We GPDU’d. Did you?

Thank you Penny Wilson. General Practice is exactly this; adaptable responsive and human. We were intent as an organising committee to not pursue the traditional pedagogy of medical conferences which isolate the intellectual pursuit of excellence from the excellent pursuit of our own humanity. I am so proud we had participants holding babies we had eight year olds playing in the Sim emergency sessions and four year olds sitting on mummy’s knee while she talked on stage. Later I heard he held the microphone for a prominent Australian GP researcher. We had Charlie the rescue dog whose early traumatic and abused life was invisible as he wandered around tail wagging collecting hearts minds and pats off GP delegates. Bringing humanity into our workplace is one of my passions. Without this we are mere automatons and the risks of a less integrated life to both doctors and their patients are not inconsiderable. We were also proud to support #crazysocksforDocs on June 1st.

Keeping it real.
Never perfect.
Which is the only thing to be.

Thanks to all our contributors our participants our sponsors our critics and co-conspirators.
None of us do alone.

Nomadic GP

GPs Down Under, as an entity, is kind of a hard thing to describe.

In it’s most basic form it’s a Facebook group of over five thousand Aussie and Kiwi GPs. Depending on the day, and who you talk to, it’s also a national park, a family, a support group, an educational resource, an advocacy platform, a source of entertainment, a soapbox and a time-sink. Sometimes it’s ablaze with controversy. Sometimes, it’s a lifeline for drowning colleagues.

Indeed, this motley crew of so many GPs from across the spectrum of cultural, geographical and clinical backgrounds was always bound to end up as complex and varied as general practice itself.

So I was interested to see what would would happen when, last week, a couple of hundred of those GPDU souls congregated on the Gold Coast for the first ever conference. And believe me, #GPDU18 was NOT your typical GP conference.

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Your Medical Records Exposed… Confirmed!

Great thoughts from David Dahm on the opt out issues related to the My Health Record. The ethics on the consent processneed to be examined very closely imho. Not withstanding the secondary use of your private health data does not have a framework around it as yet. Consent seems therefore flawed.

David Dahm

As I predicted in February 2016, your personal health record is being exposed, with or without your full knowledge. The Federal Government’s new $2bn national patient electronic health record system rollout is at full throttle.


This potentially means others have electronic access to your mental health, drug and alcohol abuse, sexually transmitted disease, domestic violence, and other sensitive information.

Do I opt out?

We have a saying’ ‘if in doubt opt out’. Indeed, you may wish to do this, but only after you have thoroughly researched how this may affect you or a loved one.

If you have any doubts, you need to opt out now before the three month deadline or an automated record will be created for you.

If you do opt out your records will not be deleted if you have opted in by default or with your permission – see Opt-out e-health records won’t be deleted

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Every attempt to manage academia makes it worse

Great questions for complex systems. Whilst this references mostly performance metrics this pervasive buffoonery is also applied to health.
It lacks understanding of the sector and is misapplied.
Good to ponder and to rebut the bean counters who are necessary but should never be in charge. IMHO of course. You may have a different view. Enjoy.

Sauropod Vertebra Picture of the Week

I’ve been on Twitter since April 2011 — nearly six years. A few weeks ago, for the first time, something I tweeted broke the thousand-retweets barrier. And I am really unhappy about it. For two reasons.

First, it’s not my own content — it’s a screen-shot of Table 1 from Edwards and Roy (2017):


And second, it’s so darned depressing.

The problem is a well-known one, and indeed one we have discussed here before: as soon as you try to measure how well people are doing, they will switch to optimising for whatever you’re measuring, rather than putting their best efforts into actually doing good work.

In fact, this phenomenon is so very well known and understood that it’s been given at least three different names by different people:

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Top Trip articles for 2016

On Hanson’s claims that women lie about sexual assault

Well written piece on the complexities bigotry and bias around sexual assault. Everyone is innocent until proven guilty. Well said.

No Place For Sheep

Michaelia Cash, Minister for Women, hugs Senator Pauline Hanson Michaelia Cash, Minister for Women, hugs Senator Pauline Hanson

My default attitude to Pauline Hanson is that my life is too short to spend much time contemplating her, however, an interview on Sunrise (no, I’m not linking) in which she gloated about the Trump victory and sputteringly claimed that women who accuse him of sexual assault are liars and women in general should toughen up when a man, uninvited, strokes our breasts and grabs our pudendas enraged me to the extent that I have to address it.

Aside: Sunrise enrages me as well, as does all breakfast television: who the hell wants to start the day with overly-cosmeticised women in tube frocks, and self-congratulatory men in nifty suits cackling & exclaiming, not me, I’d rather listen to the parrots & wattle birds brawling outside my window, they make more sense. Somebody thoughtfully sent me a clip of the Hanson…

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Another Reblog. Sourced from another clinician colleague on GPSDownUnder closed Facebook group for Australian and New Zealand GP’s.
I thought this was a great article explains the complexity of the pain experience to both clinicians and patients.
The DIM -SIM model may well help our consultations with these very complex patients
By deconstructing and reconstructing the pain there may well be advances in recovery and therapeutic relationship.



Ever since Explain Pain emerged in 2003, Lorimer Moseley and I have been asked by clinicians for a “simpler version… for patients”. We actually wrote something in 2005 but we resisted publishing this “short version” for a number of reasons – the data showed that people, even without medical training could get it – the material in “Explain Pain” wasn’t too hard or complicated, rather most clinicians underestimated their patient’s ability to learn about, and understand their pain. Additionally, and also important, the material was changing rapidly and so too were delivery modes. Remember YouTube only started in 2005.

Since Explain Pain, many clinicians have written their own short manuals – some are excellent, some are scary, others are plain wrong and many defy basic multimedia principles. We’ve noted that some, including published books and manuals, closely resemble the structure, text, ideas and style of Explain Pain

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