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proper aged care – part 3

February 21, 2021 by Dr Nick Tellis, posted in Aged care, General Practice, Glenelg, GP, health, How to, Influence, Information, PartridgeGP, thoughtoftheday

In part 1, we learnt:

Part of the comprehensive care we provide at PartridgeGP includes visiting Residential Aged Care Facilities

It is a pleasure and a privilege to serve our older patients

We MUST remember certain rules

You MUST see your patient (face to face or via telephone/telehealth) for them to claim a Medicare Rebate

There is NO such thing as a QUICK LOOK

Older patients are frail – do not prescribe powerful medications (opioids, benzodiazepines, anti-hypertensives) without careful consideration and review.

In part 2:

James Reason Swiss Cheese Model. BMJ, 2000 Mar 18:320(7237): 768-770

The Swiss Cheese model of accident causation, originally proposed by James Reason, likens human system defences to a series of slices of randomly-holed Swiss Cheese arranged vertically and parallel to each other with gaps in-between each slice.

We spend time developing a relationship with the facilities as well as our patients. This builds trust and all parties know more about the capabilities, needs, and limitations of the other. This is not just a residential aged care issue – this is an issue with hospitals as well. I have mentioned this here and here.

“PASSING the baton” describes what health care professionals try to achieve as care of patients is transferred between providers in our complex health care systems. The safety concerns related to poor clinical handover are not new: it’s a problem the health care industry and doctors as a profession have been grappling with for decades. Poor clinical handovers are wasteful of limited resources. How can we improve patient outcomes and “drop the baton” less often?

In addition to these, we believe fewer medications, less often can be a boon. To paraphrase Christian Ryan (writing about Shane Warne of all things!), we aim to be: Like the great classical painters, we stumble upon the art of simplicity. Our prescribing was never simpler, nor more effective, nor lovelier to look at. Medication reviews and keeping up to date help a lot with this. Telehealth can also help.

Limiting antipsychotic drugs in dementia

There is not a pill for every ill. Recent studies have shown what we have long thought – many medications are just not that useful for our elders. We can, will, and do support our fantastic residential aged care facilities and their staff in looking after our patients/residents without multiple excess medications. Facilities are labouring under the imposts of paperwork and bureaucracy. We will help!

Let’s continue with this!

There is not a pill for every ill and pills do not substitute for great nursing care. We will support our patients to live their best lives and we will support our Residential Aged Care Facilities and their staff in helping them do that as well. After all, some of these medications just don’t work as well as they say they do…

Calling after hours doctors (often NOT GPs) during the after hours period, when regular staff are not on, and expecting them to do great work, speaks to a failure during the in hours period, in my opinion. Clear communication, documentation, and direction based on regular in hours reviews with patients, staff, and families, should reduce inappropriate prescribing of sedative hypnotics – and reduce falls, improve quality use of medicines, and potentially, add life to years rather than years to (sedated) life.

Urine. It’s not the window to the soul. Urine samples should only be sent to the lab when the clinical decision has been made to use antibiotics. A urine dipstick (a plastic strip with colour coded boxes that turn different colours in the setting of infection or abnormalities) is more than enough to make clinical decisions with. Don’t waste money looking at urine for no reason.

Don’t just leave medications on a drug chart without thinking about whether they are still needed. A drug chart full of entries is time nursing staff have to spend with pills and charts rather than with patients. Pills aren’t care…in fact they eat away at the time and attention allocated to care. Less is very often more.

Sometimes, people need to be restrained, chemically or physically, for their own benefit. This should be safe, legal, and rare. This is always a case where some calm talking with patients, staff, and families, can produce better outcomes.

PartridgeGP works with all involved with aged care to help make better health decisions, and we won’t just ‘have a quick look’. We pride ourselves on great communication and we’re ready to share our professional skills and knowledge with you. 

Let us be the missing piece in your puzzle! This is only MORE important now, in the time of a global pandemic with a new vaccine on the horizon. The way forward is clear: make your appointment with us conveniently online right here – or call our friendly reception team on 82953200.

Better, for you.

Want more?

Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com

For everyone, we believe that having a usual GP or General Practice is central to each person’s care and recommend that people with any health issues that come to the attention of other health professionals should be advised to attend their usual GP or General Practice rather than a specialised service (ie a place not providing the holistic care a specialist GP would).   If  they say that they don’t have a usual GP or general practice, they should be helped to find one and to actually attend it. Call PartridgeGP on 82953200 or make an appointment online here.

(Hat tip: Dr Oliver Frank)

Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com

If you’re employed, get a side hustle and get into business. If you’ve already got a business, get a network. Want to get started? Find your tribe here!

Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com

If you are a great GP or a great Allied Health Professional, and you want to serve your clients or patients to the best of your ability, without worrying about all the non clinical things that get in your way, lets talk. Call Mrs Hayley Roberts on 8295 3200 and have a coffee and chat with us as to how PartridgeGP can help you to help others.

Tagged #2021goals, #agedcare, #agedcareRC, #bettercareer, #designlogo, #dreamjob, #dreamposition, #excellence #generalpractice #geepee #better #health #value #comprehensive #empowering #professional #primarycare #YourGP #OurTeam #sustainable, #glenelgbeach, #glenelgcountry, #glenelggp, #glenelgin, #glenelgjetty, #glenelgnorth, #glenelgriver, #glenelgsa, #glenelgsouth, #job, #justagp, #RACF, aged RACF nursing home, beachside, better, career, generalpractice, Glenelg, GPsCANLeave a comment

proper aged care – part 2

February 8, 2021 by Dr Nick Tellis, posted in Aged care, General Practice, Glenelg, GP, health, How to, Influence, Information, PartridgeGP, thoughtoftheday

In yesterday’s part 1, we learnt:

Part of the comprehensive care we provide at PartridgeGP includes visiting Residential Aged Care Facilities

It is a pleasure and a privilege to serve our older patients

We MUST remember certain rules

You MUST see your patient (face to face or via telephone/telehealth) for them to claim a Medicare Rebate

There is NO such thing as a QUICK LOOK

Older patients are frail – do not prescribe powerful medications (opioids, benzodiazepines, anti-hypertensives) without careful consideration and review.

James Reason Swiss Cheese Model. BMJ, 2000 Mar 18:320(7237): 768-770

This appears to be a Swiss Cheese problem. The Swiss Cheese model of accident causation, originally proposed by James Reason, likens human system defences to a series of slices of randomly-holed Swiss Cheese arranged vertically and parallel to each other with gaps in-between each slice.

Reason hypothesizes that most accidents can be traced to one or more of four levels of failure:

  • Organisational influences,
  • Unsafe supervision,
  • Preconditions for unsafe acts, and
  • The unsafe acts themselves.

In the Swiss Cheese model, an organisation’s defences against failure are modelled as a series of barriers, represented as slices of the cheese. The holes in the cheese slices represent individual weaknesses in individual parts of the system, and are continually varying in size and position in all slices. The system as a whole produces failures when holes in all of the slices momentarily align, permitting “a trajectory of accident opportunity”, so that a hazard passes through holes in all of the defences, leading to an accident.

So what does PartridgeGP do a little differently?

We spend time developing a relationship with the facilities as well as our patients. This builds trust and all parties know more about the capabilities, needs, and limitations of the other. This is not just a residential aged care issue – this is an issue with hospitals as well. I have mentioned this here and here.

“PASSING the baton” describes what health care professionals try to achieve as care of patients is transferred between providers in our complex health care systems. The safety concerns related to poor clinical handover are not new: it’s a problem the health care industry and doctors as a profession have been grappling with for decades. Poor clinical handovers are wasteful of limited resources. How can we improve patient outcomes and “drop the baton” less often?

Communication is key – better communication equals better outcomes. Documentation of communication is the secret sauce.

Of course, our fundamental ethos of time and care for our patients and their families doesn’t stop as they progress to residential care – Advance Care Directives allow THEIR wishes to take centre stage at all times. In addition to these, we believe fewer medications, less often can be a boon. To paraphrase Christian Ryan (writing about Shane Warne of all things!), we aim to be: Like the great classical painters, we stumble upon the art of simplicity. Our prescribing was never simpler, nor more effective, nor lovelier to look at. Medication reviews and keeping up to date help a lot with this. Telehealth can also help.

Limiting antipsychotic drugs in dementia

There is not a pill for every ill. Recent studies have shown what we have long thought – many medications are just not that useful for our elders. We can, will, and do support our fantastic residential aged care facilities and their staff in looking after our patients/residents without multiple excess medications. Facilities are labouring under the imposts of paperwork and bureaucracy. We will help!

PartridgeGP works with all involved with aged care to help make better health decisions, and we won’t just ‘have a quick look’. We pride ourselves on great communication and we’re ready to share our professional skills and knowledge with you. 

Let us be the missing piece in your puzzle! This is only MORE important now, in the time of a global pandemic with a new vaccine on the horizon. The way forward is clear: make your appointment with us conveniently online right here – or call our friendly reception team on 82953200.

Better, for you.

Want more?

Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com

For everyone, we believe that having a usual GP or General Practice is central to each person’s care and recommend that people with any health issues that come to the attention of other health professionals should be advised to attend their usual GP or General Practice rather than a specialised service (ie a place not providing the holistic care a specialist GP would).   If  they say that they don’t have a usual GP or general practice, they should be helped to find one and to actually attend it. Call PartridgeGP on 82953200 or make an appointment online here.

(Hat tip: Dr Oliver Frank)

Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com

If you’re employed, get a side hustle and get into business. If you’ve already got a business, get a network. Want to get started? Find your tribe here!

Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com

If you are a great GP or a great Allied Health Professional, and you want to serve your clients or patients to the best of your ability, without worrying about all the non clinical things that get in your way, lets talk. Call Mrs Hayley Roberts on 8295 3200 and have a coffee and chat with us as to how PartridgeGP can help you to help others.

Tagged #2021goals, #agedcare, #agedcareRC, #bettercareer, #designlogo, #dreamjob, #dreamposition, #excellence #generalpractice #geepee #better #health #value #comprehensive #empowering #professional #primarycare #YourGP #OurTeam #sustainable, #glenelgbeach, #glenelgcountry, #glenelggp, #glenelgin, #glenelgjetty, #glenelgnorth, #glenelgriver, #glenelgsa, #glenelgsouth, #job, #justagp, #RACF, aged RACF nursing home, beachside, better, career, generalpractice, Glenelg, GPsCAN1 Comment

proper aged care – part 1

February 8, 2021 by Dr Nick Tellis, posted in Aged care, General Practice, Glenelg, GP, health, How to, Influence, Information, PartridgeGP, thoughtoftheday

Part of the comprehensive care we provide at PartridgeGP can include visiting Residential Aged Care Facilities. While it is a pleasure and a privilege to serve our older patients, we MUST remember certain rules:

You MUST see your patient (face to face or via telephone/telehealth) for them to claim a Medicare Rebate

(You may spend some time with their notes and then a brief consult – your patient can claim a Medicare rebate for this, but there is no time able to be claimed for reviewing the notes without attending to your patient)

There is NO such thing as a QUICK LOOK

Older patients are frail – do not prescribe powerful medications (opioids, benzodiazepines, anti-hypertensives) without careful consideration and review.

The story below highlights this…

cid:image003.png@01D3BDF2.85506490

EVERY square is 80mg of Oxycontin a day!

I have omitted the identifying details in the story below – it is not intended to malign any particular doctor or area, just to highlight the dangers to doctors, and most importantly, our valued elder patients.

A GP has been suspended for six months after prescribing oxycodone to a nursing home patient they didn’t examine and later prescribing fentanyl patches to the same patient without checking their drug history. The doctor was visiting another patient when nurses asked him to prescribe a painkiller for an elderly resident.

The doctor, who had first consulted with the patient two years ago at the practice, did not examine or check records before prescribing oxycodone 5mg four times daily. Authorities heard that, five days later, the nurses incorrectly told the doctor the oxycodone was not working, so the patient was then examined and prescribed a 50mcg/hr fentanyl patch.

The patient subsequently fell unconscious for several days. When the doctor was called, they diagnosed a stroke and prescribed morphine for palliative care. The patient died soon after.

An expert GP witness said the fentanyl patch was unnecessarily strong and the patient’s ‘stroke’ could have been a narcotic overdose. “In the presence of pin-point pupils which are reactive and in a situation where a patient has recently been administered a narcotic analgesic, it would stand to reason that narcotic overdose could be a diagnosis”.

It emerged during the tribunal hearing that there were no records at the nursing home that the patient received the oxycodone the GP had prescribed.

The tribunal said that the nurses incorrectly told the GP that the oxycodone was not working and they should have also asked for a medical review when the patient fell unconscious after the fentanyl script was administered.

But the tribunal stressed that the GP should have examined the patient before prescribing oxycodone and should have checked the patient’s medication chart before prescribing fentanyl to determine whether they were opioid naïve. Even had they received oxycodone, 50mcg/hr fentanyl was still “excessively high”, the tribunal concluded.

The GP admitted the main charges, although claiming the nurses were told to make contact if the patient’s condition changed after the fentanyl patch was applied, which they did not do.

The tribunal found the GP guilty of professional misconduct and a suspension of six months was advised, with the further condition of being banned from prescribing opioids unless extra education modules were completed.

James Reason Swiss Cheese Model. BMJ, 2000 Mar 18:320(7237): 768-770

This appears to be a Swiss Cheese problem. The Swiss Cheese model of accident causation, originally proposed by James Reason, likens human system defences to a series of slices of randomly-holed Swiss Cheese arranged vertically and parallel to each other with gaps in-between each slice.

