back - With Claire Kaye

In this episode of the Heart podcast, Digital Media Editor Dr. James Rudd is joined by a vascular biology legend, Professor Peter Libby from Harvard University and Chief of Cardiovascular Medicine at Brigham and Women's Hospital in Boston. They discuss how the inflammation hypothesis of atherosclerosis has been proven by the CANTOS trial and what the future might hold. We trust you'll enjoy the police sirens in the middle of the interview and hope you enjoy the discussion.

Link for CANTOS study - http://www.nejm.org/doi/full/10.1056/NEJMoa1707914

Inflammation and heart disease - what's next?

In this episode of the Heart podcast, Digital Media Editor DrJames Rudd is joined by Dr Cara Hendry from Manchester and Dr Iain Simpson from Southampton. They are passionate about reducing barriers that exist in cardiology and other medical specialities. They discuss what the issues are and what is being done to help in the UK and beyond. If you enjoy the show, please leave us a podcast review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2

Women in cardiology - breaking down the barriers

In this episode of the Heart podcast, Digital Media Editor, Dr James Rudd, is joined by Professor Charalambos Antoniades from Oxford, UK. They discuss his novel method of measuring coronary plaque inflammation using CT imaging, and how this method might be important for predicting heart attacks.
If you enjoy the show, please leave us a podcast review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2
Link to published paper: https://heart.bmj.com/content/early/2018/07/24/heartjnl-2017-312324

Perivascular adipose tissue and coronary atherosclerosis

In this episode of the Heart podcast, Digital Media Editor, Dr James Rudd, is joined by Dr Charlotte Warren-Gash from the London School of Hygiene and Tropical Medicine. They discuss the links between respiratory infections and subsequent heart attacks and strokes.
If you enjoy the show, please subscribe to the podcast to get episodes automatically downloaded to your phone and computer. Also, please consider leaving us a review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2
Link to published paper: https://www.lshtm.ac.uk/newsevents/news/2018/respiratory-infections-could-increase-risk-heart-attack-and-stroke

Respiratory infections and subsequent heart attacks and strokes

In this episode of the Heart podcast, Digital Media Editor Dr James Rudd, is joined by Professor Bernard Prendergast from St Thomas' Hospital, London. They discuss his recent publication in Heart concerning the ability of the stethoscope to detect important valve disease in asymptomatic primary care patients. They also cover POCUS, the feasibility of screening elderly patients for valve disease and whether Bernard still uses a stethoscope in real life.

If you enjoy the show, please subscribe to the podcast to get episodes automatically downloaded to your phone and computer. Also, please consider leaving us a review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2

Link to published paper: 
Primary paper: https://heart.bmj.com/content/early/2018/07/24/heartjnl-2018-313082
Editorial: https://heart.bmj.com/content/early/2018/05/24/heartjnl-2018-313474
The Oxvalve study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5216199/

Do we still need stethoscopes?

In this episode of the Heart podcast, Digital Media Editor, Dr James Rudd, is joined by Dr Eric Topol, founder and director of the Scripps Research Translational Institute. They discuss the impact that AI will have in medicine and how this will affect us all.

Relevant links related to this podcast:
About Dr Topol - https://drerictopol.com/about/
Nature Medicine AI review - https://www.nature.com/articles/s41591-018-0300-7
Twitter - https://twitter.com/EricTopol?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor
Book - https://drerictopol.com/book/deep-medicine/
NHS Topol review - https://www.hee.nhs.uk/our-work/topol-review

Deep Medicine with Eric Topol, author of the Topol NHS review

In this episode of the Heart podcast, Digital Media Editor, Dr James Rudd, is joined by Dr Thomas Butler from the University of Chester. They discuss his Review paper in Heart entitled "Optimum nutritional strategies for cardiovascular disease prevention and rehabilitation (BACPR)".

If you enjoy the show, please subscribe to the podcast to get episodes automatically downloaded to your phone and computer. Also, please consider leaving us a review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2

Link to published paper: https://heart.bmj.com/content/106/10/724

Diet after a heart attack - what should we tell patients?

In this episode of the Heart podcast, Digital Media Editor, Dr James Rudd, is joined by lipid expert Dr Susan Connolly from Enniskillen, Northern Ireland. They discuss primary and secondary prevention, risk scores, imaging and two new drugs with the potential to improve lipid management significantly over the next 5 years.
If you enjoy the show, please subscribe to the podcast to get episodes automatically downloaded to your phone and computer. Also, please consider leaving us a review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2

Musculoskeletal pain and osteoarthritis with Imran Sajid

BMJ talk medicine

Related tracks