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Breasts and Babies
19 Plays18 days ago
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Transcript
Introduction and Health Topics Overview
00:00:00
Speaker
Welcome again to This Might Sting. Julie McCrossan with you and with me also, Dr Aidan Barron. And we talk about what's happening in all the world to do with health and news.
00:00:11
Speaker
And we try to bring you an evidence-based response. And look, Aidan... We're going to talk about many things today, but the first one is about new information being provided by Breast Screen New South Wales.
00:00:25
Speaker
All over Australia, we have these breast screen organisations where women go and have their breasts checked to see if there's any sign of cancer. And Breast Screen New South Wales has announced they're going to be giving us information about how dense our breasts are and that this is really good news. they're giving us important information.
Understanding Breast Density and Imaging Options
00:00:44
Speaker
What is the significance of density in breasts when it comes to our risk of cancer? The first thing when people think about density in breasts is they think, does that mean my breast is firmer or harder than another person's breast? I just want to dispel that to start with. That's not what we're talking about.
00:01:01
Speaker
When we talk about density, what we're talking about is actually what kind of tissue is inside your breast and how much fat there is versus how much sort of fibrous glandular tissue there is. so When we talk about density, fat is a less dense kind of tissue.
00:01:16
Speaker
And so the very low dose x-rays in a mammogram goes through that really easily and give us a really clear picture. When there's a lot more fibrous and glandular tissue, then the density increases. And so the x-rays don't get through easily.
00:01:38
Speaker
And what that means is essentially, it's slightly harder to pick up the cancers that we're looking for in breasts with a mammogram. um in a denser breast than in a less dense breast.
00:01:50
Speaker
And so the aim of this change is to inform women that their breasts are denser and therefore the low dose x-rays the mammograms have a less sensitive way of, or are less sensitive at picking up breast cancer. And that then means that if you have particularly dense breasts, this is the beginning of a conversation with your GP about whether if there is something suspicious looking, it's worthwhile having more imaging. Or even if there isn't something suspicious, but you have really dense breasts, if it's worthwhile doing more imaging. And it's a very individualized case by case discussion.
00:02:31
Speaker
But that discussion starts with giving people information. And that information is, hey, you have really dense breasts. This mammogram is not as accurate in you as it is in most other people. Well, look, I can tell you just because I'm still getting my mammograms, I immediately think if I find out I've got dense breasts, should I be paying for a a higher level of scan? I don't know, an ultrasound, an MRI?
00:02:56
Speaker
And of course, then it comes down to whether you have to pay for it yourself and how equitable access is. Can you expand on that a little bit more? Is that where we're this this new information will lead to a discussion about that?
00:03:10
Speaker
The truth will come out as we go down this process. It's something that's being considered very heavily. by the public health experts. It's a great question and I think time will tell. There'll certainly be a teething period and this is just in New South Wales at the moment that women are going to be told how dense their breasts are.
00:03:27
Speaker
The Royal Australian College of General Practitioners has already put out some guidance to GPs on how to interpret this and how to have that discussion where the next steps are. When we talk about density, there's a classification system that goes from A to D.
00:03:42
Speaker
of very low density to very high density called the BIRAD system. It's the breast imaging reporting data system that and they have that ADD classification. I don't actually know how the health department are going to communicate to people what their breast density is. It might be using that, it might be with a percentage, it might be something else.
00:04:01
Speaker
I'm not aware of what this the current situation is. But if you sit down with your GP and you are worried and you have quite dense breasts and they think it's appropriate, then the next avenues are things like ultrasound, things like MRI, things like, and this is a technical term, digital breast tomosynthesis or DBT.
00:04:25
Speaker
It's the same DBT acronym as is used in psychotherapy, but this time it's digital breast tomosynthesis. And essentially what it does is instead of taking a single picture through the breast, there's an arc of multiple pictures that go around. The same mammogram machine goes around the breast.
00:04:44
Speaker
What it means is you're exposed to a much higher dose, so more than double the dose of radiation, but you get a much more accurate picture of what's going on and you can see a lot more.