Reason hypothesizes that most accidents can be traced to one or more of four levels of failure:

  • Organisational influences,
  • Unsafe supervision,
  • Preconditions for unsafe acts, and
  • The unsafe acts themselves.

In the Swiss Cheese model, an organisation’s defences against failure are modelled as a series of barriers, represented as slices of the cheese. The holes in the cheese slices represent individual weaknesses in individual parts of the system, and are continually varying in size and position in all slices. The system as a whole produces failures when holes in all of the slices momentarily align, permitting “a trajectory of accident opportunity”, so that a hazard passes through holes in all of the defences, leading to an accident.

Tomorrow, we will go through all the ways that PartridgeGP does things a little differently.

PartridgeGP works with you to help you make your best health decisions, and we won’t back away from being your companion, guide, advisor, and sounding board through your health journey. We pride ourselves on great communication and we’re ready to share our professional skills and knowledge with you. 

Let us be the missing piece in your puzzle! This is only MORE important now, in the time of a global pandemic with a new vaccine on the horizon. The way forward is clear: make your appointment with us conveniently online right here – or call our friendly reception team on 82953200.

Better, for you.

Want more?

Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com

For everyone, we believe that having a usual GP or General Practice is central to each person’s care and recommend that people with any health issues that come to the attention of other health professionals should be advised to attend their usual GP or General Practice rather than a specialised service (ie a place not providing the holistic care a specialist GP would).   If  they say that they don’t have a usual GP or general practice, they should be helped to find one and to actually attend it. Call PartridgeGP on 82953200 or make an appointment online here.

(Hat tip: Dr Oliver Frank)

Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com

If you’re employed, get a side hustle and get into business. If you’ve already got a business, get a network. Want to get started? Find your tribe here!

Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com

If you are a great GP or a great Allied Health Professional, and you want to serve your clients or patients to the best of your ability, without worrying about all the non clinical things that get in your way, lets talk. Call Mrs Hayley Roberts on 8295 3200 and have a coffee and chat with us as to how PartridgeGP can help you to help others.

Tagged #2021goals, #agedcareRC, #bettercareer, #designlogo, #dreamjob, #dreamposition, #excellence #generalpractice #geepee #better #health #value #comprehensive #empowering #professional #primarycare #YourGP #OurTeam #sustainable, #glenelgbeach, #glenelgcountry, #glenelggp, #glenelgin, #glenelgjetty, #glenelgnorth, #glenelgriver, #glenelgsa, #glenelgsouth, #job, #justagp, #RACF, aged RACF nursing home, agedcare, beachside, better, career, generalpractice, Glenelg, GPsCANLeave a comment

lego

February 2, 2021February 2, 2021 by Dr Nick Tellis, posted in General Practice, Glenelg, GP, health, How to, Influence, Information, PartridgeGP, thoughtoftheday

Peter Rufus has written an excellent thought provoking article on jigsaws and business planning. To summarise (and go read the whole thing because it’s that good):

I was also, at the same time, working on the vision for our business; something that I’d been working on for the past few months but only in bits and pieces. The Christmas break was finally the time to give it a good, hard crack.

As I worked on the puzzle and the vision, I couldn’t help but observe how alike they are.



The clearer the final picture, the easier it is to work towards

The clearer the final picture, the easier it is to fit the pieces

The clearer the final picture, the easier it is for everyone to work together

Jamming the pieces doesn’t work

You know when something fits

Be prepared to undo some pieces and fit them elsewhere

The simplest moves can make all the difference

Just because you are crystal clear on the end goal doesn’t mean you won’t make mistakes on the way there



Now, the analogy of a business vision as a jigsaw is, in my opinion, a great mental model. Scott Adams notes that analogies are good tools for explaining a concept to someone for the first time. One downside is that all discussions that involve analogies devolve into arguments about the quality of the analogy, not the underlying situation. So, to avoid this, I’m going to use my own analogy to be on an equal footing. I’ve never completed a jigsaw so I’m going to pull out the Lego!

Analogies aren’t all bad!

Dr Nick, the goal, the end, and the box




We will start in the same place, Lego and Jigsaw. Peter says the clearer the final picture, the easier it is to work towards. I will say, borrowing from Stephen Covey, start with the end in mind. This is easy, with Lego, and Jigsaws, because the end is pictured on the box. You can, literally, choose your own adventure. Real life is a little more complex though, and sometimes the end in mind at the outset changes during the journey. My Lego Porsche GT3RS has 8000+ pieces. With 1 (yes, ONE) additional piece and $15 worth of additional instructions, you can build something even more amazing.

