The Good GP

In this episode, host Dr Maria Li is joined by Associate Professor Antonio Di Dio, a practicing GP and Director of the Professional Services Review (PSR), to discuss Medicare compliance, a topic of growing relevance and concern for Australian general practitioners.
Associate Professor Antonio Di Dio explains the role and remit of the PSR in Australia, outlining how it operates independently from Medicare and exists to protect both patients and the Commonwealth from inappropriate or unnecessary healthcare.
Key points:
The origins and legislative framework of the PSR and its place within Australia’s compliance ecosystem.
The mechanisms that trigger Medicare referrals to the PSR, including unusual billing patterns (data triggers) and external tip-offs.
The structured review process, possible outcomes (including no action, agreement under Section 92, or referral to a committee), and criteria for progressing cases.
Reassurances for GPs that a PSR referral does not automatically mean adverse findings, with many cases resulting in no further action.
The role of peer input throughout the process, and emphasis on seeking mitigating circumstances.
Consequences of adverse findings, including financial repayments and restricted billing, while clarifying that the PSR does not impact a doctor’s licence to practise (though it may refer cases to AHPRA under certain circumstances).
Practical advice for GPs if subject to a PSR review: notify medical defence organisations early, seek support from trusted colleagues and family, and, if necessary, access doctors’ health services.

This episode is aimed at demystifying the PSR process, reducing unnecessary fear, and empowering GPs with knowledge on best practices for engagement and self-protection if under review.
Links & Resources:
https://www.psr.gov.au/
Medicare compliance | Australian Government Department of Health, Disability and Ageing
https://www.health.gov.au/topics/medicare/compliance/how-to-comply?language=en

The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialisation. Learn more at www.talkinghealthtech.com/podcast/network
If you have any questions or would like to contact The Good GP, send an email to [email protected]. Visit www.thegoodgp.com.au for previous episodes and more information. You can also find us on our Instagram page: @thegoodgppodcast. Follow us for more updates!

In this episode, host Dr Krystyna De Lange is joined by Dr Ashley Bowden, ACRRM registrar and exercise science graduate, to discuss the growing interest in peptides, particularly those promoted in the fitness and wellness sectors.
Dr Ashley Bowden defines peptides as short chains of amino acids and distinguishes between regulated, TGA-approved peptides (such as insulin and GLP-1 analogues) and unregulated, research-use-only peptides commonly discussed online and in gyms. Exploring the demographics of peptide users in Australia, noting that use extends from athletes to recreational gym users, occupational groups, and young adults influenced by social media trends.
They also addressed the limited evidence for the efficacy and safety of unregulated peptides, highlighting that most claims are based on anecdotal reports rather than robust clinical trials. Associated risks include potential side effects, the dangers of unregulated products, and complications related to injection practices.
Dr Bowden provides a practical harm-minimisation approach for GPs whose patients raise questions about or disclose use of peptides. He stresses the value of a non-judgemental, curious approach to build rapport, assess risks, offer regular monitoring, and support overall patient health, while recognising the ethical complexities faced when evidence is lacking.
Links & Resources:
Healthy Male article: https://healthymale.org.au/health-article/peptides-australia-what-you-need-know
Webinar: Understanding the use of androgens, SARMS and peptides by Australian males: https://medcast.com.au/courses/1153

The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialisation. Learn more at www.talkinghealthtech.com/podcast/network
If you have any questions or would like to contact The Good GP, send an email to [email protected]. Visit www.thegoodgp.com.au for previous episodes and more information. You can also find us on our Instagram page: @thegoodgppodcast. Follow us for more updates!

In this episode, host Dr Krystyna De Lange speaks with Sydney-based cardiologist Dr Natasha Gorrie from St Vincent's Hospital and the Victor Chang Cardiac Research Institute. They discuss cardiac amyloidosis, an under-recognised cause of heart failure in older adults and a condition with evolving diagnostic and treatment approaches.
Dr Natasha Gorrie outlines the basics of amyloidosis, emphasising that it is an umbrella term for disorders characterised by the deposition of abnormal protein fibrils in tissues and organs.
Key Points:
Understanding Amyloidosis: The pathology and range of organ involvement; why diagnosis depends on identifying the causative protein.
Epidemiology and Prevalence: Recent recognition that transthyretin-related amyloidosis (ATTR) is more common than previously thought, with prevalence as high as one in six in certain heart failure populations.
Key Clinical Clues: Red flag features in patients (particularly those over the age of 65), including heart failure with preserved ejection fraction, left ventricular wall thickening, atrial fibrillation, aortic stenosis, carpal tunnel syndrome, and unexplained changes in blood pressure medication requirements.
Diagnostic Pathway: The importance of timely suspicion, appropriate specialist referral, and the role of the monoclonal screen (serum and urine electrophoresis and serum free light chains) to rule out AL (light chain) amyloidosis. The role of bone scintigraphy and when tissue biopsy is indicated.
Therapeutic Options: Overview of disease-modifying treatments available for different amyloid subtypes, including the PBS-approved medication tafamidis for ATTR cardiac amyloidosis.
The GP’s Role: GPs are essential for early suspicion, referral, initiation of screening tests, and, following diagnosis, ongoing care; including regular review, heart failure management, coordination of multidisciplinary care, and supporting the patient’s mental health and quality of life.

