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Welcome to the Oral Apothecary Podcast, authentic chat about medicines,
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pharmacy and healthcare in the UK.
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Pharmacists Jamie, Gimmo and STC take on topical and controversial
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stories but keep it edgy yet lighthearted.
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Guests share their career defining drug song and book and
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also share their joyful patient stories. Welcome to the Oral
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Apothcrey Podcast. My name is Jamie Hayes. For this the
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final episode of series eight, we're joined by doctor Ellie Cannon.
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Ellie is an NHSGP with a special interest in women's health.
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We will welcome Ellie in a moment as she shares
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a drug for our former eye, her career anthem and
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recommends a book for the Oral Apothcary Library. Microdiscussion looks
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at online patient access to clinical notes and the impact
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on the quality of care. First, let me welcome my
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two fellow apothecarys. STC is in Bournemouth and Gimmo is
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in Cardiff. Welcome both evening.
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You know what you've been up to doing so yesterday
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I was I think I've mentioned before as part of
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an improvement collaborative around Sea diff seediff sil infections, which
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was great, because the whole aim of it is to
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ramp up prevention and improve treatment. And so yeah, they
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asked she asked me to speak because, as I've said
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on here before, my mum had seed diff roughly about
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the same time I was in the collaborative, and it
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was a pretty horrendous experience, to be honest. So taught
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me a lot because I'd never really thought that much
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about it beyond it being a diarrheal infection. And that
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was the point of my talk really was that we've
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got to think beyond it as a was a diaring infection.
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It's something that really affects people's lives. So that was
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nice to do that. I mean, I was I was
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trying to come at it, and it fits in with
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today's guest really trying to come at it from point
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of view of a care but also as being a
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healthcare professional. You can offer some insight into it. So
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if anyone's interested, I did write a blog about it
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as well, and so I'll put that in the show notes.
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Yeah, it was very good to you tell about it before,
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but it was an excellent as I tried to learn
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more about AI. I've been reading the excellent book Intelligent
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The Evolution of AI Transforming Healthcare by Professor Schaffi Ahmed.
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I can highly recommend that really really well written. Mayb
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been not too jo very.
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Good when I've got a book recommendation as well. I
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went to the Royal College of Pharmacy Fellows dinner a
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couple of weeks ago. The guest speaker was doctor Ragashri
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darow An, the author of Unheard, The Medical Practice of Silencing.
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She gave a brilliant speech at the dinner. I signed
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it up to come on the podcast for series nine
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and since then I've read and heard and it is.
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I'm going to put it as essential reading. Wow, it's
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a it's a cracker. It's a cracker. So yeah, so
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a few book recommendations.
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If we do a series nine, well she'd be a
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good guest.
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Yeah, Me and Gimmo will be doing when with somebody.
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Oh.
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Actually I was at a respiratory study day today and
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there was a phenomenal respiratory consultant from Southampton and he
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was super specialist, right, so he was dealing with severe
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brittle asthmatics and all the monoclonal antibodies for these people,
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so quite very specialist really, but his whole presentation was
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about multi morbidity and how you know if you just
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look at it in a super specialist way, you're missing
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a large section. And he said that for the moniclonal antibodies,
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he said, only thirty percent of the patients that they've
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ever given it to it are in remission and that's
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because of all the other things that are going on.
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So again I signed him up.
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Very good. Okay, let's move on our great pleasure to
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welcome doctor Ellie Cannon to the Oral Apothcary. As I mentioned,
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Elie is an NHS and private GP with a specially
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interest in women's health. She's the resident health columnist for
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The Mail on Sunday and Mail Online and frequently appears
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as the medical expert for ITV, BBC, Women, Zoe and LBC.
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She's been a GP for twenty years on the world
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famous Abbey Road in London, having graduated from Cambridge. Ellie
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goes on to say, look, with the amount of conflicting
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information on menopause, navigating this journey can be overwhelming. She
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mentions it's been framed in some quarters as the panacea.
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The more home ones you take, the better you'll feel
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but highlights. There's also lots of concern GPS that women
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are being over promised a positive menopause and prescribed far
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too much. Doctor Ellie decided to redress the balance with
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her third book. I've got maybe fourth book, the Little
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Book of HRT in support of HRT but sensible about
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the pros and cons of treatment. I've read it as well, Ellie.
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So welcome to the podcast.
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Thank you very much for having me.
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Very good. So we'll come on to a few of
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the books, Ellie, because I've read a couple of your books.
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Let's start with you know, media medicine, Ellie, what does
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that mean for you? What does your working week look like?
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Oh, that's a great question. So I do about sort
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of four to five clinical sessions a week across the
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NHS and now privately as well, So very normal NHS
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and private general practice, very diverse populations in North London.
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As you said in your lovely intro, I've been working
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on Abbey Road for about eighteen years in the same
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GP surgery, which obviously nowadays is quite unusual and very
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lucky that I've always worked with the same group of doctors,
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which has been fantastic and also within the same community,
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so very very much embedded in the community cradle to
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grave care. So that's really good and very satisfying. And
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then media medicine basically means that I like talking about
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health and medicine to the public and so I've been
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doing that for as long as I've been a GP
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in the Mail on Sunday, where I've got a weekly
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page where I answer readers questions and write about topical
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health stories. As you said, I've always done a lot
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of reactive media, so health stories in the news and
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then I might be on the news talking about them,
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and so lots of different things like that, And as
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you mentioned, I have written written some books as well.
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Very good.
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So Abbey Road, the famous Abbey Road, where is where
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are you in relation to the crossing?
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Okay, well, I have a great story about that because
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I'm about i would say, three quarters of a mile
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north of the crossing and if you know that area,
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that area of London's called Saint John's Wood and it's
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an incredibly diverse area. So I actually work in, as
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I say, quite away from the crossing and within a
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large area of social housing, which is very different from
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Abbey Roads. To studios and obviously the sort of much
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more privileged sort of area down there. But we also
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have a zebra crossing outside our practice. And what happens.
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Does it feel lonely?
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No, it doesn't, And I'll tell you why, because tourists
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get a bit confused. And so we sometimes, despite not
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having a studio and despite having a GP surgery and
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large areas of social housing flats, people will cross our
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zebra crossing and they will think that it's that's the crossing,
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and it isn't. And I sometimes tell them they're in
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the wrong place, and I sometimes don't brilliant.
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There may be one or two people who wondered what
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the heck we're on about. So it's the cover of
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It's the cover of the famous Beatles album, isn't it?
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It is the cover of the famous Beatles album. And
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you can sort of see, you can see down Abbey
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Road they walk across the zebra crossing. You can't see
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as far as much practice.
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And he's just had a new album, Steven And if
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you've heard it is it's got a new album anyway.
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So I mean, so I've been reading quite a few
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of the columns over the last week or so sort
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of in preparation for the conversation. And I think it's
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I think, you know, one of the things on this
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podcast because we're three pharmacists and take it quite seriously.
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And so it's a really fine line to tread between
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talking about medicines and in your case health and given
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in appropriate advice. So it must be a difficult thing
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to do week in and week out in terms of
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getting that balance between wanting to wanted to give advice,
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but obviously there's a professional risk to you in terms
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of how that advice is interpreted. Is that something you
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think much about or.
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Yeah, absolutely.
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I Mean the nice thing about the column is it's
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genuine reader questions. So it's really no different to sitting
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in my GP surgery and either reading the consults or
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having somebody come in and talk to you. I mean,
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they are very in depth issues. Obviously, people are aware
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and we make it very clear that I can't really
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be giving individualized advice. But I think it's a very
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good platform to talk to people about the pros and
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cons of treatment and the risks of things and give
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some patient education across. And the interesting thing is we
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have many readers who are pretty elderly, and I'm assuming
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not digitally enabled, because obviously nowadays there is health advice
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across across sort of the online world for all and sundry,
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but there's still a whole load of people who actually
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have never accessed that advice online.
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I was gonna say that. So we were talking about
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people often go to advice to chatchubut or copilot, and
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we've talked about this in the past, get a whole
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amalgamation of different evidence, whereas obviously you're presenting it quite
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as a binary piece of advice as and it's from
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you to the person reading the thing. And it sounds odd,
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but reading it was quite nice reading stuff in the
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paper because it felt quite traditional. And I guess that's
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what you're talking about, because I'm so used to now
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reading things on Google and on chat GPT.
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Well, I think that in terms of people looking things
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up on AI or on Google, as you said, people
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aren't really curating that information. And that's one of the
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issues when you look anything up on AI or on
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Google is we don't know what the sources are. It's
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particularly pertinent in health, as you will all know, because
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now easily the majority of information that is framed as
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health online, particularly on social media, is actually what my
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friend and co author Deborah Cohen calls health fiction.
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It's actually not health advice or health information.
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It's health fiction. It's somebody trying to sell you something.
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And unless you are training your LLM, your AI to
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use specific sources, you're going to get a whole host
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of wrong information and sales pitch really in terms of
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what you're looking for. So I'm all for using AR
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and I'm all for using Google, but you have to
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make sure that you are curating what you're looking up.
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So, Ellie, the last three books I've read are yours,
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little Book of HRT, Deborah's Bad.
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Influence, Good, glad to hear it.
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Yeah, Deborah is coming on in series nine as well,
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So that's well, that's.
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Good because I was going to recommend that you had Herolin.
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Yeah.
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No, no, we're not just thrown together on here. Early again.
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I put Deborah's book up there with Essential Reading as well.
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It's a it's a cracker for very different reasons. Before
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we come back to HYT and talk a little bit
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more about that, I just wanted to share with you then, Ellie,
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that I read your book, is your job Making You ILL.
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I do a lot of coaching and the book was
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very pertinent to many of the people that you'll come
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into my coaching practice. And there's two quotes that I
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use in my workshops fairly often. One is from the
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organizational psychologist John Amichi, and he addressed the Royal Pharmaceutical
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Society conference a couple of years ago and he said,
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he said, can you show your hands if you line
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manage staff? And out of six hundred people, you can
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imagine lots of people put their hands up. And then
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John delivered a line that sort of stayed with me.
