The Good GP

• Beyond the Label: Rethinking Penicillin Allergy in General Practice

  In this episode of The Good GP, host Dr Maria Li welcomes Dr Arthur Price, an immunologist based in Wellington, New Zealand, to discuss penicillin allergy—one of the most frequently reported and commonly misunderstood drug allergies in general practice.Dr Price clarifies the true prevalence of penicillin allergy, explaining that while approximately 10% of patients admitted to hospital carry a penicillin allergy label, only about 10% of those actually have a genuine allergy. Emphasising that most patients with a penicillin allergy label can be safely de-labelled after proper assessment.They address the typical presentations of penicillin allergy. Outlining three main patient groups: those who clearly are not allergic based on history (such as patients with only gastrointestinal side effects or late-onset rashes), those with uncertain or vague histories (including childhood reactions where details are unclear), and those with definitive immediate or severe delayed reactions (such as anaphylaxis or severe cutaneous adverse reactions like Stevens-Johnson syndrome). Dr Price provides practical advice on history-taking to help GPs risk stratify and identify true penicillin allergy, including key questions to ask about timing, symptoms, and the nature of the reaction.Discussing the investigation and referral pathways for suspected penicillin allergy. Dr Price recommends that patients with unclear or potentially significant histories should generally be referred to an immunologist for assessment, rather than managed solely in primary care. He highlights the limitations of current tests and the importance of specialist input.For general practitioners, Dr Price advocates a proactive approach to reviewing penicillin allergy labels and encourages considering referral for possible de-labelling where appropriate. They highlight the value of accurate documentation and patient education in ensuring safe and effective future care.Links & Resources:The ASCIA guidelines Arthur referred to in the podcast: https://www.allergy.org.au/images/stories/hp/info/ASCIA_HP_Consensus_Penicillin_Allergy_2020.pdfAimed at immunologists, so while GPs may find it useful for context and interest, it’s not something intended for day-to-day practice in primary careThe 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/networkIf 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.

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• Oral Allergy Syndrome Unpacked: From Food Triggers to Management Strategies

  In this episode of The Good GP, host Dr Maria Li speaks with Dr Arthur Price, a clinical immunologist with expertise spanning food allergy and immunodeficiency, on the frequently overlooked condition known as oral allergy syndrome (OAS).Dr Price begins by defining oral allergy syndrome as a mild form of food allergy where symptoms—typically oral itching—are limited to the mouth, lips, and throat following the consumption of raw fruits, vegetables, or certain nuts. He highlights the prevalence of OAS, noting that it affects up to 10% of the general population and is even more common among patients with hay fever and eczema.Covering typical clinical presentations seen in general practice, commonly triggered foods (such as apples, stone fruits, and hazelnuts), and the distinct lack of systemic symptoms in classic OAS cases. They provide practical advice on recognising OAS, taking a thorough history, and distinguishing it from more severe or systemic food allergies. Dr Price emphasises the importance of a clinical diagnosis and discusses why routine allergy testing is seldom indicated unless the case is atypical. They also talked about the management of OAS, the role of dietary avoidance, the use of antihistamines if symptoms do not resolve quickly, and reassurance regarding the very low risk of severe or life-threatening reactions.Discussing the impact of food preparation (e.g. tolerance of well-cooked fruits vs. raw forms), when to consider referral to allergy specialists, and how to support patients in making sensible, evidence-based decisions about food avoidance while maintaining good quality of life.Links & Resources:https://www.allergyuk.org/wp-content/uploads/2022/03/Oral-Allergy-Syndrome-v5.pdfhttps://www.allergy.org.au/patients/food-other-adverse-reactions/oral-allergy-syndromehttps://www.bsaci.org/wp-content/uploads/2024/03/Pollen-Food-Syndrome-PIL.pdfThe 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/networkIf 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.

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• Lung Cancer Screening Launch: Eligibility, Process, and GP Guidance with Dr David Manners