Dr. Natasha Gorrie also highlighted an upcoming Australian Prescriber article (due for publication mid 2026) on cardiac amyloidosis, which expands on today’s discussion with practical flowcharts and insights into the central role of GPs. Well worth checking out! https://australianprescriber.tg.org.au/
Links & Resources:
St Vincents Heart Health Amyloidosis page: https://www.svhhearthealth.com.au/conditions/cardiac-amyloidosis
Australian Amyloidosis Network: https://aan.org.au

The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialisation. Learn more at www.talkinghealthtech.com/podcast/network
If you have any questions or would like to contact The Good GP, send an email to [email protected]. Visit www.thegoodgp.com.au for previous episodes and more information. You can also find us on our Instagram page: @thegoodgppodcast. Follow us for more updates!

In this episode, Dr Tim Koh speaks with Dr Grace Phua, a GP and public health clinician from the Health Department of Western Australia’s Syphilis Response Team, to provide an update on syphilis in Australia and practical guidance for general practitioners.
Key Points:
Changing Epidemiology: They highlight the recent increase in syphilis, with cases now extending beyond traditional higher-risk groups. All sexually active patients may be at risk, making ongoing awareness in general practice essential.
Clinical Presentation: The primary, secondary, latent, and tertiary stages of syphilis, noting the diverse and often atypical presentations. Classic signs such as ulcers and rashes may vary, and neurological symptoms can occur at any stage.
Screening and Testing: GPs are reminded to include syphilis serology in routine STI screening and to swab any ulcer for syphilis PCR (using a dry swab and requesting “syphilis PCR” on the form). Pregnant people require syphilis screening in early and late pregnancy, and higher-risk groups need more frequent testing.
Serology Interpretation and Treatment: The use of treponemal and non-treponemal tests. Benzathine benzylpenicillin is the recommended treatment. Empirical treatment of contacts, especially for hard-to-reach patients, is encouraged.
Further Resources and Support: GPs are advised to access national guidelines and decision-making aids for detailed management and to consult public health units as required.

The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialisation. Learn more at www.talkinghealthtech.com/podcast/network
If you have any questions or would like to contact The Good GP, send an email to [email protected]. Visit www.thegoodgp.com.au for previous episodes and more information. You can also find us on our Instagram page: @thegoodgppodcast. Follow us for more updates!

In this episode of The Good GP, host Julia Rawlinson welcomes Dr Erin Horsley, an experienced GP anaesthetist, to provide practical guidance on pre-anaesthetic medication management for general practitioners. Focusing on how to prepare patients for elective surgery by knowing which medications to pause, continue, or adjust.
Highlights include:
SGLT2 inhibitors: Advice on withholding these medications prior to surgery, especially for diabetic patients, due to risk of euglycaemic diabetic ketoacidosis.
Diabetes medications and insulin: Specific instructions for perioperative management in procedures such as colonoscopy and gastroscopy.
GLP-1 receptor agonists: Discussion on Ozempic, Wegovy, and Mounjaro. They emphasise that stopping them is not routinely required. Instead, they recommend clear fluid fasting protocols.
Anticoagulants and antiplatelet agents: Practical approaches for managing DOACs, warfarin, and antiplatelet therapy based on procedure risk, including guidance on bridging and specialist consultation.
Other medications: Tips on ACE inhibitors, opioids, and pain medications regarding continuation or withholding.
Useful GP actions: An accurate medication list, allergy documentation, and direct communication with anaesthetic teams or pre-admission clinics.

Providing concise, evidence-based recommendations for medication management in the perioperative setting to assist GPs and ensure safer outcomes for their patients.
Links & Resources:
NSW CEC Guidelines on Perioperative management of anticoagulant and antiplatelet agents
WA Country Health Service Anaesthetic Services, Pre-operative Assessment and Investigations Guideline(good summary)
Australian Diabetes Society Periprocedural DKA with SGLT-2 inhibitor
Australian Diabetes Society Perioperative Diabetes and Hyperglycaemia Guidelines

The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialisation. Learn more at www.talkinghealthtech.com/podcast/network
If you have any questions or would like to contact The Good GP, send an email to [email protected]. Visit www.thegoodgp.com.au for previous episodes and more information. You can also find us on our Instagram page: @thegoodgppodcast. Follow us for more updates!