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He said, if you're line managing staff, your staff's children
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know your name. Okay, that was that one. And then
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the other one I use is from a Gallup quote
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that your line manager has more impact on your mental
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health than your clinician. And so your book is your
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Job Making You ILL? Really fits in with that that ethos,
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doesn't it. And so yeah, I read it around about
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COVID time. I think you mentioned it came up just
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before COVID.
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Was that right, Yeah, so it came out just before COVID.
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And it's very interesting because I was actually asked by
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a publisher to write a book. That was it. I
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was asked to write a book and they said, we'd
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like you to write a book for us. Give us
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some ideas, and so I gave them some ideas and
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I said to them, you would be amazed at the
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number of people that come into a GP surgery with
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work related ill health. And they were amazed and they said, well,
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what are you even talking about. Of course, people don't
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do that. And I said to them, week on week,
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year after year, I have had patients come in to
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see me because they are ill as a result of
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their job, a lot of bullying, a lot of toxicity,
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workplace stress, trauma from the job itself, physical health problems, this,
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that and the other. And they were absolutely astounded, which
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is why they gave me a book deal about it,
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because they just couldn't believe it. And I said, and
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they sort of said, well, what if that's a problem,
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why are they're coming to a GP. Why they're coming
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to a GP? And I explained that actually there's a
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lot of shame in that. You know, work plays a
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very big part in people's lives, in their egos and
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their self esteem. It can be very very hard to
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admit that something's going wrong, and you know, we spend
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more time at work often than we do at home
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or certainly with our friends. So I said, you know,
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it's a very big deal. And people often go to
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the doctor and it's often a GP who is collating
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all of the help for them or you know, And
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so that's why I wrote the book. And I can
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remember cases, all the cases in the book, although they've
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been anonymized. The cases that I've looked after, people who
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have ended up homeless as a result of their job
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going around, people whose relationships have broken down, people who've
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been tipped into very severe mental illness, and also you know,
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the things that go on behind the closed doors of
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a working environment. And I think for me, the most
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interesting aspect, which I've definitely seen on a personal level,
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both you know, amongst friends, amongst family, for myself, is
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that sort of the single biggest aspect of your working
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life and of whether or not you're going to survive
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or thrive or be well are the people around you.
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And you can be doing the hardest, most traumatic job
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in the world, and if you have got a good
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team around you, if you've got a good line manager,
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if you've got good colleagues. It's incredibly protective. And conversely,
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you can be doing a job that you absolutely love,
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that is great and you really enjoy get tremendous satisfaction
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from it. But if you are working with people who
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do not make you feel well, and who bully you
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or don't support you, then it will all go wrong.
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You might leave your job and move three hundred miles
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to a different part of the world and start working
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in a completely different sector.
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He says, Oh, she says.
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You might stay in a job for eighteen years, even
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though the practice is probably quite sort of difficult and
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probably you know, quite sort of disorganized and has all
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the admin problems of every other NHS practice. But if
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you're working with good people, you might stay there for
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eighteen years.
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This is a good sign. Any when I reached it
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off the shelf, look you can see that I've done
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the pharmacist thing and it's stickered up.
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Of that's so nice.
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I'm so touched by that. Very good.
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As you say, it still comes up. Been coaching now,
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I think, you know, and when I'm running sessions leadership
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performance sessions, and i highlight some of the things that
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you've just highlighted, where you know, leaders of micromanaging, and
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you know they're scratching their head why this staff aren't engaged,
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why they're not motivated, and they're looking for some magic source.
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Then yeah, I turned to many of the principles that
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you that you highlighted, So.
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Thank you linked to what we talked to Gregor, the
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Chief Medical Office of Scotland about, because his report was
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all about connections and how that's important for well being.
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But actually I don't think it probably considered work or
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connections through work to the extent that you just described.
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So I think that's I think your time for that
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book may have come again because you said he wrote
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it before COVID, and I suspect post COVID, when we're
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all now on zoom and teams and working from home,
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or lots of us are, then I suspect the problems
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even worse.
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To publishers do relaunches.
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Ellie Well, I can certainly because I wrote another book
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with her afterwards, so I could ask her about our relaunch.
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Well, the Oral Apothecary is right behind it, so that's
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worth it. I mean, you know, we seem to be
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getting into our last few guests of written books. We
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had professor Nick barbera on recently who just published a book. So, yeah,
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we seem to be going down that line, don't we
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should we get.
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Onto some hormones. Yeah, So here's a quote from your
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the Little what you called the Little Book of HRT.
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There seemed to be no space for a calm and
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balanced narrative around HRT to reflect what is realistic, safe
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and rational for all women. So I decided to make
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that space for you, and here it is. So it's
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a lovely introduction to your latest work.
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Well, we went from a situation of never talking about
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menopause or HRT to always talking about it, which I
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think everybody must have noticed. Men, women, whatever age you are,
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we never ever spoke about it, and then people were
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talking about it all the time, and so we had
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this enormous pendulum swing from sort of one end to
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the other, and there was no middle ground. And so
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we just went from saying nobody should ever have it
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because it causes breast cancer, which is what people sort
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of thought in the nineties and noughties, to every celebrity
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endorsing some form of HRT. And so you've got this
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whole group of women who are the women who I
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look after. Who are the majority of women in the
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UK accessing NHS care who were left sort of absolutely
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in the dark and confused. And I am a pragmatist
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and I believe that there's not really black and white
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in many situations. Everything's lots of sort of middle ground,
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and so I wanted to I wanted to sort of
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explain it to everybody, make sure people understand, not try
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and sell it to people. Help women understand there's lots
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of different options, many of which are not HRT. Understand
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why HRT is so good, all the sorts of all
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those sorts of things. So Yeah's and that's why it
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was a little book and very small and just a
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small amount of information. It's not supposed to be the
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world's greatest encyclopedia or menopause. It's just the fact I
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would give a patient if they were with me for
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an afternoon rather than ten minutes.
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I think your introduction was spot on, Ellie, and we
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probably got taken along with everybody else. We had doctor
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Luiz Neusen on here in twenty twenty one, we had
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the Divina effect, as you've already alluded to, and others,
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and so yeah, I think that's a great way of
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putting it, really, and pragmatism and general practice is about
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the gray, isn't it. So I suppose it's a crowded market.
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I suppose what I was going to say. And I
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don't know, you know what you found because as you say,
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we've the pendulum has swung the other way. But as
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you say, there's also still lots of need for all
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the people who are now heading into perimenopause and touch like.
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So it should continue to be available and relevant because
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you've got every year, you've got more people coming on
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who weren't on it before.
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I guess, yeah, I hope so. And there's so much
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spoken now as we've said about menopause and specifically about HRT.
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And then what I'm sure you'll be familiar with is
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that people are really now sold a lot of products.
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So if you look up something on social media, if
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you look up something online, you'll then sold things according
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to your demographic and that has really hit menopause. So
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women in their forties and fifties are sold online a
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huge number of supplements and menopause products at menopause face
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creams and all sorts of things. And I suppose my
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work is always and you know, it's always been a
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noisy space when you're talking about health, and I suppose
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my work has always been to be the sort of
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calm voice of mainstream medicine from the cold face of
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general practice and just sort of telling it how it is.
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You can't always, obviously shout loud enough to get beyond
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those other sort of very noisy voices, but it's still
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sort of worth doing, and you get through to some people.
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And as you say, you know, the book will stay relevant,
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and it's in It's always in bookshops when I sort
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of pop in, so it seems to be sort of
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staying on the shelves. So hopefully that will continue.
400
00:22:39.720 --> 00:22:41.519
And I think we need stuff like this, don't we,
401
00:22:41.559 --> 00:22:44.559
Because we've talked a lot on this podcast about shared
402
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decision making and how difficult it is in real life.
403
00:22:47.480 --> 00:22:50.279
And I remember you, Steve, when we did talk about
404
00:22:50.319 --> 00:22:54.039
this in the past, you were expressing doubts about the
405
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over enthusiasm for hr T visus. I remember it and
406
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not agree with at time, and probably changing my mind since.
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And I think I think, well, it's what the books about,
408
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isn't It's about balance isn't it. And it's about it's
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about that sort of pragmatic conversation about the evidence, because
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if you've got it's the same situation, isn't it. If
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you've got you know, if you've got the menopause, you
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still get your ten minutes of the doctor and you
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don't get anything else to you. So so we need
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a better system, and so we do need, you know,
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reliable sources of information for people on really complex topics.
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00:23:29.599 --> 00:23:32.200
I think the thing that I was particularly fixated on
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I remember distinctly in conversation with Louise was and I'd
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be interested in your take on this, Elie, was around
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the duration of use. Okay, so as an evidence based person,
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the point that I, you know, this is great, you
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know we've now got people have got access to something
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that they should have had access to. But it is
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should be a shared decision making process. It should involve
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the benefits, the risks, the alternatives, there nothing. But it
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was the duration of use thing that I kept coming
426
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back to, which is, but where is the evidence that
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it's okay to still be on it after thirty odd years?
428
00:24:04.000 --> 00:24:05.519
So I don't know if you have a view on that.
429
00:24:05.559 --> 00:24:08.960
And in preparation for this I came across and I
430
00:24:08.960 --> 00:24:11.000
think I'd heard of it but never looked at it,
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00:24:11.039 --> 00:24:16.240
which is the NHS Menopause Optimal Pathway Toolkit Wow, which
432
00:24:16.279 --> 00:24:17.920
I don't know if you've come across that, And there's
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a huge amount of work behind it, and there's a
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bit in there about duration of use. But what would
435
00:24:22.319 --> 00:24:23.759
what would your view be about that?
