Deep Breath In
84 episodes - English - Latest episode: 4 months ago -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.
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Episodes
GPs vs. surgeons with Clara Munro and Sarah Robinson
April 22, 2021 17:11 - 59 minutes - 54.2 MBThere is a common perception of surgery that it’s an old boys’ club, and that anyone joining the profession is expected to match the archetypal personality type in order to fit in. Whilst this is starting to change in some specialities, it does still present a challenge, especially to junior staff trying to establish themselves. The relationship between primary and secondary care can be quite remote, and approaches towards patient care can sometimes seem at odds with each other. In this wee...
Vaccines and headaches - with Heather Angus-Leppan and Whitney Robinson
April 09, 2021 17:31 - 57 minutes - 45.7 MBTwo topics currently being hotly discussed in the media and in clinical practice are headaches after the COVID vaccine, and the impact that structural racism is having on vaccine uptake. Headache and fever are common symptoms after a vaccination, but there are concerns about the potential link between the AstraZeneca vaccine and blood clots, and these concerns, exacerbated by the recent frenzy of media coverage, may be damaging the general public’s faith in the vaccination programme, and im...
Remote prescribing with Geva Greenfield and Benedict Hayhoe
March 26, 2021 11:27 - 50 minutes - 46.3 MBThe past year has seen an increase in antibiotic prescriptions, especially for broad-spectrum antibiotics. This might be due to the rise in teleconsultations, which limit the ability to examine patients, causing GPs to experience higher levels of uncertainty in making diagnoses. This week, we discuss the impact that COVID-19, and COVID tests, have had on access to healthcare, the risk of antimicrobial resistance, and how the pandemic has altered the presentation and case mix seen in GP surg...
Making the most of tele-dermatology with Lucy Thomas and Afzal Ansary
March 14, 2021 17:25 - 42 minutes - 38.8 MBThe use of telemedicine is on the rise, and the pandemic has led to an increased demand for this service, due to the availability of face-to-face appointments being severely limited. In this week’s episode, we discuss the benefits and pitfalls of teledermatology. With long waits for secondary care referrals, teledermatology allows dermatologists to fast-track patients requiring urgent investigations, and to direct them to the most appropriate care, which helps to alleviate some of the press...
Suddenly shielding and vaccination variation, with Kevin Fenton and Kamlesh Khunti
February 26, 2021 18:31 - 1 hour - 56 MBSuddenly 1.7m extra people have been told to shield from coronavirus, thanks to the QCovid algorithm, and that's causing confusion - ethnicity is one of the risk factors in QCovid, and yet there is a signal that there is lower update of the vaccine amongst ethnic minorities in the UK. In this week’s episode, we discuss how particular factors, such as age, ethnicity, and comorbidities, affect your QCovid score, and why a GP can help people interpret that population level risk to themselves. ...
Mental health toll of lockdown with Daisy Fancourt and Farhana Mann
February 11, 2021 13:19 - 51 minutes - 46.8 MBIn the UK, we are currently in the midst of our third lockdown since the pandemic began, and there has been a huge surge in people experiencing mental distress, anxiety and depression during the past year. The novelty of the first lockdown, in which people optimistically took up a variety of new activities, such as learning a language or baking endless loaves of banana bread, has long worn off, and many people now feel like they’ve used up their “coping resources”. Confusing public health mes...
Long covid with Melissa Heightman and Jenny Mollica
January 29, 2021 14:06 - 40 minutes - 36.7 MBIt has been estimated that 10% of people who get covid-19 are still experiencing symptoms over 10 weeks later, and the common symptoms of long covid include fatigue, breathlessness, chest pain and ‘brain fog’. In this week’s episode, we discuss the challenges of assessing long covid symptoms, especially chest pain, in primary care. As we still don’t know enough about the trajectory of the disease, how can we balance the assumption that a patient’s symptom is caused by long covid, as is like...
Tips on rolling out the covid-19 vaccine with Mark Porter, Andrew Pollard and Julia Marcus
January 14, 2021 18:04 - 48 minutes - 44.7 MBThanks to an incredible scientific effort, vaccines for COVID-19 have arrived in the UK and GPs, and other primary care health professionals, are now being faced with the monumental challenge of vaccinating high volumes of patients in a matter of days, whilst maintaining a COVID-safe environment, and fielding the myriad questions and concerns patients may have around the vaccine. In this week’s episode, we talk about the practical difficulties in preparing and administering the vaccine. We ...
The Deep Breath talking wellbeing evidence round-up of the year.
