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Pomegranate Health

Pomegranate Health

Welcome to Pomegranate Health, a podcast about the culture of medicine. You’ll hear clinicians, academics and advocates grapple with some big questions. How to make difficult clinical and ethical decisions free from cognitive bias. How to improve communication with patients and peers. How to deliver healthcare with efficiency and equity.

Fellows of the RACP can log time spent listening towards their CPD. Basic Physician Trainees will find the Case Report series a useful model for presentation of long-cases at their clinical examinations.

This is also the home of IMJ On-Air, where authors from the College's Internal Medicine Journal present their work. Meanwhile, the Journal Club episodes invite RACP researchers published in other academic journals to showcase their work.

Please add to the discussion in the comments section for each episode and send any feedback or ideas to podcast@racp.edu.au

Latest episodes

Ep57: The Art of Telehealth

COVID-19 has disrupted delivery of routine healthcare in many ways. Consulting patients by video or phone can be a way to keep patients safe, but many doctors are nervous as they adopt it for the first time. In this podcast we go over some of the bureaucratic and tech support questions that clinicians have been asking during the current crisis. We also discuss the art of building trust with new patients, and conducting a physical examination through telehealth.

Ep56: Billing in Byzantium

Australia has one of the best value health systems in the world, but also some of the most complicated health regulation that ties together public and private payers. This creates some traps for well-intentioned providers and loopholes for the less well-intentioned.

Ep55: Starting out in Private Practice

When doctors are starting out in private practice, they typically do so within the safety net of an established practice, and typically renting a room in exchange for an agreed portion of the consultation. The next levels of complexity involve setting up a business for oneself, or partnering in a group practice. In this podcast we discuss the personal and financial challenges, and also how to build awareness and trust in the community.

Ep54: My Health Record in Practice

Australia’s personal health record has been around for seven years, but it’s been hard getting health providers to upload data the MyHealth Record routinely. The uptake differs wildly between primary, secondary and tertiary care, so in this podcast we visit each of these settings and hear what the different expectations are of this new tool, what are the benefits gained, and how well it fits into the workflow of a consultation.

Ep53: Marrabinya—a hand outstretched

Marrabinya is a Wiradjuri word meaning “hand outstretched.” It’s the name of a service in the Western New South Wales Primary Health Network which financially supports Indigenous Australians to attend specialist consultaions. Aboriginal and Torres Strait Islander Peoples currently receive specialist medical care 40% less often than non-indigenous Australians. The Marrabinya staff explain how socioeconomic factors and institutional biases even in these settings can accumulate to prevent Aboriginal patients from receiving the care they need.

Ep52: Opioids Part 2- Regulation and Marketing

This episode looks at influencers of opioid prescribing. First we ask which are the opioids most commonly leading to dependence and why are they prescribed. Then we discuss the mixed messages that prescribers are getting from guidelines and pharmaceutical regulation, not to mention promotional campaigns by pharmaceutical companies. In Tasmania these influences have be countered by education, regulation and real-time prescription monitoring.

Ep51: Getting off the Opioids- Part 1

Australia and New Zealand have seen a fourfold increase in opioid use over the last thirty years. Most of this prescribing has been for chronic non-cancer pain, but there is little evidence to support this indication. In this podcast we’ll discuss some of the latest studies that provide evidence against the efficacy of opioid use for chronic non-cancer pain. We explain how to identify patients that have developed dependence on or addiction to opioids and how to wean them off this medication. And we describe an alternative approach to therapy that involves breaking maladaptive pain associations in the nervous system.

Ep50: Rural Medicine in NZ- Congress 2019

In this episode we hear three perspectives on rural medicine in New Zealand-Aotearoa, recorded at the RACP Congress in Auckland. New Zealand doesn’t have the same extremes of remoteness of Australia, but it does have a rugged landscape that results in small and scattered communities. The populations which are disproportionately under-serviced and in worse health, are not necessarily the most remote, and the demarcations fall much more starkly along lines of socioeconomic status.

Ep49: Training in the Bush Part 2—Remote WA

Remote settings in Australia only have 11 percent as many specialists per capita as major cities and this means that pathology is often more advanced by the time it’s diagnosed The medicine can be confronting but the training experience is great and rewarding. In this episode we visit Broome, two and a half thousand kilometres from tertiary facilities in WA, and find out what it’s like to train as a generalist up there.

Ep48: Training in the Bush Part 1—Country NSW

A third of Australia’s population is classified as regional or remote, but as it’s such a big place it’s hard to provide comprehensive heath care all over. In this episode we visit the country town of Dubbo which services a catchment of 130,000 people across Western NSW. While need in this area is high, Dubbo presents an example of strong clinical leadership and training across many specialties.

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