436
00:24:24.119 --> 00:24:26.640
Well, it's one of those things which I think has
437
00:24:26.759 --> 00:24:30.720
been sort of fueled by, as you say, the Divina
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effect and the power of the people more so than
439
00:24:37.240 --> 00:24:40.160
the evidence. And it's a bit like sort of the
440
00:24:40.279 --> 00:24:43.319
various I suppose legislations that we've seen in the last
441
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few years that have come out of TV programs or
442
00:24:46.519 --> 00:24:48.880
you know, these sort of type of things, and that's
443
00:24:48.920 --> 00:24:50.319
really sort of what it's been like.
444
00:24:51.039 --> 00:24:54.200
I mean, what happens in reality, really.
445
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And that's why it's so important to have healthcare professionals
446
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speaking from their experience, is that actually most women don't
447
00:25:02.279 --> 00:25:02.880
even want.
448
00:25:02.759 --> 00:25:05.599
To stay on it for a long time because as
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00:25:05.640 --> 00:25:08.480
you know as well as I do, that things change
450
00:25:08.519 --> 00:25:12.599
all the time in terms of people's medications and for
451
00:25:12.720 --> 00:25:15.960
a whole host of reasons which you all.
452
00:25:15.920 --> 00:25:20.000
Know far better than I do. People decide to stop,
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they can't be bothered to take something anymore. They end
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up starting five other medications, so they want to bin
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their HRT, or they get in in another way, or
456
00:25:31.079 --> 00:25:33.720
it becomes pain to pick it up, or they forget
457
00:25:33.759 --> 00:25:37.440
a prescription and then they realize they're fine without it.
458
00:25:37.559 --> 00:25:42.000
So the reality that I see is that actually very
459
00:25:42.039 --> 00:25:45.880
few women do want to stay on it long term
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or end up staying on it long term. I think
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the British menopause society line is that there shouldn't be
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any duration, fixed duration as long as the benefits out
463
00:26:01.359 --> 00:26:05.119
weigh the risks, which is obviously very wooly and obviously
464
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just basically leaves it not even to share decision making.
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It puts it in the hands of the woman herself.
466
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And they are realistic conversations.
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That we have.
468
00:26:17.279 --> 00:26:19.799
Yeah, well, this this document that I'm looking at says
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00:26:19.799 --> 00:26:22.240
obviously exactly that, and then it does actually go on
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to say the median duration of menopausal symptoms is over
471
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seven years, but it's estimated that approximately twenty percent of
472
00:26:29.519 --> 00:26:33.799
women experience symptoms for up to fifteen years. But so, yeah,
473
00:26:34.000 --> 00:26:36.039
your points are incredibly well made.
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I think on your comment earlier about the effect of
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the media on and you know, the divino effect in
476
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that case and others. It's I think it's Deborah mentions
477
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in her book, you know, we talk about the social
478
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determinants of health, and then she goes on to talk
479
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about the digital determinants of health and then the commercial
480
00:26:53.519 --> 00:26:56.559
determinants of health, and I thought, well, yeah, that's that
481
00:26:56.680 --> 00:26:58.720
covers it, really, doesn't it The way that the way
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that we're living at the moment, the way that we're
483
00:27:00.559 --> 00:27:06.880
being influenced and bombarded with with data and technology.
484
00:27:07.400 --> 00:27:11.279
That's absolutely right, and sometimes those influences are really valuable.
485
00:27:11.400 --> 00:27:14.680
So obviously, as somebody who's been involved in the media
486
00:27:14.720 --> 00:27:19.039
for a long time, I totally appreciate how valuable the
487
00:27:19.160 --> 00:27:24.079
media has been and can be in terms of health. So,
488
00:27:24.480 --> 00:27:30.039
for example, it was a very sad situation, but when
489
00:27:30.599 --> 00:27:36.359
Jade Goody, the reality star, died from cervical cancer, cevical
490
00:27:36.400 --> 00:27:40.960
cancer screening shot up and a huge number of people
491
00:27:41.039 --> 00:27:44.720
went on to be screened. I know that, for example,
492
00:27:44.839 --> 00:27:50.400
with certain diseases and conditions, the support charities, the patient
493
00:27:50.559 --> 00:27:56.960
charities really work hard to get those diseases and conditions
494
00:27:57.000 --> 00:28:03.400
mentioned in the mainstream media. So for example, when Coronation
495
00:28:03.640 --> 00:28:08.640
Street covers miscarriage, or when they cover infertility, or I
496
00:28:08.680 --> 00:28:14.319
think the Archers had a storyline about sepsis. I mean,
497
00:28:14.359 --> 00:28:17.759
these are the best forms of public health education.
498
00:28:18.200 --> 00:28:21.839
These really really are. That's what speaks to people. We
499
00:28:22.319 --> 00:28:25.039
don't sort of live in a situation anymore where people
500
00:28:25.119 --> 00:28:27.720
sit in a waiting room at a doctor's surgery or
501
00:28:28.000 --> 00:28:31.079
in your pharmacies and read the posters on the wall.
502
00:28:31.200 --> 00:28:33.319
We still have the posters on the wall, but that's
503
00:28:33.359 --> 00:28:35.240
not how people consume their media.
504
00:28:35.799 --> 00:28:37.880
To say I saw something you did recently which was good.
505
00:28:37.960 --> 00:28:41.799
Was because obviously an area that applies to is screening
506
00:28:41.799 --> 00:28:43.680
for prostate cancer, isn't it, And so there's a huge
507
00:28:43.759 --> 00:28:48.079
narrative often from the charities and celebrities that were you know,
508
00:28:48.440 --> 00:28:50.559
they should be a wider excess, but the evidence isn't there.
509
00:28:51.039 --> 00:28:55.359
And I think you commented in you around its prostate
510
00:28:55.400 --> 00:29:00.160
screen and for certain communities but others, and you you
511
00:29:00.200 --> 00:29:03.160
made the point to reform that it's not racist to51200:29:03.160 --> 00:29:06.680
sort of have whose boundaries it's based on evidence. That's right,51300:29:06.920 --> 00:29:09.119
a narrative out there that we're not getting it, but51400:29:09.160 --> 00:29:09.839
some people.51500:29:09.559 --> 00:29:12.839
Are, Yeah, well you know, it's good that we've had51600:29:12.880 --> 00:29:16.799
the sort of democratization of health care and health information,51700:29:17.079 --> 00:29:20.839
but that has come with also a huge number of disadvantages,51800:29:20.920 --> 00:29:24.319
and that is that you have This is what Deborah,51900:29:24.359 --> 00:29:28.079
I'm sure we'll talk about when she's on your podcast.52000:29:28.119 --> 00:29:30.640
You have a huge number of people who are self52100:29:30.680 --> 00:29:35.680
declared experts talking about these things, and they haven't necessarily52200:29:35.680 --> 00:29:39.799
read the evidence, they haven't necessarily understood the evidence. They52300:29:39.880 --> 00:29:43.319
don't have the sort of holistic approach that we might52400:29:43.400 --> 00:29:46.240
have from years of experience and being able to sort52500:29:46.240 --> 00:29:48.559
of look at these things. And screening is a great52600:29:48.599 --> 00:29:51.519
example of that. People get themselves all in the twist52700:29:51.559 --> 00:29:54.920
about prostate cancer screening and they get very upset about it.52800:29:55.000 --> 00:29:58.319
And I totally appreciate that there are people like Sir52900:29:58.400 --> 00:30:01.920
Chris Hoy and David Cameron. You had a PSA, of course,53000:30:01.960 --> 00:30:04.720
and that is how they found their prostate cancer. But53100:30:04.839 --> 00:30:08.279
that is not as you know, that does not means53200:30:08.480 --> 00:30:11.599
that PSA is a good screening test for the majority53300:30:11.599 --> 00:30:14.759
of men. And I have seen over the years, I've53400:30:14.759 --> 00:30:18.559
seen even within my own family, that having treatment for53500:30:18.640 --> 00:30:22.279
prostate cancer that you do not need can be a53600:30:22.319 --> 00:30:24.079
life sentence. Of other problems.53700:30:24.440 --> 00:30:26.519
Yeah. Now I saw your piece as well and thought53800:30:26.519 --> 00:30:28.799
it was spot on about there. As you said. PSA53900:30:28.920 --> 00:30:31.240
testing for black men is genetics, not racist.54000:30:32.200 --> 00:30:36.839
The Oral Apothecary is sponsored by Jamie Hayes Executive Coaching54100:30:37.160 --> 00:30:39.079
and One Less Pill dot Com.54200:30:39.240 --> 00:30:43.839