January 01, 2021 12:29 - 1 hour - 59.6 MBIn this end-of-year podcast from Deep Breath In, we're bringing you a light hearted look back at 2020, and trying to remember some of the non-covid-19 medicine that has crossed our desks. This festive quiz features the deep breath in gang, as well as Cat Chatfield from the Wellbeing podcast, and Helen Macdonald from our Talk Evidence podcasts. Reading list; Thyroid disease assessment and management: summary of NICE guidance https://www.bmj.com/content/368/bmj.m41 Thyroid hormones treatment...
Changing behaviour with Cindy Gray and Shahroo Izadi
December 17, 2020 09:49 - 48 minutes - 44.3 MBOld habits die hard, and never does the saying seem more apt than at this time of the year, when many of us start thinking about our New Year’s resolutions, and try to adopt a “new year, new me” mentality, in order to make positive changes to our health. As GPs, discussions around lowering alcohol consumption, smoking cessation, and becoming more active are commonplace in our consultations. However, how can we have meaningful conversations with our patients around “kicking the habit”, and hel...
Insomnia with Lauren Hale and Michael Kelleher
December 04, 2020 10:14 - 53 minutes - 48.6 MBGP consultations with patients about sleep problems can go in several directions – could they be a symptom of depression? Financial worries? Sleep apnoea? Is poor sleep merely a condition of modern life? Sleep is a key component of our wellbeing, and talking to a patient about their sleep patterns and habits can be a great window into their life. For optimal sleep health, it is important to follow good sleep hygiene practices, but how can we convey what seems like such a simple message to p...
Long breath - when someone has problem swallowing pills
November 21, 2020 11:36 - 30 minutes - 27.7 MBWhen someone, either an adult or child, has problem swallowing pills or capsules, there are some options open to help. In this podcast, a pharmacist and a psychologist join us to talk about liquid formulations, how to disguise the taste of medicine mixed with food, and some techniques that can be used to help with swallowing a whole pill. Deonne Dersch-Mills is the clinical practice leader for pharmacy for paediatrics & neonatology with Alberta Health Services. She is based at Alberta Childr...
A lump in the throat with Nick Hamilton, Deonne Dersch-Mills and Bonnie Kaplan
November 05, 2020 16:51 - 58 minutes - 53.7 MBA lump in the throat is a classic GP presentation, but one that often causes a lot of worry. Many people are struggling with high levels of anxiety anyway at the moment, and this may manifest physical symptoms, such as fatigue, insomnia and dysphagia. In this week’s episode, we discuss how to differentiate between causes of a lump in the throat: is my patient experiencing laryngopharyngeal reflux, or could it be cancer? How do we reassure distressed patients when we need to refer them on for...
Deep Breath In - EUPD with Leisha Davies, Soumitra Burman-Roy and Marie Stella McClure
October 22, 2020 14:21 - 59 minutes - 54.1 MBPersonality disorder is often referred to as the “Cinderella” diagnosis of mental health. Around 1 in 20 people is estimated to have a personality disorder, and it is a neglected and under-resourced area of our healthcare system. In this week’s episode, we discuss the stigma surrounding personality disorder, which can often manifest itself in high levels of anxiety for both patients and GPs, when it comes to diagnosing and managing it, and how to help a patient come to terms with their diagno...
Coughing kids with Tim Spector and Ed Snelson
October 08, 2020 14:06Persistent coughing in children is always a challenge, both for parents trying to describe and measure the cough, and for doctors making a diagnosis. In the current climate, this is all the more difficult, seeing as a continual cough is one of the major symptoms of COVID-19. UK Government guidance advises that anyone with a persistent cough should get a coronavirus test. But with the reopening of schools and the beginning of the cold & flu season both coinciding with a national shortage of te...
Coughing kids with Tim Spector and Edward Snelson
October 08, 2020 14:06 - 43 minutes - 39.5 MBPersistent coughing in children is always a challenge, both for parents trying to describe and measure the cough, and for doctors making a diagnosis. In the current climate, this is all the more difficult, seeing as a continual cough is one of the major symptoms of COVID-19. UK Government guidance advises that anyone with a persistent cough should get a coronavirus test. But with the reopening of schools and the beginning of the cold & flu season both coinciding with a national shortage of te...
'Flu vaccine season - with Nikki Turner and Jeff Kwong
September 24, 2020 16:00 - 58 minutesWith the annual flu season looming, GPs are anticipating a frenzy of vaccinations, perhaps more so than ever this year. As so many 'flu and respiratory viruses circulate every year, and as the 'flu vaccine is for one strain of influenza only, is the vaccine worth getting, and what are the risks associated with vaccinating vs. not vaccinating? In this week’s episode, we discuss the high vaccine uptake in New Zealand, and the role that social distancing for COVID-19 may have played in their ...