00:04:55
Speaker
And then of course, ultrasound and MRI don't have any radiation associated with them, but they are good and bad at different things. And there's risks associated with them. Not everyone can have an MRI if there's metal in your body.
00:05:07
Speaker
They're very expensive. Ultrasound is good at seeing some things. It's not good at seeing other things. Every different kind of imaging has its risks and benefits, has its advantages, its drawbacks. And that's why it's something you need to discuss with your general practitioner. It's something you might discuss with your breast physician if you've been referred to one.
00:05:26
Speaker
It's a very individualized thing. Just because you have dense breasts doesn't mean you need extra scans is the take home point there. And I want to say it again, just because you have dense breasts doesn't mean you need more scans.
00:05:38
Speaker
What it's doing is informing you that the accuracy of the scan might be slightly lower depending on the density of the breast. And that's the point at which you can make further decisions.
00:05:49
Speaker
Presumably they're going to do studies in New South Wales as they've initiated this and it will be interesting to see if it does lead to better results in terms of identifying the existence of cancer.
00:06:01
Speaker
And I guess on the other side there'll be concern about unnecessarily raising anxiety by being told you have cancer. dense breasts. But it's I'm glad we're talking about it because it's really alerting our listeners to have this conversation with their general practitioner if they're a person with breasts, a woman, and they're concerned about it, and to watch out for the the media stories and others.
00:06:25
Speaker
Is there any anything else do you think we should know? The deep fear that was probably inside the public health doctors' minds when they launched this was that people who were told your breasts are denser would immediately go, I need further scans and that they'd get digital breast thermosynthesis.
00:06:44
Speaker
And that because thousands more women, or rather, and I want to apologize, thousands more people who had breast imaging done with radiation, Over time, there might be a trend towards more cancer if you expose more people to more radiation.
00:07:00
Speaker
And so that's the fear that probably lives inside every public policy and health policy decision maker's mind is, have I done the right thing or the wrong thing here? And so they've really carefully considered this. And it's going to be really interesting to see what happens.
00:07:13
Speaker
And I guess, and of course, men do get breast cancer, but I don't know if this density issue applies to men as well. Not in the same way because men don't tend to have nearly as well-developed glandular tissue.
00:07:29
Speaker
And the truth is breast cancer in men is so understudied and so under sort of discussed and the testing is different. It's very hard to do a mammogram on many men in the same way that you could do on a woman.
00:07:44
Speaker
So it's an area for involvement, but certainly the same principle applies, which is essentially the mammograms, which are low dose radiation and very safe. They are not as good at penetrating denser tissue. And so there's no reason why it wouldn't be useful as a guy with breasts to know this as well.
Debunking Health Myths on Social Media
00:08:00
Speaker
Look, we are going to, in this episode of This Might Sting, talk about another major health issue affecting women, and many women, and that is whether maternity care or giving birth to ah a baby inside a private hospital is safer than inside a public hospital, something that's had quite a lot of media attention in Australia recently.
00:08:19
Speaker
But before we go to that, let's go to our favourite area of TikTok, Australia. claims that are made about health on TikTok. And there's one happening now claiming that French fries, as they're called, I tend to think of them as chips, but the chips or French fries are in some way more dangerous than cigarettes due to a higher level of something.
00:08:42
Speaker
I'd pronounce it acrylamide, but that may be incorrect. So what's the French fries story and how it may link to cigarettes, even though i surely smoking is always more dangerous than almost anything?
00:08:54
Speaker
My goodness me. this pack of marrough reds by this fredryers for mcdonald' i'm a board- certified md and you're not going to believe what i'm about to tell you after lane is a toxic substance known to be in the gaseous form of cigarette smoke also known to cause cancer by harming your dna metabolic pathways you're not going to believe that this package of french rice has more alinene in it than this package of smokes acoline is a toxic substance you must avoid it my goodness me You heard it here, folks.