Great stuff. So shall we move on to ask you,54300:30:43.880 --> 00:30:46.599
if we will that the three items for your oral54400:30:46.640 --> 00:30:51.079
Apothecary prescription. If that's okay, Ellie. So each guest is54500:30:51.279 --> 00:30:54.079
afforded this, and we usually start with the medicine. So54600:30:54.160 --> 00:30:57.160
we're looking for something that has got a good story54700:30:57.319 --> 00:31:00.359
and is something that attributes a powerful memory to you. You54800:31:00.400 --> 00:31:02.000
So what would that be and why?54900:31:02.200 --> 00:31:05.000
Well, I don't think it attributes a powerful memory, but55000:31:05.079 --> 00:31:10.480
it's a good story. So I'm going to say topical estrogen.55100:31:10.720 --> 00:31:11.119
Okay.55200:31:12.200 --> 00:31:15.880
So lots of reasons actually. So, first of all, and55300:31:15.920 --> 00:31:18.680
this is something I've really thought about since writing the book,55400:31:18.720 --> 00:31:20.839
but also as a result of writing the book, I've55500:31:20.880 --> 00:31:24.319
done a lot of talks on menopause and it really55600:31:24.359 --> 00:31:30.599
made me think about pharmaceuticals and medicine and estrogen is55700:31:30.640 --> 00:31:33.799
a really clever drug. It's obviously not a drug, it's55800:31:33.799 --> 00:31:36.319
a hormone, but it's really cool. It must be very55900:31:36.359 --> 00:31:38.319
cool from your point of view. I mean you can56000:31:38.359 --> 00:31:39.839
shove it in a.56100:31:39.720 --> 00:31:44.400
Tablet, a patch, a pill, a pesory, a gel, all56200:31:44.440 --> 00:31:46.200
sorts of things. I don't know if there's any other56300:31:46.319 --> 00:31:50.079
sort of medications that are so versatile. So I think56400:31:50.119 --> 00:31:53.599
that's very cool from a sort of geeky science point56500:31:53.640 --> 00:31:56.079
of view. If you think about, you know, lots of56600:31:56.160 --> 00:31:58.359
other medications where we have.56700:31:58.359 --> 00:32:00.519
To inject them or you have to take it in56800:32:00.599 --> 00:32:02.799
a certain way. I think it's very cool that estrogen56900:32:02.880 --> 00:32:06.240
comes in all of these forms. And often women's health57000:32:06.279 --> 00:32:10.240
campaigners will say, oh no, no sort of resources are57100:32:10.240 --> 00:32:13.079
ever put into women's health, or somebody's obviously put a57200:32:13.119 --> 00:32:16.599
lot of time into thinking about estrogen because we've made57300:32:16.599 --> 00:32:18.119
it into so many forms.57400:32:18.599 --> 00:32:21.279
So I specifically chose topical.57500:32:21.079 --> 00:32:24.759
Estrogen because there's a huge amount of evidence on its57600:32:24.839 --> 00:32:30.079
safety and how helpful it is for women. We haven't57700:32:30.119 --> 00:32:33.920
spoken a lot in the last few years about the57800:32:34.160 --> 00:32:40.279
sort of more embarrassing perhaps symptoms of menopause, like bladder57900:32:40.359 --> 00:32:43.559
problems and vaginal problems and all of that. That hasn't58000:32:43.599 --> 00:32:46.480
really been you know, what the Divina effect has been58100:32:46.519 --> 00:32:49.559
all about. But what I see in my practices, that's58200:32:49.559 --> 00:32:53.599
a huge issue for women. It often stops women going out,58300:32:53.720 --> 00:32:57.759
stops them working, makes them afraid of relationships. So having58400:32:57.799 --> 00:33:03.079
a medication that is for for that for the sort58500:33:03.119 --> 00:33:08.079
of genito urinary issues of menopause is brilliant. And it's58600:33:08.200 --> 00:33:12.920
available over the counter as well as on prescription, which58700:33:12.960 --> 00:33:16.039
is also really cool. So women can just access this58800:33:16.200 --> 00:33:20.279
without even having a conversation with their doctor, which takes58900:33:20.359 --> 00:33:23.440
down a barrier. So there's just lots of things that59000:33:23.559 --> 00:33:28.039
are really good about It works really well in this59100:33:28.160 --> 00:33:34.200
big menopause conversation. Sadly, we have excluded a lot of women,59200:33:34.359 --> 00:33:38.160
including women who have or have had breast cancer, but59300:33:38.279 --> 00:33:41.440
they do not need to be excluded from topical estrogen59400:33:41.599 --> 00:33:44.880
because they are allowed to use it. So it's just59500:33:45.920 --> 00:33:49.799
a very nice sort of inclusive treatment with a good history,59600:33:50.240 --> 00:33:53.880
good efficacy. You can buy it over the counter from59700:33:53.920 --> 00:33:59.960
your local friendly pharmacist. And yeah, I think it's cool,59800:34:00.039 --> 00:34:02.680
and I think it's very funny that they gave it59900:34:02.799 --> 00:34:06.160
the trade name Gina, which is the second half of60000:34:06.200 --> 00:34:07.440
the word vagina.60100:34:07.720 --> 00:34:10.000
So your publishers will be very pleased that you've brought60200:34:10.039 --> 00:34:12.599
it back on message early as well. I just wanted60300:34:12.599 --> 00:34:15.119
to take the opportunity in that case to say, and60400:34:15.159 --> 00:34:16.719
I didn't say this earlier, that you know you were60500:34:16.760 --> 00:34:18.960
aiming with the Book of Calm and Balanced.60600:34:19.679 --> 00:34:19.920
I have.60700:34:20.079 --> 00:34:22.960
I've read the book cover to cover, okay, because you60800:34:22.960 --> 00:34:26.159
were coming on. And the other word I would add is,60900:34:26.280 --> 00:34:28.440
especially as you're listing some of the side effects that61000:34:28.599 --> 00:34:30.440
you know, the less common side effects, the ones you're61100:34:30.440 --> 00:34:34.000
dealing with, I would add the word gentle as well. Yeah,61200:34:34.079 --> 00:34:37.159
it's a very lovely, gentle read as well, the way61300:34:37.199 --> 00:34:40.679
that you bring the subject across to the to the readers.61400:34:41.000 --> 00:34:43.960
So yeah, that's very nice of you. Thank you very much.61500:34:44.119 --> 00:34:47.719
I loved your example of it being versatile. So Professor61600:34:47.800 --> 00:34:51.800
Nick Barber, who was on last about how to take drugs,61700:34:52.719 --> 00:34:56.599
talked about a drug and a medicine okay, and the61800:34:56.719 --> 00:34:59.119
drug in this case would be the issue or granted61900:34:59.119 --> 00:35:02.119
it's a hormone, and the medicine was how you would62000:35:02.119 --> 00:35:04.719
take the drug and put it into different formulations. So62100:35:05.199 --> 00:35:08.159
this couldn't be better as the first choice after the62200:35:08.239 --> 00:35:13.000
Nick Barber about this, So this is absolutely spot on.62300:35:13.079 --> 00:35:15.000
And I'll tell you that when Luise Newsom was on,62400:35:15.119 --> 00:35:18.960
she picked testosterone as a desert island drug. However, she62500:35:19.239 --> 00:35:23.800
picked estrogen matters while taking hormones in menopause can improve62600:35:23.800 --> 00:35:27.679
women's well being as her book. So in that sense,62700:35:28.079 --> 00:35:31.480
you know, as we might expect. And we've had other people,62800:35:31.760 --> 00:35:38.239
other female doctors on who picked into uterine estrogen as62900:35:38.280 --> 00:35:42.320
a contraceptive as well. For somebody who worked in sub63000:35:42.320 --> 00:35:43.440
Saharan Africa, if I.63100:35:43.400 --> 00:35:46.079
Remember introduced and progesterone.63200:35:46.320 --> 00:35:47.840
Yes, of course it is, thank you.63300:35:49.360 --> 00:35:53.360
And we love chemistry on this podcast, and so hormones63400:35:53.400 --> 00:35:56.559
have a lovely chemistry about them. So I think it's63500:35:56.639 --> 00:35:58.760
kind of nice, simple chemistry with I.63600:35:58.719 --> 00:36:00.840
Blow people's mind when I say that to them. I63700:36:00.880 --> 00:36:03.239
say to them when I talk to give them menopause talk,63800:36:03.280 --> 00:36:05.519
and I sort of start to talk about estrogen and63900:36:05.559 --> 00:36:07.800
I say to them, I say to them, think about64000:36:07.800 --> 00:36:10.480
weight loss jabs. And I said, everybody knows their weight64100:36:10.559 --> 00:36:13.119
loss jabs, right, I said, you know, most people aren't64200:36:13.199 --> 00:36:15.280
used to injecting themselves, and you know a lot of64300:36:15.280 --> 00:36:16.920
people don't know need dels. I said, where do you64400:36:16.960 --> 00:36:19.800
think that they're weight loss jabs? And I said, it's64500:36:19.840 --> 00:36:22.400
because the medicine is in an injection form. You know,64600:36:22.480 --> 00:36:24.760
we haven't got obviously they might be coming, but we64700:36:24.840 --> 00:36:26.559
haven't got a tablet yet. You know, it has to64800:36:26.599 --> 00:36:28.920
be an injection, so you have to put yourself through this.64900:36:29.840 --> 00:36:31.920
And I say, and I think about estrogen and all65000:36:31.920 --> 00:36:33.920
the different ways you can have it in a pill,65100:36:34.000 --> 00:36:36.159
in a patch and all of this, and then minds65200:36:36.159 --> 00:36:37.679
are blown by that idea.65300:36:38.039 --> 00:36:40.400
Okay, well that's a brilliant choice. It goes into the65400:36:40.519 --> 00:36:44.320
oral apothecar formery. Well, the next thing on your items65500:36:45.000 --> 00:36:50.760
is a song for the oral apothecary Spotify playlist. So65600:36:50.960 --> 00:36:52.079
what would you like to give us?65700:36:52.440 --> 00:36:56.280
I will give you George Michael and Aretha Franklin. I65800:36:56.360 --> 00:36:57.320
knew you were waiting.65900:36:58.119 --> 00:36:58.800
Great track.66000:36:59.320 --> 00:37:00.960
Yeah, thank you.66100:37:01.800 --> 00:37:04.480
