Drug-drug interactions might be responsible for a million hospitalisations in Australia every year. They have become more frequent over the decades, as more medications reach the market. More than half of people over the age of 75 are on five or more prescriptions—a state referred to as polypharmacy. This episode examines some of the systems that have led to current rates of polypharmacy, and some strategies for deprescribing. We also discuss a review from the Internal Medicine Journal on the common drug interactions physicians should be most concerned about.

Transitioning from trainee to consultant marks an exciting and daunting and step in a clinician’s career. Suddenly you take on responsibility for everyone on the ward—both patients and other staff. While the clinical skills have been hammered in over years of training, the ‘hidden curriculum’ can be harder to pick up. This episode captures the experience of striking out as a leader, manager and mentor to others. At the same time, recognising limitations and knowing when and how to seek help is all important.

For years the management model for asthma has been empirical. The more serious the disease, the more the dose of controller therapy is increased. But this doesn’t work for everyone and a more rational approach involves identifying one of three distinct pathological pathways. This episode describes emerging diagnostic tools therapies such as monoclonal antibodies that are targeted to specific disease phenotypes.

Uncertainty is a frightening but unavoidable fact in every speciality. In the second of a two-part series, we look at the stigma and disorientation experienced by patients with medically unexplained syndromes, and some behavioural interventions for functional disorders. Since treatment outcomes are never guaranteed, we also discuss how a patient’s expectations must be managed from the beginning of a consultation, and the importance of long-term coping strategies.

Uncertainty is a frightening but unavoidable fact in every speciality. In the first of a two-part series, we examine the culture within the profession and general public that expects nothing less that perfection in medicine. We also ask whether hospital training might shelter younger doctors from the experience of complex, chronic conditions, and how much the simplicity of protocol can be relied upon.

At May’s RACP Congress, there was great interest in sessions examining the moral obligations physicians have to society. On this episode of Pomegranate, three speakers from these panels reflect on some of the themes raised at the event.

People with autism spectrum disorder can become very agitated when experiencing pain, as they often have trouble making sense of their own emotional and physical states. Many also have difficulty communicating, and are thus difficult to assess in the emergency department. This episode covers techniques to calm distressed patients with autism and make medical assessments.

It’s common to avoid thinking about retirement, and the idea can sometimes come as a shock—professionally, personally, or financially. This month, we speak with physicians both in and out of retirement, as well as two psychiatrists whose research focuses on medical professionals’ identity.

This is a two-part series looking at how modern genomics is changing clinical practice. In our second episode, we consider genetic risk, the ethics of consenting patients, and gene-targeted treatments in cancer research.

This is a two-part series looking at how modern genomics is changing clinical practice. In our first episode, we look at the differences in gene-testing technologies and their practical utility in clinical practice.