’Flu vaccine season - with Nikki Turner and Jeff Kwong
September 24, 2020 16:00 - 58 minutes - 53.2 MBWith the annual flu season looming, GPs are anticipating a frenzy of vaccinations, perhaps more so than ever this year. As so many 'flu and respiratory viruses circulate every year, and as the 'flu vaccine is for one strain of influenza only, is the vaccine worth getting, and what are the risks associated with vaccinating vs. not vaccinating? In this week’s episode, we discuss the high vaccine uptake in New Zealand, and the role that social distancing for COVID-19 may have played in their ...
Take a deep breath with Stephanie DiGiorgio
September 17, 2020 10:53 - 33 minutes - 30.5 MBSometimes, in Deep Breath In, we only get a chance to include a brief bit of a much longer conversation with our guests. In these Deep Breaths, we're going to bring you some of those more in depth conversations. This is long conversation with Stephanie DiGiorgio, GP and expert on obesity, who had a lot of advice on how GPs can really help their patients lose weight. She talks about having non-stigmatising conversations, why she thinks going for 10% body weight loss is much more achievable th...
Talking about obesity with Stephanie deGiorgio and Naveed Sattar
September 10, 2020 08:41 - 59 minutes - 81.5 MBFatphobia has been described as society’s last ‘ism’. Whilst our understanding of weight and health has changed over time, there is still a stigma towards people who are overweight or obese, and an assumption that they must be unhealthy, and unhealthy by choice. However, the correlation between weight and health may not be as clear cut as our societal biases would lead us to believe, and, therefore, the challenge for GPs is to make a conscious efforts to overcome our preconceptions so that th...
Time For A Pill Check With Anne McGregor And Tara Stein
August 28, 2020 07:23 - 58 minutes - 53.6 MBContraceptive pill check-up appointments used to be simple and straightforward for GPs, and frequently felt like a welcome reprieve from more complex consultations. However, there’s often more to them these days, especially given the rise in tailored regimens, with more and more women moving away from the standard of 21 pills followed by a 7-day break. In this week’s episode, we discuss common misconceptions around the pill cycle compared with a woman’s natural cycle, the various side effec...
Take a long breath with Tom Chatfield
August 21, 2020 09:50Sometimes, in our Deep Breath In podcasts, we only get a chance to include a brief bit of a much longer conversation with our guests. In these Long Breath podcasts, we're going to bring you some of those more in depth conversations. This first one is with philosopher and author Tom Chatfield (he literally wrote the book on critical thinking) and explained to me the ways in which the heuristics we use in our everyday thought, those shortcuts in our thinking, can be hijacked by biases. https...
Take a deep breath with Tom Chatfield
August 21, 2020 09:50 - 17 minutes - 15.9 MBSometimes, in Deep Breath In, we only get a chance to include a brief bit of a much longer conversation with our guests. In these Deep Breaths, we're going to bring you some of those more in depth conversations. This first one is with philosopher and author Tom Chatfield (he literally wrote the book on critical thinking) and explained to me the ways in which the heuristics we use in our everyday thought, those shortcuts in our thinking, can be hijacked by biases. https://www.tomchatfield.n...
Thinking about vitamin D with Andrew Grey and Tom Chatfield
August 13, 2020 14:00 - 1 hour - 55.6 MBInterest in vitamin D, and it’s association with a range of health outcomes continues - at least if the regular flurry of papers on the subject that are submitted to The BMJ are anything to go by, and with Covid-19, interest has piqued again. GPs are regularly asked to prescribe it, and to test for deficiencies. Low levels of vitamin D are associated with a large number of health outcomes, but, given the high costs and low accuracy of tests, would it be easier just to recommend taking supple...
“Trust me, I’m a GP” with Karen Praeter and Rhea Boyd
July 31, 2020 14:28 - 49 minutes - 67.5 MBIn light of the publication of the Independent Medicines and Medical Devices Safety Review (the Cumberlege report) in early July, which assessed the use of vaginal mesh, sodium valproate and Primodos and their associated under-acknowledged complications, this week we discuss trust between patients and doctors, and how that relationship of trust can break down when patients feel that their concerns and their pain are not being recognised and supported. We talk about the influence of racial ine...
Tackling racism with Annabel Sowemimo, Shani Scott and Joan Saddler OBE
July 16, 2020 17:02 - 1 hour - 7.33 MBThe signs and symptoms of racism have long permeated our society, and are embedded in our clinical practice and medical education. Recent events in the US, including the murder of George Floyd, have brought the Black Lives Matter movement to the fore of public consciousness, and have sparked outrage and protests in countries around the world. COVID-19 has exposed the inequalities in our healthcare systems, as the virus has had a disproportionate impact on some ethnic minority communities. In ...