So I'm a child of where I was born in66200:37:04.480 --> 00:37:07.039
the late seventies, but I consider myself to be a66300:37:07.159 --> 00:37:13.559
child of the eighties and have always always listened to66400:37:14.519 --> 00:37:17.960
commercial radio, from being in the car on the way66500:37:18.000 --> 00:37:21.960
to school with my dad all the way through even now,66600:37:22.000 --> 00:37:25.400
I always listen to commercial radio. I've always liked pop66700:37:25.519 --> 00:37:31.159
music and music, and George Michael has been a constant66800:37:31.280 --> 00:37:35.960
source of joy in my life until that terrible Christmas66900:37:36.000 --> 00:37:41.440
when he died. And this to me. This came out67000:37:41.480 --> 00:37:44.559
in the late eighties. Takes me when I hear it,67100:37:44.559 --> 00:37:47.199
it's you can't sort of not sing along to it.67200:37:47.199 --> 00:37:50.719
It's one of those very very joyful songs, obviously with67300:37:50.760 --> 00:37:55.760
Aretha Franklin, not just George Michael. Takes me right back67400:37:55.800 --> 00:38:02.719
to the eighties and being in the car and singing along.67500:38:03.239 --> 00:38:09.000
And I think George Michael's very essence of a British67600:38:09.400 --> 00:38:16.519
singer songwriter, hugely talented, hugely underrated actually until very late67700:38:16.599 --> 00:38:19.400
on in his career, writing his own music, writing his67800:38:19.440 --> 00:38:24.360
own songs, very essence of the eighties. Wham's Last Christmas67900:38:24.440 --> 00:38:26.079
was the first single that I ever bought.68000:38:26.920 --> 00:38:28.400
Oh now it's coming out now.68100:38:30.440 --> 00:38:34.559
And I feel sad, but I feel sad that he died,68200:38:34.760 --> 00:38:38.159
and I feel and I think he was I think68300:38:38.960 --> 00:38:43.639
celebrities today, famous people today have got a lot to68400:38:43.800 --> 00:38:50.639
learn from those talents from earlier people like well, people68500:38:50.639 --> 00:38:53.480
like Aretha Franklin as well, but people like George Michael,68600:38:53.639 --> 00:38:57.400
who were very very good at what they did and68700:38:57.599 --> 00:39:01.719
were very humble, and he was a huge philanthropist, George68800:39:01.760 --> 00:39:04.960
Michael who gave a lot of money to charity. He68900:39:05.079 --> 00:39:07.679
knew you know, we all know when he sort of,69000:39:07.719 --> 00:39:11.880
you know, famously would come unstuck, but he handled those69100:39:12.000 --> 00:39:18.840
He handled those situations so well, whilst carrying this huge69200:39:18.880 --> 00:39:22.519
secret about his sexuality really the whole way through his career,69300:39:23.920 --> 00:39:27.400
which you know is unfathomable to think about now, but69400:39:27.559 --> 00:39:30.280
was obviously very normal in the eighties, particularly with the69500:39:30.360 --> 00:39:35.239
advent of HIV. So, yeah, I'm a huge George Michael fan.69600:39:35.400 --> 00:39:37.719
So I was going to have to choose a George69700:39:37.719 --> 00:39:41.159
Michael song and that was one of about thirty I69800:39:41.199 --> 00:39:43.360
could have said, but that's it.69900:39:43.760 --> 00:39:46.880
I think that's the first George Michael track into the playlist.70000:39:47.280 --> 00:39:49.000
Wow, she is shocking.70100:39:49.199 --> 00:39:51.079
Remiss, Yeah, remiss.70200:39:51.199 --> 00:39:53.079
Yeah, I'm not sure I would have agreed to come70300:39:53.119 --> 00:39:53.840
on name.70400:39:53.920 --> 00:39:57.159
That's a good job. So Ellie, it's a lovely story.70500:39:57.159 --> 00:39:59.880
Thank you. In amongst that story, you mentioned your dan70600:40:01.079 --> 00:40:02.599
he was a doctor as well.70700:40:03.159 --> 00:40:05.480
Yeah, my dad was an amazing guy.70800:40:06.159 --> 00:40:08.719
Both my parents had passed away, but my dad was70900:40:08.920 --> 00:40:15.679
a obstetrician, actually obstatrician and gynecologist. He worked. I grew71000:40:15.760 --> 00:40:18.440
up in the North of England and my dad worked71100:40:18.559 --> 00:40:25.519
actually very interestingly in the in Gateshead and people may71200:40:25.639 --> 00:40:30.159
or may not know that Gateshead has a very large71300:40:31.079 --> 00:40:36.159
community of ultra Orthodox Jews, and ultra Orthodox Jews have71400:40:36.320 --> 00:40:40.000
a huge number of babies, so it's a great place71500:40:40.079 --> 00:40:45.480
to be an obstetrician. So my dad delivered lots of71600:40:45.519 --> 00:40:49.400
those babies, and he used to take me on his71700:40:49.559 --> 00:40:54.280
post natal ward rounds in the hospital. And when I71800:40:54.320 --> 00:40:57.760
was little and I went to medical school to look71900:40:57.840 --> 00:40:59.960
after those babies that he delivered.72000:41:00.079 --> 00:41:03.199
I wanted to be a pediatrician, but.72100:41:04.800 --> 00:41:08.480
One of my weaknesses is that I am a massive72200:41:08.559 --> 00:41:13.000
EmPATH and I find it very very hard to very72300:41:13.079 --> 00:41:16.599
very hard to put myself in those very emotional situations.72400:41:16.679 --> 00:41:20.119
So I didn't end up becoming a pediatrician, and I72500:41:20.199 --> 00:41:23.360
ended up becoming a GP, which I think was sort72600:41:23.360 --> 00:41:24.440
of the next best thing.72700:41:24.840 --> 00:41:28.880
Brilliant, great story. A lot of thought went into that,72800:41:28.920 --> 00:41:31.719
and we very much appreciate it. So that's I knew72900:41:31.760 --> 00:41:34.760
you were waiting for me by George Michael and let's73000:41:34.840 --> 00:41:38.119
keep on message and Urethra Franklin are.73100:41:38.039 --> 00:41:41.159
Sometimes known very good, very very cool.73200:41:44.119 --> 00:41:46.679
Okay, So onto the third thing. So this you get73300:41:46.679 --> 00:41:50.280
three items on your oropothetically prescription. So the third is73400:41:50.320 --> 00:41:52.400
a book for the oral apothecary library.73500:41:52.760 --> 00:41:55.880
Yeah, so I'm going to go quite heavy with my book,73600:41:55.920 --> 00:41:59.760
I'm afraid. But my book is The Periodic Table by73700:42:00.079 --> 00:42:00.880
Primo Levy.73800:42:01.559 --> 00:42:01.920
Wow.73900:42:04.159 --> 00:42:09.119
So I was a big science nerd as a child.74000:42:09.480 --> 00:42:11.599
I was very clever when I was at school. I74100:42:11.679 --> 00:42:13.480
was one of the kids who was always in these74200:42:13.519 --> 00:42:17.039
science Olympiads and used to win all of these science74300:42:17.039 --> 00:42:23.639
competitions and actually could have considered doing chemistry not medicine,74400:42:23.679 --> 00:42:27.599
but didn't decided to do medicine, but really really loved74500:42:27.639 --> 00:42:33.000
chemistry and absolutely was I was very much also the74600:42:33.039 --> 00:42:36.039
product of my parents, with a doctor father and a74700:42:36.159 --> 00:42:42.159
very pushy teacher mum who would tell me what books74800:42:42.159 --> 00:42:47.079
to read for my Cambridge interview to talk about, and74900:42:47.199 --> 00:42:51.639
she sort of forced the books of Primo Levey onto me.75000:42:51.840 --> 00:42:57.039
And Primo Levee was a chemist, an Italian chemist who75100:42:57.639 --> 00:43:01.679
was Jewish and who was a Holocaust survivor. He actually75200:43:02.840 --> 00:43:08.559
survived Auschwitz. And it's very interesting growing up in a75300:43:08.639 --> 00:43:14.719
Jewish household, how much the discussions around the Holocaust and75400:43:14.760 --> 00:43:18.239
the war, and my family were European, my mum's family75500:43:18.320 --> 00:43:22.679
were French. It's very much how those very interesting, how75600:43:22.679 --> 00:43:25.559
those stories are shaped in a household, and how you75700:43:25.639 --> 00:43:31.039
teach your children about those stories and those things that happened.75800:43:31.079 --> 00:43:33.599
And it's only really as an adult that I realized75900:43:33.639 --> 00:43:38.320
that I saw Auschwitz tattoos as a child on cousins76000:43:38.320 --> 00:43:41.679
of mine and this type of thing. And how do76100:43:41.760 --> 00:43:44.480
you tell those stories to children, and how do you76200:43:44.559 --> 00:43:48.239
keep those memories alive and sort of carrying on the76300:43:48.360 --> 00:43:52.880
witness testimonies. And whilst I thought my mum was giving76400:43:52.880 --> 00:43:55.599
me a book about chemistry because I love the Periodic76500:43:55.679 --> 00:43:58.360
Table and probably could have mentioned anything, she was actually76600:43:58.360 --> 00:44:01.119
given me. She actually to me to read this book76700:44:01.159 --> 00:44:07.119
because it is his probably quite a palatable way of76800:44:07.199 --> 00:44:10.199
describing what happened to him, and it's very clever, and76900:44:10.239 --> 00:44:12.719
it's a tool that's now used, i think by more77000:44:12.760 --> 00:44:17.199
and more authors of taking different sort of vignettes and77100:44:17.400 --> 00:44:20.559
using those as short stories. And so it's called the77200:44:20.599 --> 00:44:25.519
periodic table because he takes different elements from the periodic table,77300:44:25.760 --> 00:44:30.320
like zinc and hydrogen and he uses them to talk77400:44:30.400 --> 00:44:34.360
about either aspects of his childhood or aspects of fascism,77500:44:34.519 --> 00:44:38.519
or aspects of the Holocaust and aspects after as well.77600:44:38.559 --> 00:44:42.840
And it's a very palatable way and a very insightful77700:44:42.880 --> 00:44:48.159
way of explaining to people what happened and giving his77800:44:48.440 --> 00:44:53.920
giving his testimony and a story of survival sort of77900:44:53.960 --> 00:44:59.639
