NEW YEAR - NEW TELEHEALTH CLINIC
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Episode 236:
Show Notes
Episode 236:
Transcript
Dr Mary Barson (0:04) Hello, my lovely friends. I am Dr Mary Barson.
Dr Lucy Burns (0:09) And I'm Dr Lucy Burns. We are doctors and weight management and metabolic health experts.
Both (0:16) And this is the Real Health and Weight Loss podcast!
Dr Mary Barson (0:17) Good morning, my lovely friend. How are you last day of the year? And I'm joined by Dr Mary and we've got lots and lots of things to talk about for 2025. Dr Mary, welcome. Hello, hello. I don't know why I'm welcoming you to our own podcast, but it just came out.
Dr Mary Barson (00:33) I feel welcomed. It's fine. Nothing wrong with being welcomed. It's exciting times it is. Yeah, so this beautiful episode is coming out on December 31st. And it's a great time to get reflective, I think, on the year that was and the year that is coming. Wonderful time to set your intentions, think about how far you've come, all the wonderful things you've done, achieved and learnt in the last year, all the things that didn't go well, all the things that you want to change, and all of the beautiful things that you are looking forward to, your hopes, plans, dreams and intentions for the year ahead. And I mean, this is true for us individually. This is also true for Real Life Medicine. We have some exciting things for our lovely Real Life Medicine community that we would like to chat about on this fabulous day.
Dr Lucy Burns (01:28) Absolutely. And I guess the first thing that we want to talk about is something that has been in the pipeline for a couple of years. But it's just not been the right time. You know, we've been busy with our programs, busy with our memberships, busy creating courses, busy recording hypnosis, busy, you know, thinking about what do people need and being able to provide solutions for them. And one of the things that we got and got lots of requests for was individual medical appointments. And the thing is that that is a whole different entity. It's a whole different entity to creating courses. It requires a whole different platform, a whole different level of clinical governance and all of the things that are really important with AHPRA registered practitioners. But it's coming, it's happening, we're actually doing it. So yes, we're super excited to announce the Real Life Medicine Telehealth Clinic, where people will be able to book in appointments, at the moment, it will just be us. So you know, Dr Mary, and Dr Lucy, are soon to be joined, though, by other practitioners who have the same ethos as us. And you will be able to book appointments under our three areas of interest and our three areas really of expertise. So Miss, would you like to tell them about our three areas?
Dr Mary Barson (03:05) Yes, yes. Our three areas of expertise are metabolic health, people who want to improve their metabolism, lose weight in a healthy way, it is mental health. You and I, Lucy, are so passionate about mental health and trained in focused psychological strategies. And also for our fabulous women out there, women's health, certainly starting with an emphasis on menopause and menopausal health for women, you know, menopause, perimenopause, and facing all of the unique challenges with that transition. Metabolic health, mental health, menopause.
Dr Lucy Burns (03:44) All the Ms, which goes well with RLM, real life mental health, real life metabolic health, real life menopause health. Again, so they are definitely our three passions and the areas that we see that sometimes people feel let down in. And look, when I was a general practitioner in the clinic doing, you know, standard general practice, it is a hard gig. There is so much to know these days, so many conditions, so many medications. It's hard to be across all of the things all of the time. And like humans, we also have our own interests. So as an example, I was rubbish at musculoskeletal medicine and it was not my favourite thing. You know, someone's come in with a sore knee, neck pain, back pain, like all of that, that was just not my jam. And yeah, I did an adequate job, but I wouldn't say I did a stellar job.
Dr Mary Barson (04:55) Yeah. Similar to musculoskeletal medicine, I used to work in general practice, but it's not my absolute favourite. You know, I'm so fortunate to work in a clinic with other GPs who love it and even do, you know, medical acupuncture and fantastic things to help with musculoskeletal issues. And I don't do acupuncture. I think it's a fabulous evidence-based intervention, but it's not my jam.
Dr Lucy Burns (05:19) No, absolutely. And so it's about playing to your skill set. And there are plenty of GPs out there the phrase is GP with a specific interest, quite hard to say. And again, these are doctors that have upskilled in there, you know, again, the thing they're passionate about. So as you all know, for us, it is, it's metabolic health, mental health, and menopause health. So this is what the clinic will be providing. And I love it because it's going to be, it's going to be an option for people whose doctors perhaps aren't able to help them with that specific problem. So, you know, maybe a doctor is fabulous and they're great and they're great at skin cancer and they're great at, you know, gastro, and they're great at looking after, you know, your infected toe and your sore knee and, you know, potentially your autoimmune condition, but they're not so great with menopause. And, you know, you're sort of thinking, oh, well, where will I go? Well, you know, this is the sort of thing that we can help with. So I'm really excited. And I guess one of the things, the drivers for doing this is, again, it's always been on the long-term plan, but the thing that has really helped me decide that this is something that will be helpful for our members is that there's plenty of clinics popping up, you know, thanks COVID, because telehealth is really useful. You know, I think gone are the days where people want to spend hours in a waiting room, you know, and again, it's a bit of a barrier if you're working full-time and you've got to take a day off work or half a day off work and you go and you're, you know, you're sitting in the clinic for a long time. And again, I know when I ran my clinic, I ran late all the time.