00:09:26
Speaker
Yeah, every French fry is going to kill you. it ah It's basically a lethal single dose toxin, one French fry, immediate death. No, no. Look, that there's a few fallacies that we have to break down.
00:09:39
Speaker
The first is...
00:09:44
Speaker
There's a thing called cumulative toxicity. And what that means is when you smoke a cigarette, it's not just the acrolein in the cigarette, it's everything in the cigarette that's causing harm.
00:09:56
Speaker
The smoke's causing harm, the heat's causing harm, the 30 different highly carcinogenic chemicals are causing harm. And carcinogenic means cancer-causing.
00:10:07
Speaker
Genic means causing and carcinos means cancer. So the carcinogenic cancer-causing chemicals combined have a high risk of cancer. So you can't just compare apples and every fruit.
00:10:22
Speaker
Yes, if I've got five apples in my bucket and you've only got four in your bucket, I've got more apples. And if apples cause cancer, then yes, I would technically have a higher risk of cancer. The problem is I've got five apples in my bucket and you've got four apples in yours plus 21 other chemicals which cause cancer.
00:10:42
Speaker
So it's not quite a fair comparison. That's the first thing.
00:10:47
Speaker
And everyone listening to this will go, duh, of course it makes sense that French fries are not as lethal, not as dangerous as smoking cigarettes. This is trying to make news out of something that that's not.
00:10:59
Speaker
That's the first thing. The second thing is, coming back to our previous episode, I mentioned one of the famous toxicologists of history, Paracelsus, who said the dose determines the poison. Acrolein is not a great chemical.
00:11:12
Speaker
I personally would not choose to to ingest a whole heap of it. It is probably quite carcinogenic and mutagenic, i.e. it causes mutations in your cells, which can cause cancer at high doses.
00:11:24
Speaker
And the literature seems to suggest that the toxic level is approximately 7.5 micrograms per kilogram of body weight. And whenever we talk about toxicity, we don't just talk about a dose. We talk about it in terms of how much in relation to how much body weight you have.
00:11:41
Speaker
And that's because when you eat something or you're injected with something or you swallow something and it goes from your tummy into your bloodstream through your liver and then spreads to your entire body, if I'm a little kid,
00:11:53
Speaker
i have many I have a much smaller body. I have less cells, which will each individually take in a little bit of that chemical. If I'm an elephant, I've got a huge body. I've got billions more cells.
00:12:07
Speaker
And so if the toxic level of a chemical is one part per million, but I've got millions more cells, I have many more cells to distribute that toxin in.
00:12:19
Speaker
so that it's no longer a toxin. It's just a chemical that's no longer toxic because everything at the wrong dose is toxic. Oxygen, toxic at high doses for too long.
00:12:31
Speaker
In fact, oxygen is the cause of aging. ah We are aging because the end caps of our DNA are being ripped off by radical oxygen species inside our body. Oxygen, it gives us life and it's also the reason we all die.
00:12:45
Speaker
Everything's toxic at the wrong dose, which is a real paradigm shift. So when it comes to acrolein, yes, there is acrolein in French fries, in certain foods, particularly fried foods where there's animal and seed oil fats exposed to heat and you have kind changes in in the structure of different chemicals, you can get acrolein.
00:13:06
Speaker
Would I recommend avoiding high doses of fried chips? Yes, for multiple different reasons. The polyunsaturated fats is one of them. The fact that they're a high source of fatty oils and carbohydrates is another one.
00:13:19
Speaker
And yeah, they have some acrolein in them and acrolein is not great for you. but you're not going to die because you've exposed yourself to hot chips. And in fact, the proof is in the pudding in that we have many people on this earth who have been eating McDonald's every day of their life, and they're still going strong into their 70s and eighty s
00:13:40
Speaker
Look, I just have to reveal to you before we go on to our next topic, Aidan, that I did have fish and chips prior to this conversation, not knowing that we were going to be talking about this, but at least I stopped smoking in the very early nineteen eighty s There you go But can I tell you, when I did have cancer, even though I'd stopped smoking around 81, all the doctors, every time they took my history, they wrote it down. They still took it really seriously. If there was anything that made me understand even more profoundly why it's good not to smoke, it was how seriously they took me having smoked decades before.