interlaced with a bit of science geekery as well. And78000:44:59.719 --> 00:45:02.320
it was it was very it was a very powerful thing,78100:45:02.639 --> 00:45:05.679
very powerful thing for me to read in adolescence.78200:45:06.000 --> 00:45:09.000
Wow, you've really sold it, Jamie. Have you ever read it?78300:45:09.159 --> 00:45:11.920
No, I haven't the progen The progen boymy Elli thought78400:45:11.960 --> 00:45:14.039
it was the period table when you first introduced it,78500:45:14.079 --> 00:45:14.599
So that's.78600:45:14.440 --> 00:45:16.239
What he put his arms up as if he as78700:45:16.280 --> 00:45:17.000
if he'd read.78800:45:16.840 --> 00:45:19.440
Thought we were going down the chemistry route. So no, no,78900:45:19.519 --> 00:45:21.840
And what you've just explained is yeah.79000:45:21.679 --> 00:45:23.880
Yeah, Now you feel like a right idiot. Don't even79100:45:23.880 --> 00:45:25.039
for that, not at all.79200:45:25.519 --> 00:45:27.679
I just looked it up now because I've heard of it,79300:45:27.880 --> 00:45:31.760
but I'd never quite appreciated it was it was the79400:45:31.760 --> 00:45:34.559
book that you've just described. So I think that that79500:45:34.639 --> 00:45:36.719
sounds like a must read because it echoes again with79600:45:37.840 --> 00:45:39.840
a lot of what we talk about about the power79700:45:39.960 --> 00:45:42.840
of well we talk about medicines, but we're essentially talking79800:45:42.840 --> 00:45:46.039
about chemistry and the power of story to explain science.79900:45:46.400 --> 00:45:49.239
So it sounds like well, I think also as well80000:45:49.239 --> 00:45:51.719
in the power of science to explain story, and I80100:45:51.760 --> 00:45:56.000
think with very sort of heavy topics, with very sort80200:45:56.000 --> 00:45:59.840
of difficult things that we need to impart. It goes80300:45:59.840 --> 00:46:02.920
back to I suppose what we were saying about public80400:46:03.000 --> 00:46:06.519
health information and having those stories you know, on the80500:46:06.679 --> 00:46:10.880
Archers or on Coronation Street. This is this is a80600:46:10.960 --> 00:46:16.679
way of telling of telling that story within sort of80700:46:16.719 --> 00:46:20.360
within another fashion. And I think there's lots of examples80800:46:20.400 --> 00:46:23.559
of that, of talking about difficult aspects of history and80900:46:23.639 --> 00:46:28.159
difficult aspects of trauma and how how we do that81000:46:28.400 --> 00:46:31.679
so so that sort of it speaks to different groups81100:46:31.719 --> 00:46:35.079
of people. And yeah, I think there's that that. There's81200:46:35.119 --> 00:46:37.719
other sort of testimonies of the Holocaust that are like that.81300:46:37.800 --> 00:46:41.079
There's also other sort of there's also other other books81400:46:41.119 --> 00:46:43.199
I've read that that are like that as well.81500:46:43.519 --> 00:46:46.159
Great, Okay, you've just reminded me actually that we really81600:46:46.239 --> 00:46:49.800
are looking for a celebrity for the POLYPHARMACD prescribing work81700:46:49.840 --> 00:46:53.320
that we do around frail toys. Genuinely a question that81800:46:53.360 --> 00:46:55.039
we talk about, you know, how do you find a81900:46:55.079 --> 00:46:59.039
celebrity to help move move your story and your subject82000:46:59.119 --> 00:47:01.559
matter to them as so, if you have any ideas82100:47:01.599 --> 00:47:04.760
on that you sound well connected, so do let us know.82200:47:05.000 --> 00:47:07.440
But anyway, that does sound like a great read. So82300:47:07.480 --> 00:47:10.400
it's the Periodic Table by Primo Levy.82400:47:10.840 --> 00:47:15.559
Is Adrian Child is not your man. He went public82500:47:15.559 --> 00:47:16.760
with it a couple of years ago, didn't he.82600:47:16.880 --> 00:47:19.039
I think we tried contacting him to get him on82700:47:19.079 --> 00:47:22.039
the podcast and people said no. People said no. So82800:47:23.079 --> 00:47:26.119
maybe Ellie's got people who know their people. I don't know. Anyway,82900:47:26.400 --> 00:47:29.119
that goes into the oral Pothecary library and it again83000:47:29.239 --> 00:47:30.360
a great, a great story.83100:47:30.400 --> 00:47:32.400
I have to say Ellie that in the green room83200:47:32.440 --> 00:47:34.559
earlier I was a little bit concerned. I was thinking,83300:47:34.800 --> 00:47:38.079
was Ellie just gonna read on? But the thought that83400:47:38.119 --> 00:47:40.920
has gone into your choices is exactly again what we're83500:47:40.960 --> 00:47:43.360
looking for, what the purpose of this podcast is all about.83600:47:43.639 --> 00:47:45.320
Thank you, thank you very much for that.83700:47:45.960 --> 00:47:48.920
He's gushing tonight, Ellie, isn't he but with good reason?83800:47:49.159 --> 00:47:50.519
And he's read my books.83900:47:51.159 --> 00:47:51.480
I know.84000:47:51.559 --> 00:47:54.280
Well that's what I mean. There's no better person for84100:47:54.320 --> 00:47:55.039
you tonight.84200:47:54.800 --> 00:47:57.960
And could discussion next. I'll save you from this one84300:47:58.000 --> 00:48:00.599
as well. Ellie watched this now. A systematic review from84400:48:00.679 --> 00:48:06.039
BMJ Quality and Safety by Yoku Yoshimulla and colleagues, Department84500:48:06.079 --> 00:48:10.440
of Primary Care and Public Health, Imperial College London, Impact84600:48:10.519 --> 00:48:14.280
of online patient access to clinical notes on quality of care.84700:48:14.960 --> 00:48:18.719
I think I will come to STC first to start84800:48:18.719 --> 00:48:21.320
the ball rolling with this one, and then Ellie you84900:48:21.360 --> 00:48:23.920
can come in. You can come in after Stevers set85000:48:23.920 --> 00:48:25.440
the scene, so as.85100:48:25.280 --> 00:48:27.719
In early episodes when I would go on too long.85200:48:27.840 --> 00:48:30.360
But I think it's important to explain this. So one85300:48:31.159 --> 00:48:34.400
we thought it was relevant because obviously Ellie works in85400:48:34.400 --> 00:48:39.400
general practice, as do I. Secondly, in the story this85500:48:39.480 --> 00:48:42.000
week and last week was around the possible move to85600:48:42.039 --> 00:48:44.880
a single care record, which has been very much in85700:48:44.920 --> 00:48:47.960
the news that also ticks the box for Ellie, and85800:48:48.960 --> 00:48:51.800
the a very good editorial about the single care rash85900:48:51.840 --> 00:48:56.760
record actually by previous Oral Apothecary alumni Jess Morley, who86000:48:56.880 --> 00:49:00.079
was scathing about yes, it's a great idea, but but86100:49:00.519 --> 00:49:02.360
you know, how are you actually going to do it86200:49:02.440 --> 00:49:05.239
and all the risks associated with it. So when this86300:49:05.360 --> 00:49:07.360
paper came up, and it's also in one of our86400:49:07.400 --> 00:49:10.760
favorite journals, so the BMJ Quality and Safety, I thought86500:49:10.800 --> 00:49:12.320
this would be a great one to talk about, so86600:49:12.480 --> 00:49:14.079
just for the listener, and then I'll let Ellie come86700:49:14.079 --> 00:49:16.679
in to begin with, is that it's important to note86800:49:16.679 --> 00:49:21.880
that this was a meta analysis of nineteen studies, nearly86900:49:21.920 --> 00:49:25.119
all in the US of A. But it involved nearly87000:49:25.360 --> 00:49:28.639
two thousand people. You had to be eighteen or over,87100:49:29.320 --> 00:49:34.480
and they were studies looking for people's views about having87200:49:34.639 --> 00:49:38.360
access to their own care record. So if you're living87300:49:38.360 --> 00:49:41.079
in England now you will know that you've got access87400:49:41.079 --> 00:49:44.599
to your GP record. And so it's the open the87500:49:44.639 --> 00:49:47.599
notes that Ellie and I make every day, the notes87600:49:47.639 --> 00:49:50.719
that you can actually see about yourself. And so what87700:49:50.800 --> 00:49:53.719
they tried to do, obviously in an academic sense, is87800:49:53.760 --> 00:49:56.559
they look through all these studies and they were interested87900:49:56.599 --> 00:50:01.360
in its effects on the institute of medicine domains, which88000:50:01.360 --> 00:50:06.960
are patient centeredness, effectiveness, timeliness, efficacy, safety, and equity. So88100:50:07.079 --> 00:50:09.000
that's what they were trying to do, to find out88200:50:09.039 --> 00:50:12.440
whether or not actually having your own access to your88300:50:12.480 --> 00:50:16.039
own care record electronically was a good or a bad thing.88400:50:16.440 --> 00:50:17.800
Over to you, Ellie, well.88500:50:17.599 --> 00:50:21.960
It will be no surprise to anybody that people felt88600:50:22.039 --> 00:50:24.719
which came out of obviously this, as you say, this88700:50:24.840 --> 00:50:33.079
meta analysis that people feel having access to their records88800:50:35.159 --> 00:50:39.400
means that they can be more empowered. They feel it88900:50:39.440 --> 00:50:42.599
puts them at the heart of their care. And so89000:50:42.760 --> 00:50:46.039
this idea of sharing clinical notes, of course it sort89100:50:46.079 --> 00:50:51.480
of positively impacts people's perception of their healthcare as well89200:50:51.519 --> 00:50:54.679
as their safety. And I think what's good is that89300:50:55.199 --> 00:50:59.679
it said it particularly helped more vulnerable populations, so perhaps89400:51:00.239 --> 00:51:04.559
who are more undeserved and underserved, sorry, not undeserved, that's89500:51:04.599 --> 00:51:09.360
completely different underserved, which I think we would find surprising.89600:51:09.440 --> 00:51:12.639