Dr Mary Barson (07:24) The time pressures that are so significant in general practice in particular, yeah.
Dr Lucy Burns (07:30) Yeah, they are. And it's again, it's not the doctor's fault. They're not sitting and they're doing, you know, painting their toenails. They are busy and they get interrupted and emergencies come in and it's almost like your time isn't always your own. So I get it. But again, now with the advent of things like telehealth, then you can bypass that waiting room. Not for everything, because obviously, you can't examine an abdomen over video or, you know, do a proper knee joint exam or even take someone's blood pressure. And I still think primary care is at the heart of good quality medicine. As do I. So, you know, we would definitely encourage people to make sure they've got a primary care clinic, a GP clinic, which is, and when we say primary care, that means what they're doing. They're looking after your care at a primary level, as opposed to a hospital, which is secondary level or a big hospital, you know, it's a big specialised hospital like in Melbourne, the Alfred, for example, which would be called a tertiary level hospital. So we've got these three layers of care. And one of the things that bothers me a little bit is the fragmentation of this care.
Dr Mary Barson (09:02) Yeah, it's happening a lot, I think. And I know that one thing that was really driven you, Lucy, with developing this, or both of us in developing this telehealth clinic is wanting to make sure that people's care is not fragmented, but it really is unified because that just leads to much better health outcomes overall.
Dr Lucy Burns (09:28) Yes, absolutely. I think that when there's nobody kind of, a bit like the conductor, if there's nobody coordinating or nobody that's across everything, then things get missed. Medication interactions happen, you know, drug side effects, drug interactions happen, people's diagnoses get missed, because the right hand doesn't know what the left hand's doing. And so I think it's really, really important for people to have, you know, a conductor, that will be your GP, and then you get the people in the orchestra. So, you know, that might be a GP with a specific interest, you know, and again, there are plenty of people out there doing little things, but the key would be for them to coordinate and liaise with your conductor.
Dr Mary Barson (10:32) One thing that we've sort of talked about a lot with telehealth is really wanting a telehealth practice that is ethical, that just kept coming out that ethical, and elaborate on this, Lucy, like what does it mean for you to have an ethical practice?
Dr Lucy Burns (10:53) Well, I think that ethical practice is, so you and I, Miss, we care deeply about our patients or our members, participants, like we really want for them to enjoy optimal health. And in particular, you know, live out their glory, glory years. So as doctors, we saw people who worked hard all their lives and then spent their 60s, 70s, and 80s, just beholden to chronic disease. So ethical practice is really a way of looking at a patient through that lens and then helping them with the decisions on what they want to do for their health, which will ensure their glory years are lived out well. What I'm seeing, though, is that there are clinics that are not interested in that, they're very short-term. So there's, and again, you know, maybe there's a role at some level, but it's manipulating the Medicare system in order to achieve a specific outcome that they can bill for, rather than looking at the person as a whole. And an example of this, and again, I'm not interested in naming and shaming any clinics, that's not our jam. But an example of this was, is that there are medicinal cannabis clinics that are set up. Now again, I am, and I think you are, we're sort of agnostic on medicinal cannabis. And in fact, I will tell you, I don't know anything about it.
Dr Mary Barson (12:40) So it can be helpful. Sometimes it's good. Sometimes it's not. Absolutely. Yeah, it's a tool that can be great for some people.
Dr Lucy Burns (12:46) Yeah, so I know nothing about it. I wouldn't be able to prescribe it. Again, if I were in a clinic, and somebody wanted me to talk to them about it, I would have to be one of those people. I don't know anything about it. So there are clinics that have come up to help people access medicinal cannabis. And for some of these clinics, they're, again, they're ethical, they're looking at the patient as a whole, they're working out, is this an appropriate tool for them? And there are other clinics where the prescription is a slam dunk. But that's basically the outcome you will get to the patient's house. And again, that all sounds great. Like, Oh, wouldn't it be good? I don't have to go to the chemist. It's so easy if it just arrives at my house. And to opt out of this system is pretty much impossible. There are people getting scripts, not scripts, but products delivered to their door long after they don't want to take it anymore.
Dr Mary Barson (13:48) Yeah. An example of a not unethical medical practice. Yes.