00:14:16
Speaker
But look, let's move now to this topic of that's received a lot of media attention in Australia in recent weeks, and that is some research that indicated to quite a significant degree it was safer for both the mother and the child.
Maternity Care: Public vs Private Hospital Insights
00:14:33
Speaker
to have your baby in a private hospital rather than a public hospital. There was a discussion that continuity of care may have been the absolutely the key factor because it specifically said it it was safer to have your baby with a consistent obstetrician in a private hospital.
00:14:55
Speaker
but it But it also looked at staffing ratios and levels of intervention as well. Your your thoughts are on why this may be so? And I guess for me, I immediately thought about access and equity because and not everybody can afford private health insurance.
00:15:14
Speaker
This is such a tricky, emotion-laden, personal issue for so many people. And it's a difficult topic and it's not a new topic. This is a conversation and a debate that's been going on for decades.
00:15:28
Speaker
The choice of where to have your baby is personal and you have to take certain risks into consideration. And this is a big deal and it should be a big deal for a lot of people.
00:15:41
Speaker
The researchers have tried to assess the levels of risk in the population and present us with as good a calculation as they can of the different levels of risk.
00:15:52
Speaker
And when I talk about risk, what I'm talking about is when you compare two groups, you go what's happening in one group versus what's happening in the other? And ideally, you have two completely equal groups.
00:16:06
Speaker
So in an ideal situation, you would take two pregnant people who have the exact same socioeconomic status, the exact same geographic relationship to their hospital, the exact same diet, and one of them would go to a public hospital and one of them would go to a private hospital.
00:16:25
Speaker
And then you would compare that hundreds of times over. That's not what's happened here because we live in the real world and it's impossible to do these studies where we account for all these differences.
00:16:38
Speaker
And so what's happened is these researchers, and there's multiple research papers on this topic, and the most recent ones are showing between 47% and 53% increased risk of bad things happening, neonatal death, maternal death,
00:16:55
Speaker
terrible things. We're talking about babies and moms dying. This is really, it it's it has huge impacts on the family and the community and on trust in the healthcare system.
00:17:07
Speaker
People who are at very high risk, don't go typically to private hospitals. They tend to be cared for in public hospitals because only public hospitals have the multidisciplinary team of experts in pediatric neon- needles and neonatal intensive care, in maternal fetal medicine, in obstetrics and gynecology, because it's not just about delivering a baby. It's about what happens before and after the baby's delivered, the kind of care they get, where if you are a very complex pregnancy, you need multiple specialists involved.
00:17:39
Speaker
So that's the first thing. trying to account for the increased risk patients who go to public versus private. They've done cool statistical tests to manipulate the data to try and reduce the effect of that bias.
00:17:54
Speaker
But then you have the impact of how much you earn per year and how we know that has a bigger impact on your health than almost anything else. So that's a huge impact.
00:18:04
Speaker
The fact that people who can't afford a private ah obstetric team, a private midwife are going to be seen in public hospitals and are more likely to have negative outcomes. That's a real impact here.
00:18:16
Speaker
Then we talk about shared care and continuity of care. What we do know is that continuity of care often leads to better outcomes. And what does that mean, continuity of care?
00:18:27
Speaker
Continuity of care means I have an ongoing relationship with you as a healthcare professional and as a patient so that you know me, I know you, and I take care of you through a journey. So it's not just an episode of care where I see someone in a clinic, I come the next time to a clinic and a random in person. And then on the day that I give birth, there's a new midwife and a new obstetric doctor.