Lowering the shield with Julia Marcus and Carol Liddle
July 02, 2020 13:44 - 54 minutes - 49.8 MBThe relaxation of the COVID-19 lockdown regulations is raising a lot of questions, both for doctors and for patients. This week, we discuss how the lack of clarity and coherence in public health messages over the past few months has caused anxiety and confusion for our patients, especially those who have been told to shield. We talk about GPs tailoring shielding advice to suit the individuals they treat, the politicisation of mask wearing, and the flaws of ‘abstinence-only’ health messaging. ...
Resetting General Practice with Martin Marshall, Jenny Doust and Toyin Ajayi
June 17, 2020 13:34 - 1 hour - 60.7 MBIn this week’s episode, our focus is on what the post-COVID world of general practice might look like. The pandemic has exposed the inequalities in our social and healthcare systems, but has also given GPs some much-needed headspace to reflect on changes to make going forward. Will we be able to turn general practice off and on again, like a faulty computer? Will we just drift back to the status quo, or will we seize this opportunity to shake up the old routines in order to redefine the role ...
Testing times with James McCormack and Jess Watson
June 04, 2020 10:39 - 51 minutes - 47.2 MBFor GPs, testing patients is their “bread and butter”. This week, we discuss the “better safe than sorry” attitude towards testing, which is so common among doctors – are we guilty of over-testing purely out of force of habit, or are we worried about missing something vital, and therefore find reassurance in doing them? How should we interpret test results, and how do these results affect the way we manage our patients? And, with the huge focus on COVID-19 testing in the media, how do we comm...
Talking about dying from covid with Scott Murray and Katherine Shear
May 21, 2020 16:39 - 54 minutes - 50.1 MBWith COVID-19 still ongoing, and at the forefront of the minds of doctors, patients and members of the public alike, difficult conversations are taking place - GPs are encouraged to talk about death with those who might not be ready to discuss it, and families are losing loved ones without being able to say goodbye. In this episode, we also look at survivor guilt, the range of emotions that grieving encompasses, and how to address the potentially thorny subject of advance care planning with C...
Coping with Covid with Monica Schoch-Spana and Jud Brewer
May 06, 2020 23:27 - 48 minutes - 44.7 MBIn this week’s episode, we discuss bystander guilt, convergence, brain hacks and “how you can sneeze on someone’s brain from anywhere in the world”. How can GPs cope with the myriad worries around treating patients during the current pandemic, both on the frontline and in general practice? How do we recognise and break unhelpful anxious behaviour habits and stop fixating on the news? Our guests: Monica Schoch-Spana is a medical anthropologist and a Senior Scholar at Johns Hopkins Center for...
Teleconsulting with Trish Greenhalgh and Fiona Stevenson
April 22, 2020 17:41 - 46 minutes - 42.5 MBA new podcast from The BMJ, to help GP's feel more connected, heard, and supported. Subscribe on; Apple podcasts - https://bit.ly/applepodsDBI Spotify - https://bit.ly/spotifyDBI Google podcasts - https://bit.ly/googlepodsDBI In our first episode, we discuss the highs and lows of video consultations, and how coronavirus has altered the landscape of business as usual for GPs. How will this change affect our relationships with our patients? How do we cope with frustrating technical issues? Ar...
Feeling the fear with Iona Heath and Danielle Ofri
April 22, 2020 17:11 - 49 minutes - 45.8 MBA new podcast from The BMJ, to help GP's feel more connected, heard, and supported. Subscribe on; Apple podcasts - https://bit.ly/applepodsDBI Spotify - https://bit.ly/spotifyDBI Google podcasts - https://bit.ly/googlepodsDBI This week, our topic is fear: we try to get a better understanding of fear, how it affects all of us as clinicians for better or for worse, and the impact that fear has on the ways in which we approach our patients & practice. Does fear distort our judgement, and increa...
Deep Breath In - breathe more easily with The BMJ
April 08, 2020 17:09 - 1 minute - 1.21 MB“Deep breath in…and out. Again, deep breath in…and out.” We tune in to patients’ breath sounds, seeking confirmation of a diagnosis - one more supporting piece of evidence to reassure anxious patients or to narrow the differential. But since the SARS-CoV-2 pandemic arrived, saying “deep breath in” has been replaced by the need to take one ourselves: before opening the morning news, before venturing out (or logging-on) to work each morning, and before ringing the next patient on your list w...