Dr Lucy Burns (13:55) Yeah, absolutely. You know, and as part of mental health for us, again, it's really important that there is a team of people caring for a person. And that, you know, again, we believe the best person to do that is the patient's general practitioner or their general practice. Because again, you know, GPs aren't, they're humans that can't be on call 24, seven, seven days a week, but somebody who understands or can at least get history on the patient. And the way our mental health clinic works is it's a referral base. So as you mentioned, Miss, we have mental health, extra mental health training, which is called focus psychological strategies. And it's what people can access once they've got a mental health care plan. So the idea being you go to your GP, you get a mental health care plan, they then refer you, or you can refer yourself to somebody who has these specific skills. And then the doctor or psychologist, or it can be a mental health, social worker or OT, somebody again with the specific skills will then liaise with your conductor, give them feedback, request potentially extra sessions, and that everybody's in the loop. And again, if your doctor's not trained in, in psychological therapy, it's really, it's hard as a GP, it's hard. The GP practices are not set up for it, it's time-consuming, there are barriers, all those sorts of things. But they need to at least have some idea about what's going on with you. And yet there are clinics that are being set up where their psychologist are going, yes, you can get these Medicare rebates, it's great, yay. But don't go to your GP, because that's going to take you too long. And they refer you to an online instant service where just some random doctor who's never met you before, who has really no interest in your ongoing care, will write the mental health care plan. And basically, it's ticking a box. And then you can access the psychology services. And whilst I can see, I get why that's been set up, I get it, you know, the patients are going, I need some therapy, I'm ready now, please, I don't want to have to wait any longer. And so it seems like a really good idea and a simple solution. But honestly, it's, I think it's fraught because we need a safety system, like a backup, who's going to help you if things are going awry, like people at the end of a telehealth clinic, they can't manage that. How are they going to notice, you know, and again, even things like medication issues, DPs providing focused psychological strategies, aren't necessarily the prescriber of mental health medications, but they know about them. And they can refer back to the doctor, the conductor, with thoughts and opinions around it. Yes. Unified care is what we want for people. Yeah. So I guess the thing I look at this clinic is that it's potentially a missing piece of the puzzle for you. So if you look at your healthcare, as literally it is like a jigsaw puzzle, there's lots of things that you can do, bits and pieces that all pop in together. And when they're unified, you've got a complete puzzle. But when you've got fragmented care, you've got, you know, it's like having bits of your puzzle on the floor. It's never gonna quite coordinate together.
Dr Mary Barson (17:47) So I mean, it is, it's all new. And you know, we're still in the process of setting it up because we want it to be set up properly and, you know, from the ground up. But people want to learn more about our Real Life Medicine clinics that are coming very, very soon. Where can they go?
Dr Lucy Burns (18:09) Yeah. So if they can just go to our website it's rlmedicine.com forward slash clinic. And at the moment, when we're recording this, which is mid-December, there's just a waitlist page. But by the time this episode goes to air, there will be a booking service so that you can book in and we'll be opening early Jan and you'll be able to see it all there. And I guess one of the things we get asked a lot about in particular with metabolic health is medications. And we talked a bit about this last week. And I think one of the things you and I are good at is both de-prescribing medications for people who no longer need them. Because here's the thing, honestly, the less meds you need, the better. Like that's the crux of it. But if you do need medications, that's not a failure either. So, you know, I take medications for various conditions. I hope and I think that I take them with the lowest effective dose so that I have the least side effects. I know you take medications for various things too, Dr Mary. Taking medication is not a failure. But to optimise your health have longevity and live out your glory days, medications are not the answer to that either. No. Piece of the puzzle, but they're not the end all be all. No. Yeah. So no, I think we are well-placed to discuss the pros and cons of all medications around metabolic health in particular.
Dr Mary Barson (20:09) And weight loss.
Dr Lucy Burns (20:10) And weight loss. Yes. In a way that will make you be able to make a decision that, and again, I'm going to bang on, I'm going to say this because I think it's really important because again, there are essentially prescription-only services that are prescribing injectable weight loss medications without the patient having the full knowledge of the implications of that. Now, that doesn't mean that you shouldn't take them. That's not at all what I'm saying. There are plenty of people for whom I think they have been life-changing. But I do know there are people who weren't told that you know when you stop them, that the chances of rebound weight gain are there. One of the tricky things that's coming out seems to be, again, it's anecdotal, but I think the evidence will confirm this is that stopping and starting seems to diminish the effect for some reason. And we only know this because of the issues we've had in Australia with accessing some of these medications. People have stopped and started because of supply and they're finding the second or third time round, it's not as effective. So there are lots of things that need to be discussed, pros and cons and all of that, and it's all doable. But what that does is put you in the driver's seat to make informed decisions.
Dr Mary Barson (21:38) In a holistic, ethical and unified way.
Dr Lucy Burns (21:41) Indeed, indeed. All right, lovely one. So that's it. rlmedicine.com/clinic. Stay tuned, let us know. I hope we're providing what you need because that's always our aim. And obviously, if you don't need us, don't look at it. But if you do, if you do, then yeah, we'll be seeing you online not quite in real life, but on a one-to-one basis as well.
Dr Mary Barson (22:08) Absolutely. Bring on 2025.
Dr Lucy Burns (22:11) Time to thrive in 2025.
Dr Mary Barson (22:15) Love it.
Dr Lucy Burns (22:17) See you next week, lovelies.
Dr Mary Barson (22:19) Bye.
Dr Lucy Burns (22:22) The information shared on the Real Health and Weight Loss Podcast, including show notes and links, provides general information only. It is not a substitute, nor is it intended to provide individualised medical advice, diagnosis or treatment, nor can it be construed as such. Please consult your doctor for any medical concerns.