00:18:50
Speaker
Continuity of care means you see an obstetrician gynecologist throughout your pregnancy, and then ideally they or one of their colleagues is there, and you might or you might see a midwife throughout your pregnancy, and then they are there at the time of delivery. It means that someone knows you really well. And this is basic logic, right? If someone knows you really well, knows what you want, has a relationship with you, knows all your medical problems, knows what you're ah allergic to and not,
00:19:14
Speaker
they're probably in a stronger position to take care of you. This is why we recommend that someone has a dedicated GP that they go to because the research shows that having a GP over a long period of time leads to better health outcomes.
00:19:26
Speaker
They know you.
00:19:29
Speaker
It's tricky though, because the public system really can't deliver that sort of care for a lot of people. It can in some ways, and certainly if you're a person with a high risk pregnancies, oftentimes the public system will try to deliver that.
00:19:43
Speaker
But it's hard. I want to come to one of the biggest things that people find difficult to appreciate though. In the news, they're quoting but big scary numbers from these studies. Things like a 50% increase in death.
00:20:00
Speaker
When we talk about 50% increase in death, what we're talking about is the difference between two deaths in one group and four deaths in the other group. And those numbers are very different to, oh my God, 50 more people died in this group. There's a 50% higher chance. It's the difference between 50% and 500%. And even researchers often, we have to go, hang on a second.
00:20:24
Speaker
What's the actual difference in terms of numbers? If I'm talking about a thousand women in one group who went to public hospitals and a thousand women in another group who went to private hospitals, two women,
00:20:36
Speaker
unfortunately died in in the public hospital group and four women died in this group, vice versa. This is terrible, but is it as big an effect size as we're talking about?
00:20:48
Speaker
Perhaps not. And can that be accounted for by the fact that the women who are going to the public hospitals have high levels of comorbidities, high levels of sickness,
00:21:00
Speaker
increased risk of complexity in their pregnancy and lower socioeconomic status and means? And that's the question. And ultimately, I don't know that we are able to account for those differences, despite how good the researchers are.
00:21:16
Speaker
And irrespective of that, we should be aiming for continuity of care, no matter what the research says, as long as there's no harm. Yeah. Look, I appreciate that anyone who listens regularly to this Might Sting, our podcast, is going to learn a lot about research and how to how it's conducted and how to thoughtfully read it and understand it better. So like absolutely take all the points that you've made. And I also want to emphasise people who hearing about this for the first time that this research wasn't only about death rates, it was about levels of complication.
00:21:51
Speaker
And so the the quality of the experience for both the birthing mother and also the impact ah ah on the on the newly born child. So it wasn't just about death, it was about other things.
00:22:04
Speaker
But I have to say, from reading about this research, even with all that you've said, I was left thinking that um but if my daughter, if I could get really family-oriented, who has had one child in the public system and one in a private hospital,
00:22:20
Speaker
that if my daughter should choose to have a third child, I would be looking closely at it and and seeing if the family can assist her ah to get the continuity of care. Because my understanding, so as you've said, is that was a key difference that is available between the public and the private private hospital system. But it was also staff ratios.
00:22:41
Speaker
And my understanding too is that, and again, correct me, I don't i can't swear to this as evidence, but my understanding from general reading is that There are higher rates of scheduled caesarean sections in private hospitals than in public hospitals.
00:22:56
Speaker
And again, I'm very well aware there are debates about that that should be done on an individual decision about that what's best for mother and child and not something ah done in any way that's routine or at the request of the mother or the doctor. I understand all of this is individual.
00:23:12
Speaker
But still, that may be a factor in higher rates of safety in the private sector. We live in a society where I guess the dream of Medicare, our publicly financed health system, was that it would give everyone in Australia equal access to health care.
00:23:31
Speaker
And I'm not sure there are many people now who are close to the health system who would say we have an equal system. That if you can and either to afford private health cover, you get more choice.
00:23:43
Speaker
And secondly, as someone who's had cancer, not everything that helped me during my treatment, um particularly to lower pain and discomfort from the treatment, not everything was provided publicly. And if you had extra cash, you could have a a bit less pain and discomfort. It was as simple as that.
