EP193: To-Do Lists With Dr Begg

Welcome to my podcast. I am Doctor Warrick Bishop, and I want to help you to live as well as possible for as long as possible. I’m a practising cardiologist, best-selling author, keynote speaker, and the creator of The Healthy Heart Network. I have over 20 years as a specialist cardiologist and a private practice of over 10,000 patients. Podcast Summary Introduction Dr. Warrick Bishop, a practicing cardiologist and author dedicated to patient education, hosts this episode with Dr. Alistair Begg, a senior cardiologist specializing in rehabilitation based in Adelaide. The discussion focuses on practical "to-do lists" patients should follow when consulting with cardiologists, managing medications, and preparing for medical appointments to ensure optimal care and understanding. Key Takeaways: Patients should bring an up-to-date list of their current medications to consultations, as medications may have changed across different healthcare providers, hospitals, or specialists without central coordination. Creating a written list of questions before visiting a cardiologist helps patients maximize their consultation time and remember important topics they want to discuss. Patients must understand the purpose of each medication, potential side effects to watch for, whether repeats are available, and distinguish between generic and brand names to avoid confusion. Avoid planting nocebo effects by not over-emphasizing side effects; frame medications as "generally well-tolerated" to prevent patients from experiencing imagined adverse effects before even leaving the consultation room. Taking medications at the same time daily establishes routine and improves compliance; some medications require specific timing (e.g., azetamide at night, some with food, others on an empty stomach). If a dose is missed, wait for the next scheduled dose rather than doubling up, as doubling is more likely to cause harm; missing doses of blood pressure medications or blood thinners is more critical than missing statins. Regulation 24 prescriptions in Australia allow patients traveling for extended periods to obtain up to six months of medication supply rather than being limited to one-month supplies. Split medication storage between hand luggage and checked luggage when traveling to ensure backup medications are available if one set is lost. Generic medications contain the same active ingredient as branded drugs but are cheaper and produced by multiple companies; however, differences in fillers and colorings can affect tolerability in some patients. Generic drugs have a wider approval margin (80-120% effectiveness) compared to branded medications, which may impact both effectiveness and tolerability for individual patients.