What’s not to love about skin rashes?

Target lesion

Man with an unfortunate target lesion on his back

Luckily beauty is only skin deep, because this rash was a beauty. Classic red rings, each containing another red circle centrally—named ‘target’ lesions after the chain store logo.

Erythema multiforme!” I announced with an Ancient Greek twang. I guess the original dermatologists were embarrassed to name any rash ‘lots of red shapes’ in English. “It’s a beauty,” I confirmed.

He looked at me dubiously. Perhaps the eye of his beholder didn’t see it. “Anything I need to avoid, doc?”

I studied the hundreds of bullseyes adorning his skin. “Duck shooting season. Next please!”

I love a good rash. Continue reading

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The secret that doctors hate revealing!!


Justin and Justin

One simple, easy trick revealed!

Warning: Reading this column will change your life. I reveal secrets which other doctors won’t tell you. They will hate me for it, because you need never pay for their services again.

I have recently given up doctoring, with its snail-paced, uncertain outcomes, and instead dedicated my life to writing popup facebook ads. Professional shackles removed, I can finally bring you proven cures which have been known since ancient times, but kept secure by the Doctors’ Code.

Ironically, the proof was there all along, if only you had clicked on the close-up photo of the exotic fruit seeds. It took me until age forty-five to allow my curiosity to overcome my bland scepticism, but since using their method I have become only thirty-two.

Eating nothing but these sensually-juicy plump seeds for a year not only made me lose 100.99% of my body fat; it smoothed my skin to the point where women in swimsuits continually ask me if I am Justin Bieber.

“No,” I smirk kindly, brushing some excess seeds out of my dark hair. “No, but he wishes I was.”

Continue reading

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Running man

Beach jogger

Photo by Januartha

I am a jogger. More specifically, I am a jogger this week. Even an actual runner, if you don’t count the uphill and flat bits. It’s been a fast-moving week.

Jogging is a fundamentally boring pastime; the only ones who claim otherwise are joggers…yawn. But after a seasonful of gastric stuffing and three months since my last soccer game, I figured a week at Noosa beach was a fine opportunity to, as our PNG neighbours so colourfully put it, ‘throwim way leg’.

I regularly prescribe one jog daily, mane before food, knowing that few patients will be eccentric enough to comply. I didn’t invent jogging—it already existed in rudimentary form before I started—but by George, I’ve helped popularise it.

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Top list of wasteful procedures in the ED and General Practice


Bucket list

The list
by Kaity Hemgesberg

Yesterday, JAMA published a list of  tests and treatments ordered in the Emergency Department which a group of 283 Emergency clinicians considered the most wasteful. Because accessing the list requires a log-in (which is a bit of a waste!) I have copied it here.

Below this is a similar list from the Choosing Wisely campaign where GPs were asked to vote on their most wasteful tests and treatments in 2012.

Consider doing them…and then don’t!



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No time for exercise? Think again!

One minute's exercise

Time of your life
Photo by Toby Bradbury

THIS message is for adults who always seem too busy to exercise. The mum who sits at work all week, then sits in the car delivering children to events on the weekend. The middle-aged man who drives to the local shop because he’s in a hurry and the walk makes him tired.

At this week’s IPC Journal Club, my GP colleague Rockley Boothroyd mentioned a brief vignette which inspired a simple literature search, which led to a profoundly useful conclusion.

The information we discovered is not new, but in my 25 years of medical reading, I have never heard it expressed as such an elegantly simple take-home message.

The message is this:

Every minute of exercise you do as an adult gains you seven minutes of life.

Or, to put it another way:

If you don’t have time in your life to exercise, you won’t have time in your life.

Continue reading

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La Trobe Uni climbs into bed with Swisse; Prof Harvey climbs out.

Photo: Steven Depolo

Photo: Steven Depolo

If Victoria’s La Trobe University was in any doubt that accepting $15 million from vitamin manufacturer Swisse Wellness would cause controversy, yesterday’s resignation of Ken Harvey, the University’s most prominent public health academic, clarified the issue.

The $30 million Complementary Medicines Evaluation Centre plans to receive half its funding from Swisse, yet the University claims that all research would be independent. According to a 6minutes report yesterday, Adjunct Associate Professor Ken Harvey suggested in his resignation letter that the University press release sounded like a plug for Swisse.

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Tweeting for health professionals

Tweet and you'll be followed

Ben Sanders, Medical Observer

This blog post is a running sheet for a workshop I’m delivering in Inala today, modified from a previous post. Feel free to ignore it if you’re not at the workshop!

It aims to encourage health professionals begin using Twitter as an educational tool. I originally ran it with Dr Tim Senior at GP13, the RACGP Annual Scientific Convention in Darwin, Oct 2013.

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My patients’ New Year’s wish list

Polishing shoes with a wish list

by Ben Sanders
Medical Observer

I’M STARTING 2014 with a wish list and some empathy.

Not my own wish list — my patients’. That’s where the empathy comes in.

I’m imagining what changes they would wish upon me, by putting myself in their shoes.

Actually, my shoes are top of the wish list. I keep mine at work because I ride a bike, and I’ve noticed patients are starting to stare at the unpolished bits. This year I’m determined to fix that, even if it means buying some shoe polish.

Number 2 is home visits. I think my patients would like me to do some. It’s hard on a pushbike because I have to change shirt and shoes, which brings me right back to the polish problem. Not the Polish problem: Walesa solved that back in ’89. Continue reading

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The non-linear consultation

by Gary Wong

Non-linear Bangkok
by Gary Wong

Most doctors treat simple medical problems similarly. The presenting problem leads to a single diagnosis, which leads to a treatment; all in an uncomplicated, linear pattern.

But in primary care, things are often not so simple. For multiple problems with complex underlying issues, no two consultations are ever the same. And a surprising amount of the variation depends on the doctor.

A shorter, edited version of this article will be published at The Conversation and a longer version will be published as a book chapter in late 2014. 

The non-linear consultation

When we think of what defines a medical consultation, we quite reasonably think of the ‘presenting complaint’: the medical problem which the patient brings to the doctor. In movies, literature, common wisdom and jokes, the doctor’s role is simple and rather passive—make the diagnosis and treat it.

Sure, some doctors might be more skilled than others—think of TV’s Dr House, who brilliantly diagnoses an incredibly rare disease at the end of each episode—but even then it all boils down to the systematic application of technical knowledge. A clever computer algorithm could, in theory, work through the same deductive process of ruling out alternative possibilities to reveal the unique diagnosis. Continue reading

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Statins and sat fats: a sceptic’s look at ABC’s Catalyst programs

Saturated fats with yummy icing

by pkingDesign

My article below was published this week at both The Conversation and in Australian Doctor. I figured I’d get in third.

On the past two Thursdays, the ABC’s Catalyst program set off a chain reaction of protest from sections of the medical community, aghast that the non-medical media would question the accepted wisdom that dietary saturated fats kill people and statins save lives.

The issue dominated the medical media, and Professor Emily Banks, chair of the Advisory Committee on the Safety of Medicines, warned the ABC to pull the second program. Yet the show went on: as befits a catalyst, it remained unaffected by the reaction it had produced.

Continue reading

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