Healthcare Inequalities and Maternity Outcomes
00:24:03
Speaker
yeah Yeah. Look, you're right. And unfortunately, that's the reality. And this is coming back to the topic of maternity care. It's it's so complicated. I'm not an obstetrician gynaecologist. I'm not an expert in this. And there are things that I will have missed discussing this. And there are very strong feelings. And This extends beyond just the science. It extends into the realm of the tensions between midwifery and medical paternalism, the tensions between medical paternalism and women's bodies.
00:24:35
Speaker
Are we being overzealous with our procedural interventions? ah There's so much history and emotion behind this. And we're just looking at a snapshot of of this topic.
00:24:46
Speaker
And I don't think that there is a right or wrong answer If I could just say something as I haven't had my own children, my ah my two children are stepchildren, but I have been present at six births as a support person. So I've seen yeah some of the extraordinary, it is a dramatic experience birth. There's no question about that.
00:25:05
Speaker
I think my big takeaway here is it's not about the choice of public versus private. I don't know about you, Julie, but my big takeaway here is when I read this and I reflect on my experiences in obstetrics and gynecology and the work of my colleagues in ONG who are midwives, who are nurses, who are ONG doctors.
00:25:24
Speaker
I sense within them a frustration that they can't do more to make the experience of people giving birth more personalized and that the system has limitations. And I would love to see a utopia where people can have a more personalized, more continuous process there.
00:25:43
Speaker
That's probably the takeaway here is that we could probably aim to do better in the public system, despite how good our public system is compared to the rest of the world. We can aim to do better. I guess the one thing I'd like to comment on is that um you talked about paternalised medicine and midwives, and I'm aware that for many years there's been a sort of really quite dynamic tension between who is the core decision maker or leader within the birthing suite.
00:26:09
Speaker
And many midwives are very passionate about natural birth and lowering like number of interventions. And my understanding, just from reading the media coverage of this research, is that it does give a big tick to the involvement of obstetricians in both the pre-birth care, the delivery, and the immediate things that happen after the baby comes out, which can be very significant in terms of both how the mother recovers from the experience of birth and anything that may have happened, any tears or whatever the...
00:26:44
Speaker
after birth coming out and so on, but also checking the child is okay. And I think this research did say that the involvement of an obstetrician, trained medical person with extra training throughout, did lead to safer times for mother and child.
00:27:00
Speaker
And I think that maybe some midwives who find that a confronting idea And I guess our whole This Might Sting podcast is all about evidence, not ideology.
00:27:12
Speaker
And so I guess as a woman and as the mother of ah ah the stepmother of a woman who may have another child, I want the decision-making to be evidence-based, not based on conflicts about who's in control.
00:27:26
Speaker
Do you know what I'm trying to say there, Aydan? I totally am on board with you here. And my personal bias is that I agree. And I think birth should have the involvement of an ah of a trained obstetrician gynecologist who is a doctor and a surgeon with expertise in this.
00:27:41
Speaker
There is a new trend towards very natural births, far away from hospitals, demedicalized births, perhaps not even a midwife there, perhaps a doula there. And that's terrifying to us.
00:27:53
Speaker
In medicine, we don't there's a saying that there's no such thing as a low-risk birth. All birthing leads to risk, and that's with good reason. We've survived as a species for millions of years, and women have given birth to children for millions of years, but at very high costs.
00:28:09
Speaker
with very high rates of maternal and neonatal death. And sometimes the patient who has everything going right for them, where everything goes really well, suddenly something terrible can happen.
00:28:22
Speaker
And if that's gonna happen, you really wanna be somewhere where there are trained experts, where there are medications that the most probably common one if I can think of to a coat of mothers, is postpartum hemorrhage, which post meaning after, partum meaning birth, and hemorrhage meaning bleeding, which is a massive life-threatening blood loss that occurs after the delivery of the baby.
00:28:44
Speaker
And if that occurs and you're in a bathtub at home far away from hospital, you're in dire straits. It's <unk> scary and it's dangerous.
00:28:55
Speaker
And the risk there is death. In a hospital, you have access to blood transfusions, medications to make the uterus clamp down, the option to take you to theatres if the obstetrician gynecologists feel that they need to do surgery.