We would think actually that vulnerable patients, you know, wouldn't89700:51:12.639 --> 00:51:17.519
benefit from that. So that's very good, I suppose, I89800:51:17.599 --> 00:51:20.559
would say, and again sort of talking about sort of89900:51:20.599 --> 00:51:26.679
from experience as opposed to from data. Unfortunately, and Steve,90000:51:26.719 --> 00:51:28.960
I don't know if you experienced this as well. There90100:51:29.039 --> 00:51:33.239
is not any sort of consistency at the moment in90200:51:33.400 --> 00:51:38.119
how much of one's record you can see. So as90300:51:38.159 --> 00:51:44.159
an example, when my husband accesses his patient access on90400:51:44.199 --> 00:51:49.159
his NHS app, he can see just the headlines what90500:51:49.199 --> 00:51:54.480
we call the codes, whereas I can see the sort90600:51:54.480 --> 00:51:56.559
of whole consultation too.90700:51:56.679 --> 00:51:59.239
I thought everybody had Actually no, you can't.90800:51:59.000 --> 00:52:02.400
So your GP, your GP practice has decided what you90900:52:02.440 --> 00:52:07.639
can see. So whilst I think this is very useful analysis.91000:52:07.679 --> 00:52:10.960
I think one of the issues with it is is91100:52:11.000 --> 00:52:15.519
it actually a sort of a false positivity that people91200:52:15.519 --> 00:52:21.679
are positively impacted because actually they don't actually know how91300:52:21.760 --> 00:52:24.679
much they could be seeing, and they're not seeing as91400:52:24.760 --> 00:52:28.639
much as they could be or as much as that91500:52:28.679 --> 00:52:33.280
could actually help them. Plus also we don't have the consistency.91600:52:33.440 --> 00:52:35.119
Well, I think that's the point, isn't it as well?91700:52:35.199 --> 00:52:40.519
Because we had Jess Morley we already mentioned talking about AI,91800:52:40.679 --> 00:52:43.039
and one of the things that she was concerned about91900:52:43.199 --> 00:52:46.880
is that the quality of the information that it's drawing92000:52:46.960 --> 00:52:50.400
on from things like patient notes and stuff is poor92100:52:50.440 --> 00:52:55.239
and inconsistent exactly. And it's it's not in the same way.92200:52:55.239 --> 00:52:58.400
It's not been written to fuel an AI learning algorithm.92300:52:58.480 --> 00:53:01.599
It's not been written from the point view of informing patients.92400:53:01.599 --> 00:53:03.599
And I think that's I'm not saying there's a reason92500:53:03.639 --> 00:53:06.320
not to do it, but it's it's pause for thought92600:53:06.400 --> 00:53:09.519
before we sort of share it, because it will have92700:53:09.559 --> 00:53:12.119
consequences in how people interpreted because it's not been written92800:53:12.159 --> 00:53:15.639
with that audience in mind. It's essentially written partly for92900:53:15.639 --> 00:53:20.599
a medico legal reason, isn't it, and partly for specifically93000:53:20.599 --> 00:53:24.639
for GPS and other doctors to read and pharmacists these days.93100:53:24.679 --> 00:53:27.159
But but yeah, so that's one of my worries with it.93200:53:27.199 --> 00:53:31.400
But I was really interested in patients access in it.93300:53:31.400 --> 00:53:33.079
They were able to spot errors. So it's almost like93400:53:33.119 --> 00:53:35.760
we've introduced a second check into the system, you know,93500:53:35.800 --> 00:53:38.159
it's almost like that the patience as a check in93600:53:38.239 --> 00:53:43.079
technician almost. I was quite intrigued by that because I'm sorry,93700:53:43.079 --> 00:53:44.800
I'll stop in a second. But the reason I'm intrigued93800:53:44.880 --> 00:53:47.679
is we've just recently we haven't got access in Wales93900:53:47.719 --> 00:53:49.920
and so we had to do you have to do94000:53:49.920 --> 00:53:52.119
a Freedom of Innovation request to get your notes and94100:53:52.159 --> 00:53:54.480
you and we got said the whole pack as a PDF.94200:53:55.239 --> 00:53:58.760
And for someone in the family who we're having to94300:53:59.119 --> 00:54:02.599
dispute a diagnos something it's a long story, but it94400:54:02.639 --> 00:54:05.559
was it was amazing how how many errors they were94500:54:05.599 --> 00:54:09.039
in it, and or inconsistencies or difference in the way94600:54:09.039 --> 00:54:11.880
that the diagnos is recorded and stuff like that. So94700:54:11.880 --> 00:54:14.199
so we're giving people rubbish information, I suppose, is what94800:54:14.239 --> 00:54:14.719
I'm saying.94900:54:15.000 --> 00:54:17.159
Yes, which I think is also I think it's sort95000:54:17.159 --> 00:54:19.920
of slightly what I'm saying. Is it actually a sort95100:54:19.960 --> 00:54:23.920
of like a sort of I can't think of what95200:54:23.960 --> 00:54:28.559
the expression is. It's a sort of it's false reassurance. Really, oh,95300:54:28.599 --> 00:54:31.280
I think I'm reading you know, all my false worry95400:54:31.599 --> 00:54:34.679
yeah or false worry yeah, yeah, either either, you know,95500:54:34.800 --> 00:54:37.800
it's it's back to the rubbish and rubbish out of95600:54:37.840 --> 00:54:40.760
the AI, Like, that's great, you've got access to your notes,95700:54:40.800 --> 00:54:43.760
but actually are they Are they even helpful or valuable95800:54:43.840 --> 00:54:44.400
or accurate?95900:54:44.639 --> 00:54:47.440
Of course there'll always be the rubbish and rubbish out point.96000:54:47.559 --> 00:54:51.239
But just going back to the study, in the studies96100:54:51.239 --> 00:54:54.360
that they looked at, and we can only go on those, yeah,96200:54:54.639 --> 00:54:58.119
it was quite clear that there were positive effects on96300:54:58.239 --> 00:55:03.119
both patient centeredness and patient safety. So people found that96400:55:03.199 --> 00:55:07.199
it was they had increased satisfaction, better engagement, better trust96500:55:07.360 --> 00:55:10.400
between clinician and patient. I mean trust is the bedrock,96600:55:10.440 --> 00:55:13.320
isn't it of everything? So and from a patient safety,96700:55:13.320 --> 00:55:16.559
as Gimo has already said, people finding errors, which you96800:55:16.639 --> 00:55:20.519
do do, and there was an increase in self reported96900:55:20.639 --> 00:55:23.159
granted these things were self reported. I should have said97000:55:23.199 --> 00:55:27.000
that around but of course there were some privacy concerns.97100:55:27.039 --> 00:55:30.039
But as you said earlier, Ellie, for non white, older97200:55:30.079 --> 00:55:34.000
and non English speaking those were the populations that they97300:55:34.000 --> 00:55:36.920
actually said, because they can almost get somebody else to97400:55:36.960 --> 00:55:38.800
read it on their behalf if they didn't take it97500:55:38.840 --> 00:55:42.880
in during the actual consultation. So all the other parts97600:55:42.920 --> 00:55:46.199
of the domains, there wasn't really any evidence or enough97700:55:46.199 --> 00:55:48.840
evidence to make a comment. But I thought that it97800:55:48.880 --> 00:55:53.280
was really powerful in relation to patient safety and patient centeredness.97900:55:53.280 --> 00:55:54.199
What did you think, Jane?98000:55:54.360 --> 00:55:55.320
It doesn't excite me.98100:55:55.800 --> 00:55:57.880
I know you said that when I picked it. You said, oh,98200:55:57.880 --> 00:55:58.719
it doesn't excite me.98300:55:58.800 --> 00:56:02.159
It doesn't, but not even now. Well, I do like98400:56:02.239 --> 00:56:06.880
Jessica Morley's editorial on a similar subject, isn't it the98500:56:06.920 --> 00:56:08.960
on the single patient record bit? And so I'm just98600:56:09.039 --> 00:56:13.760
going to bit. So Jessica identifies three mistakes. The second98700:56:13.800 --> 00:56:16.400
is is scope creep and I get that one. The98800:56:16.400 --> 00:56:20.360
third mistake is over promising on timeline and benefits, and98900:56:20.400 --> 00:56:22.840
then she goes take the timeline. The NHS was to99000:56:22.880 --> 00:56:27.400
be paperless by two thousand and eighteen, then twenty twenty,99100:56:27.559 --> 00:56:31.360
then twenty twenty four, and finally by no set date.99200:56:32.199 --> 00:56:36.519
The cause was simple, complexity was underestimated. And so we99300:56:36.599 --> 00:56:39.760
often talk about complicated and complex stuff, don't we? And99400:56:39.800 --> 00:56:42.119
so yeah, so that was. That's the bit I got99500:56:42.119 --> 00:56:46.000
out of it, rather than getting lost in the message mean.99600:56:45.920 --> 00:56:48.199
Because I beautifully segued it for you and gave you99700:56:48.239 --> 00:56:49.519
the just Morley paiper.99800:56:50.360 --> 00:56:52.920
And you know, it just shows you what happens, Ellie,99900:56:53.079 --> 00:56:57.360
is that Oral Apothecary alumni go from strength to strength.100000:56:57.119 --> 00:57:03.280
After That's what we said about relaunching your book. So100100:57:03.400 --> 00:57:06.039
if for listeners who haven't heard the Jess Morley episode,100200:57:06.079 --> 00:57:09.239
please do go back. She speaks so much sense about Annelie.100300:57:09.280 --> 00:57:11.239
You might be interested in this because she talks about100400:57:11.280 --> 00:57:15.639
the risks associated with large language models and AI generally100500:57:16.039 --> 00:57:18.679
phenomenally bright, and the way that she puts it across100600:57:18.760 --> 00:57:20.079
is excellent.100700:57:20.400 --> 00:57:21.239
That'scared to hear.100800:57:21.440 --> 00:57:23.199
Yeah, no, it was really really good. And I suppose100900:57:23.239 --> 00:57:24.559
the last thing I was just going to say from101000:57:24.559 --> 00:57:26.280
a practice point of view, Eliot, I don't about you,101100:57:26.400 --> 00:57:30.760
