Two Melbourne rheumatologists reckon the best way to make sense of an avalanche of new research might be to sit down, have a chat and see where it leads.
Rheumatologists Dr Julian Segan and Professor Stephen Hall have offices about one-and-a-half steps apart.
That proximity may soon be to the benefit of rheumatologists considerably further afield, with the pair developing a conversational podcast aimed at unpacking the papers, controversies, clinical conundrums, and occasional scandals occupying Australian rheumatology.
The idea grew out of the robust weekly clinical meetings held by their rheumatology group, where new evidence routinely collides with clinical experience.
“There’s a little bit of old bull, young bull,” Professor Hall told Rheumatology Republic.
“The younger people will present the facts, and old guys like me will sit there and say, ‘Well, if you go back and look at the history, this is what happened’.”
Dr Segan thought that this combination might be worth sharing beyond the walls of their practice.
The pair have known each other since Dr Segan began studying medicine, and Professor Hall said they had worked together particularly closely since his younger colleague chose rheumatology. Their offices are now literally across the corridor from one another.
The podcast series is taking shape, and the plan is emphatically not to reproduce a conference presentation with microphones attached.
Instead, Dr Segan wants conversations that can roam wherever the subject demands.
“It’s one thing to present a paper or an oral abstract in a certain way, but I think there’s so many advantages to being able to have a two-way conversation,” he said.
“You can take the conversation in any sort of direction. As Steve said, you can talk about the history and give context.
“So, I think in terms of covering a topic, especially a topic of someone’s deep interest, it’s a really good way of getting into the weeds and taking it to interesting places.”
Importantly, those weeds eventually have to lead back to the clinic.
One recent interview was with lupus researcher Kathryn Connelly, whose PhD and postdoctoral work has involved implementing a new clinical trial measure for lupus.
But roughly half the conversation, Professor Hall said, centred on a much more immediate question.
“How do we apply this to our patients? What does this actually mean for clinical practice, rather than just a sort of esoteric academic exercise?” he said.
That clinician-first approach is central to what the pair hope will distinguish the podcast.
“The aim is also just to wander into areas of interest that we think may not always be covered, or really the hot topics, or what’s the current zeitgeist,” said Dr Segan.
“The podcast gives us the freedom of really picking whatever topics we want at any time without having to worry about the structure of a meeting or something like that.”
Guests will span generations, from early-career rheumatologists to veterans of the pre-biologic era, provided they have something interesting to say and the expertise to say it.
“Young people, old people, really anyone that has an area of interest and expertise that can talk in depth about a topic,” said Dr Segan.
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Professor Hall, meanwhile, brings the perspective of someone who has watched rheumatology transform through the pre-biologic and biologic eras and remains involved in phase 1 clinical trials.
Dr Segan brings a rather different interviewing skill.
Professor Hall likens his colleague’s approach to that of Andrew Denton.
“It’s a very nice, respectful style that encourages people to say perhaps a little more than they would originally say if they were preparing a talk,” he said.
“And that’s exactly what we’re looking for.”
But respectful does not necessarily mean tame.
The pair hope to soon tackle the international avacopan controversy, including questions around the integrity of trial data, what the saga means for evidence-based medicine and the controversy in the context of previous scandals in medicine.
Professor Hall said they were searching for “the key that unlocks the box”, allowing experts to share knowledge they may not even realise will fascinate their colleagues.
The pair also see the podcast as a solution to a problem familiar to virtually every specialist confronted with an endlessly replenishing pile of journal alerts.
“There’s nothing really out there like this, and it’s also a really good way of keeping up to date with what’s happening in different topics,” Dr Segan said.
“With the landslide of information and papers that are published, it’s almost impossible to stay on top of everything.
“So all we’re going to do is just get leading experts in the field to tell us what’s happening.”
Initially the emphasis will be firmly Australian, showcasing local rheumatologists and researchers rather than automatically chasing the author of the latest international paper.
Eventually, however, Dr Segan hopes the guest list will extend further afield.
“The ultimate aim eventually would be to start asking people overseas,” he said.
“There’s people that we want – real leaders, thought leaders from the UK and America and Europe – to get on to ask them about their topics of interest.”
And if all this sounds suspiciously like two colleagues finding a professionally defensible reason to spend even more time talking to each other, Professor Hall has already established the ground rules.
He has never, he said, been much of a believer in boundaries between working hours, evenings, and weekends. Anyone who works with him is effectively “on 24-hour call”.
Dr Segan can presumably expect the podcast production schedule to respect the same philosophy – although with a second child due early next year, his definition of being on call may soon acquire an entirely different meaning.
The first podcast will be released here on Rheumatology Republic this month.Rheumatology Republic is also interested in hearing from anyone else looking for a platform to launch a rheumatology podcast in Australia – please contact david@medicalrepublic.com.au.