  In this episode of The Good GP, host Dr Julia Rawlinson is joined by Dr David Manners, respiratory consultant and lung cancer and bronchoscopy subspecialist at Midland Hospital, to discuss the National Lung Cancer Screening Program launching across Australia on 1 July. To outline the rationale behind the new guidelines, highlighting that lung cancer remains the leading cause of cancer-related mortality in Australia, typically presenting at a late stage when curative treatment is less likely.Dr Manners explains the evidence base for low-dose CT screening, referencing the US-based NLST and European Nelson studies, both of which demonstrated a significant reduction in lung cancer mortality among high-risk individuals. He also provides an overview of international screening efforts, comparing Australia’s rollout with programs in the US, Europe, and Canada.Eligibility criteria for the Australian program are detailed: patients aged 50 to 70 years, with a smoking history of 30 or more pack years, and for ex-smokers, having quit within the past 10 years. The reporting pathway and follow-up guidelines for detected nodules are also covered, including the importance of family history in risk assessment.They also covered why the Australian eligibility criteria were chosen, based on international evidence and local health economics analysis, and emphasises that the screening program is intended for asymptomatic individuals. For further information and resources about the National Lung Cancer Screening Program, please refer to the resources below:CPD and training: https://lungfoundation.com.au/health-professionals/training-and-events/national-lung-cancer-screening-program-health-workforce-education/?utm_source=Google&utm_medium=PerformanceMax&utm_campaign=NLCSP_2025&utm_content=PMAX&gad_source=1&gad_campaignid=22441651848&gbraid=0AAAAABIcwmqPnfnhOcrfcfcgRcZryqtqb&gclid=EAIaIQobChMI-vuFxd-TjgMVtahmAh2vtAmiEAAYASAAEgLwK_D_BwEProgramme Guidelines - pdf download: https://www.health.gov.au/sites/default/files/2025-04/national-lung-cancer-screening-program-guidelines.pdfPack year calculator: https://www.mdcalc.com/calc/10187/pack-years-calculatorThe 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/networkIf 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.

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• A Deep Dive into Diabetes Management: How Exercise and Diet Can Change Your Life

  In this episode of This Could Save Your Life podcast, Dr Catherine Bourke and Dr Anna Mullins delve into the topic of diabetes mellitus, focusing primarily on type 2 diabetes and its prevention. They begin with what diabetes is and the key differences between type 1 and type 2 diabetes. Type 1 diabetes is described as an autoimmune condition where the body attacks its own insulin-producing beta cells, whereas type 2 diabetes is more linked to lifestyle and genetic factors over a prolonged period.Dr Bourke and Dr Mullins highlight the symptoms of diabetes such as excessive thirst, hunger, frequent urination, and the more severe long-term risks like cardiovascular disease, kidney failure, and nerve damage. They emphasise the significant impact both types of diabetes can have on individuals' quality of life.They focused on the causes of type 2 diabetes, discussing the interplay between genetic predispositions and lifestyle choices. Along with emphasising the risk factors that contribute to developing type 2 diabetes, including a sedentary lifestyle, poor diet, obesity, smoking, and certain medical conditions.They also explain that pre-diabetes is a stage where intervention can successfully prevent the progression to full-blown diabetes. Dr Bourke and Dr Mullins advocate for weight loss, regular exercise, and possibly guided dietary changes as effective measures to prevent diabetes or even put it into remission.They outlined who should be screened for diabetes, focusing on risk stratification based on various factors such as age, weight, family history, and ethnicity. Dr Bourke provides guidance on the screening process, especially for those in high-risk categories.Links & Resources:https://www.health.gov.au/resources/apps-and-tools/the-australian-type-2-diabetes-risk-assessment-tool-ausdrisk/tool This Could Save Your Life Podcast is under The Good GP podcast, 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

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• Latest Alzheimer’s Treatment Advances Explained by Dr Marita Long

  In this episode of The Good GP, Dr Krystyna de Lange is joined by Dr Marita Long, to discuss recent advances in the treatment of cognitive impairment, particularly mild cognitive impairment due to Alzheimer’s disease.Dr Long outlines the approval of the first anti-amyloid therapy in Australia—approved by the TGA for use in patients with mild cognitive impairment or early Alzheimer’s dementia. Covering the evidence base for this new therapy, focusing on data from the Trailblazer Two clinical trial, which demonstrated a modest slowing in cognitive decline for patients treated with the anti-amyloid agent compared to placebo. Dr Long emphasises that these are not curative treatments, but may offer an extended period of independence and delay transition into residential care, especially if administered at an earlier stage of disease.They also addressed the challenges in identifying suitable patients for anti-amyloid therapy, given the complexities in diagnosing mild cognitive impairment and Alzheimer’s disease. Dr Long provides practical tips for GPs on recognising early cognitive symptoms and outlines the importance of thorough cognitive assessments and timely specialist referral for further diagnostic evaluation and access to new therapies.Accessibility and eligibility criteria for anti-amyloid therapy were also discussed, including the current requirements for specialist confirmation of an Alzheimer’s diagnosis (often via PET scan), and certain exclusions, such as high vascular risk or mixed dementia pathology.Dr Long also provides an overview of how these new disease-modifying therapies compared to existing symptomatic treatments (such as cholinesterase inhibitors), and notes the ongoing evolution of practice as further data become available.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/networkIf 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.

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