but for years, you know, I write my notes knowing101200:57:30.880 --> 00:57:34.760
full well that patients and their advocates are going to101300:57:34.800 --> 00:57:38.000
read what I say. And I'm sure, like you, I101400:57:38.039 --> 00:57:42.119
have certain phrases that I use which are partly for me,101500:57:42.679 --> 00:57:45.760
but I know that potentially they might see them. And101600:57:45.920 --> 00:57:49.239
I have actually been pulled up once by using the101700:57:49.360 --> 00:57:53.960
term about a family member having unrealistic expectations. And what101800:57:54.199 --> 00:57:58.039
was fascinating was we were one of the pilots before101900:57:58.119 --> 00:58:03.559
all the practices were mandated to have their records for patients,102000:58:04.039 --> 00:58:06.599
and the person who was running the qiproject for us102100:58:06.719 --> 00:58:08.280
came to me and said, oh, Steve, I need to102200:58:08.280 --> 00:58:10.280
talk to you about this. And obviously I thought, oh, dear,102300:58:10.320 --> 00:58:13.039
what have I done? And I was worried that, you know,102400:58:13.079 --> 00:58:16.679
the family members had made a complaint or whatever, and102500:58:17.159 --> 00:58:19.480
she said to me, no, no, there's a piece of102600:58:19.519 --> 00:58:22.639
software that goes with it. Although there are certain trigger102700:58:22.760 --> 00:58:26.480
terms that it fights, and so that is one of102800:58:26.519 --> 00:58:29.039
them that it used and that's how it flagged. Was102900:58:29.079 --> 00:58:32.599
flagged so that I then discussed it by GPS clinical103000:58:32.599 --> 00:58:35.639
supervisor who said, in the circumstances, he thought that the103100:58:35.719 --> 00:58:38.119
phrase that I'd use was actually was fair cop.103200:58:38.280 --> 00:58:41.960
Wow, that's so interesting. Well, I use now I've been103300:58:42.039 --> 00:58:45.480
using it for at least eighteen months. I use an103400:58:45.480 --> 00:58:52.800
AI scribe in my clinical practice and it's transformation or103500:58:52.800 --> 00:58:55.599
really in terms of the consultation, because you can really103600:58:55.679 --> 00:58:58.360
listen and it makes you you can really listen to103700:58:58.400 --> 00:59:01.719
your patient. You can really look at them. It makes103800:59:01.760 --> 00:59:04.079
you a sort of to do list for after. It's103900:59:04.119 --> 00:59:07.519
so so good, But it's been absolutely fascinating because you104000:59:07.679 --> 00:59:10.039
have to read. It doesn't get the essence of you104100:59:10.199 --> 00:59:13.639
as a person, so you have to read and edit104200:59:13.679 --> 00:59:16.119
your notes. I would say it's about sort of eighty104300:59:16.199 --> 00:59:20.559
percent perfect, and I delete about twenty percent or alter104400:59:20.719 --> 00:59:24.760
about twenty percent. But it's been really really good, really104500:59:24.800 --> 00:59:26.000
really good for practice.104600:59:26.199 --> 00:59:26.440
Yeah.104700:59:26.679 --> 00:59:28.880
I think when we've discussed it before and when somebody104800:59:29.000 --> 00:59:31.079
used it in our practice and they gave it up104900:59:31.480 --> 00:59:34.480
was because of the homogeneous nature. Like you say, so105000:59:34.519 --> 00:59:37.840
you'd read it back a year later and it's not105100:59:38.039 --> 00:59:40.719
using the terms that you would use. So another word105200:59:40.800 --> 00:59:43.360
I use is strong. I write something like this person105300:59:43.400 --> 00:59:45.920
has strong health beliefs. Now you can quite imagine what105400:59:45.960 --> 00:59:47.880
I mean by that, but it's a term that I105500:59:48.039 --> 00:59:51.280
use only in certain situations. And that's one of the So,105600:59:51.639 --> 00:59:53.920
like everything, there are pros and cons. But anyway, I105700:59:53.960 --> 00:59:56.199
find that the whole thing about notes and everything I write,105800:59:56.239 --> 00:59:58.519
I think somebody's going to read it, and that's how105900:59:58.559 --> 00:59:59.400
I write my notes.106001:00:00.440 --> 01:00:02.639
Okay, thanks all, A big thank you to Ellie for106101:00:02.719 --> 01:00:05.199
joining us on the Aural Apothcrey for sharing her stories,106201:00:05.239 --> 01:00:08.119
her Desert Island drug, her career anthem, and her book106301:00:08.159 --> 01:00:11.800
for the ural Apothecree Library. That's it for series eight.106401:00:11.920 --> 01:00:14.639
Thanks to all of you for downloading, listening and supporting106501:00:14.679 --> 01:00:17.679
the aural Apothcary. Thanks to the team behind the team106601:00:17.760 --> 01:00:20.559
once again to Apothecre's four and five Claire Howard and106701:00:20.599 --> 01:00:23.559
Jonathan Underhill. Wherever you are in the world, your support106801:00:23.599 --> 01:00:26.559
is really appreciated. A huge thank to all of our106901:00:26.559 --> 01:00:29.360
guests for recording with us and for sharing their stories.107001:00:30.000 --> 01:00:33.320
We will be back sometime later in the year with107101:00:33.599 --> 01:00:37.599
series nine. You can follow us on LinkedIn. Please do107201:00:37.719 --> 01:00:40.400
sign up. You can email us at aoropothcreepod Act, gmail107301:00:40.440 --> 01:00:44.360
dot com, the website Theoropathree dot com. Gimm out now107401:00:44.400 --> 01:00:46.239
with the final ingredient.107501:00:46.360 --> 01:00:49.559
Okay, so so thank you Ellie. That was fantastic and107601:00:49.639 --> 01:00:52.000
just a reminder of the book is the Little Book107701:00:52.119 --> 01:00:55.440
of HRT as well, I say out now it's been107801:00:55.440 --> 01:00:56.559
out for a year, so hasn't.107901:00:56.360 --> 01:00:56.800
It, Elie?108001:00:58.199 --> 01:00:59.639
About nine months?108101:01:00.159 --> 01:01:03.719
Comes comes with comes with our recommendation and it you know,108201:01:04.199 --> 01:01:06.280
is in line with everything we've talked about over the108301:01:06.360 --> 01:01:10.000
last five years. Really and actually the final ingredient sort108401:01:10.039 --> 01:01:12.039
of I think fits in. We've sort of covered it108501:01:12.039 --> 01:01:14.519
today and it fits in with what we're talking about. So, so,108601:01:14.599 --> 01:01:17.800
why have sales of anti parasitic drugs gone up in108701:01:17.840 --> 01:01:19.239
the United States.108801:01:18.880 --> 01:01:20.119
Recently, Donald Trump?108901:01:20.400 --> 01:01:23.000
It's not because, well, it's not because Americans have suddenly109001:01:23.079 --> 01:01:25.559
developed a national worm problem, although you might think that109101:01:25.599 --> 01:01:30.199
they have. The increase appears to followed comments made by109201:01:30.280 --> 01:01:33.800
Mel Gibson on Joe Rogan's podcast, where he claimed that109301:01:33.840 --> 01:01:37.559
three friends with advanced cancer had taken I've a Mechtin109401:01:37.599 --> 01:01:40.760
and fan Benderzol and we're now cancer free. So the109501:01:40.800 --> 01:01:45.239
story spread rapidly, and before long, prescriptions for I've a109601:01:45.320 --> 01:01:48.400
Mechtin were rising across the country. So I suppose what's109701:01:48.440 --> 01:01:51.599
interesting about the story isn't whether mel Gibson is right109801:01:51.679 --> 01:01:54.000
or wrong. You know, scientists have looked at thousands of109901:01:54.039 --> 01:01:57.400
existing medicines to see if they have unexpected benefits, and110001:01:57.440 --> 01:02:00.400
some have and some turned out to be genuinely useful110101:02:00.400 --> 01:02:03.159
in different diseases. I suppose the interesting thing about this110201:02:03.360 --> 01:02:05.320
is that what it tells us is what we know110301:02:05.440 --> 01:02:08.880
is a good story travels much faster than good evidence.110401:02:09.280 --> 01:02:12.440
Three people getting better is intriguing and it's worth studying,110501:02:12.480 --> 01:02:15.519
but it's not proof. Medicine worked on anecdotes had known110601:02:15.599 --> 01:02:18.199
we'd never need clinical trials, and so I think that's110701:02:18.239 --> 01:02:21.519
the link to today's episode. We talk about medicines, whether110801:02:21.559 --> 01:02:25.840
a clinicians, researchers, journalists, or even podcast hosts, we have110901:02:25.960 --> 01:02:29.480
to be careful what we say. People listen and sometimes111001:02:29.480 --> 01:02:32.400
they act the rising even Mechtin, I have a mectin111101:02:32.440 --> 01:02:35.360
prescribe and is a reminder that words can change behavior111201:02:35.440 --> 01:02:40.719
remarkably quickly. Curiosity is important, new ideas are important, but111301:02:40.840 --> 01:02:43.880
in medicines, the difference between an interesting story and a111401:02:43.920 --> 01:02:48.960
safe recommendation is evidence. People don't swallow evidence. They swallow medicines,111501:02:49.360 --> 01:02:51.880
but a compelling story about a medicine can travel around111601:02:51.920 --> 01:02:55.159
the world far longer before the evidence has even got111701:02:55.159 --> 01:02:55.679
its shoes on.111801:02:55.880 --> 01:02:58.800
You have been listening to a three Epothcreeze. Production sound111901:02:58.840 --> 01:03:03.760
engineer Jimbos, original music Jamie Brewster, artwork by David Baker112001:03:03.880 --> 01:03:04.920
and Jacob Howard.112101:03:05.119 --> 01:03:09.320
Thanks for listening to The Oral Apothecary podcast. Caution you112201:03:09.360 --> 01:03:13.280
may spontaneously combust if you take it too literally.112301:03:13.559 --> 01:03:17.840
This episode of The Oral Apothecary is sponsored by Jamiehayes112401:03:17.880 --> 01:03:19.000
dot co dot UK