00:29:10
Speaker
Many different medical options for therapy that aren't available in the community. And so personally, my my view of it is I would want someone to have their birth close to medical expertise.
00:29:25
Speaker
But at the same time, I totally recognize that there's a long history where medicine has controlled women's bodies and then a lot of people want more autonomy. And that midwifery, which is founded on the accompaniment and and being with women during birth, has a role to play in helping us to better advocate for women's needs and desires during birth. And there's a healthy tension that exists there.
00:29:48
Speaker
But the evidence certainly does show that if you're going to go through birth, you want to be in a supported place. So whether that's a private hospital or a public hospital,
00:29:59
Speaker
I would not have a birth outside of hospital if I could choose. it's I sometimes wonder if it's a situation where Western medicine has been so good at reducing the risk of death during birth that we've lost the kind of, I don't know, generation the generational memory of how risky it used to be.
00:30:19
Speaker
and it's not that long ago that it was risky.
Trust and Informed Consent in Healthcare
00:30:23
Speaker
But I guess just to close on this topic, What I will take away is importance of continuity of care because because I did have the experience of, and I know it's cancer, not birth, but because I had the experience of really a five-year relationship with a multidisciplinary team because that's what cancer care offers in Australia and it's why I think we have as I understand it, in many areas, the highest survival rates in the world.
00:30:50
Speaker
So I really knew those people, the doctors, the allied health and the nurse nurses, because you meet them all the way through before, during and after. And it meant that if they were...
00:31:02
Speaker
recommending to me a course of action, my level of trust was very high because we had a relationship. And so consent, informed consent, could be something quite meaningful and not just words.
00:31:15
Speaker
And I think it's when it comes to something like preparation for then birth and then recovery from birth, if you've had continuity of relationship with doctor and midwives, ideally both,
00:31:27
Speaker
um you've got such a better chance of in partnership with them making the safe decisions to give you and your baby the best chance and that's why I think this research indicating a higher level of continuity of care meaning you knew the people and you tend to see the same people um that must be a critical factor in the high rate of safety it just has to be.
00:31:50
Speaker
It is and it's the case in all of healthcare.
Conclusion and Key Takeaways
00:31:53
Speaker
Yeah, but exactly. Look, we are at the end of our this might sting. i I'm thinking I'm going to find out whether I've got dense breasts, then going to seek information and a conversation with my general practitioner and not assume it means I require more than a mammogram, but I will take an active interest.
00:32:13
Speaker
And I guess if I was someone with a family history and dense breasts, that might be another reason to have a more serious conversation with my GP, What are you taking away from today's? Is there something you'll take away?
00:32:27
Speaker
I'm taking away that the dose determines the poison. And so I'm not going to stop eating hot chips altogether, but I'm definitely going to see if I can decrease my hot chip intake.
00:32:38
Speaker
I love the dose determines the... The poison. The poison. The dose determines the poison. Working with you, I'm learning new things and that's number one. It's farewell from this might sting. We want you to ah like us, share us, tick us.
00:32:55
Speaker
What else do we want them to do, Aidan? Subscribe, follow us on your preferred podcast platform. ah Thank you so much for listening. It's always a pleasure. And of course, Julie McCrossin and I have the most wonderful time having these regular chats. So make sure you tune in for our next episode.
00:33:13
Speaker
I'm Dr. Aidan Barron and with Julie McCrossin, remember to take your medicine as prescribed. This is This Might Sting. This Might Sting is hosted by Aidan Barron and Julie McCrossin.
00:33:25
Speaker
Executive produced by Joshua Kirsch. While we always work to give you the best information and tips, nothing in This Might Sting should be construed as personal healthcare care advice.
00:33:36
Speaker
You should always make health decisions in consultation with your general practitioner and specialists. If you'd like to hear us talk about a topic on the show, or if you think we've made a mistake and want to request a correction, please contact us at questions at thismightsting.com.au.