The people at Rebrickable set out to change that and discovered anybody could build a Stratos out of the same pieces found in the 911 GT3RS kit.

Completed by Ashley Winston and blogged by Hooniverse, the Stratos arguably looks more accurate, less awkward, cooler, and is certainly more unique than the GT3RS kit it is spawned from. To be specific, it is modeled after the 1974 Lancia Stratos Stradale HF.

Stratos-pherically awesome



So for me, start with the end in mind, but have systems rather than goals, an ethos rather than a fixed statement. Be open to the journey leading to a different place.



Peter alludes to this when he says be prepared to undo some pieces and fit them elsewhere and just because you are crystal clear on the end goal doesn’t mean you won’t make mistakes on the way there. A goal that mandates no mistakes means you can never fail. This means you can’t take any risks. Rory Sutherland says taking no risk makes you very very predictable, and therefore very very vulnerable. Antifragility is a beautiful thing, as another great thinker, Nassim Nicholas (solid name there) Taleb said in his book of the same name.




One thing Peter doesn’t mention, because it’s not a jigsaw thing, is sometimes you have to discard pieces. You can’t play an A game with C players, and even if they are A players, sometimes they are not A players in your game. I love topgradings X/Y axis for this. I guess this is where those additional parts come in! I wonder if there are some savants out there who mix and match jigsaw sets to produce genius? For the less gifted amongst us, Peter has further advice: The simplest moves can make all the difference. If it’s not a hell yes…it’s a no. Sherlock Holmes said it well, once you have excluded all the possibilities you can exclude, whatever is left must contain the answer. Sometimes it’s obvious that people need to go. You know when something, or someone, fits. (As an aside, here is a link to an awesome answer to how you improve diversity and alignment in your company!)

Hire Alignment/Ethos, Train Skill



So now that I’ve quoted many great thinkers (and I count Peter Rufus in that group), I’ve got the appetite to go work on my own Lego – back to PartridgeGP (our website is by Peter and Nicknack as well), to help, support, and work with our valued patients, GPs, allied health professionals, nurses, and fantastic staff!

PartridgeGP works with you to help you make your best health decisions, and we won’t back away from being your companion, guide, advisor, and sounding board through your health journey. We pride ourselves on great communication and we’re ready to share our professional skills and knowledge with you. 

Let us be the missing piece in your puzzle! This is only MORE important now, in the time of a global pandemic with a new vaccine on the horizon. The way forward is clear: make your appointment with us conveniently online right here – or call our friendly reception team on 82953200.

Better, for you.

Want more?

Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com

For everyone, we believe that having a usual GP or General Practice is central to each person’s care and recommend that people with any health issues that come to the attention of other health professionals should be advised to attend their usual GP or General Practice rather than a specialised service (ie a place not providing the holistic care a specialist GP would).   If  they say that they don’t have a usual GP or general practice, they should be helped to find one and to actually attend it. Call PartridgeGP on 82953200 or make an appointment online here.

(Hat tip: Dr Oliver Frank)

Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com

If you’re employed, get a side hustle and get into business. If you’ve already got a business, get a network. Want to get started? Find your tribe here!

Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com

If you are a great GP or a great Allied Health Professional, and you want to serve your clients or patients to the best of your ability, without worrying about all the non clinical things that get in your way, lets talk. Call Mrs Hayley Roberts on 8295 3200 and have a coffee and chat with us as to how PartridgeGP can help you to help others.

Tagged #2021goals, #bettercareer, #designlogo, #dreamjob, #dreamposition, #excellence #generalpractice #geepee #better #health #value #comprehensive #empowering #professional #primarycare #YourGP #OurTeam #sustainable, #glenelgbeach, #glenelgcountry, #glenelggp, #glenelgin, #glenelgjetty, #glenelgnorth, #glenelgriver, #glenelgsa, #glenelgsouth, #happynewyear, #job, #justagp, beachside, better, career, generalpractice, Glenelg, GPsCANLeave a comment

New Logo – Who Dis?

October 14, 2020 by Dr Nick Tellis, posted in #justagp, General Practice, Glenelg, GP, News, PartridgeGP

NEW PartridgeGP Website COMING SOON

✅easier to make an appointment
✅easier to see what we do
✅easier for you

Keep an eye out!

Thanks Nicknack

Tagged #designlogo, #logo, #logodesigner, #logodesigns, #logoinspiration, #logoinspirations, #logos, #logotipo, #newwebsite, #website, #websitebuilder, #websitecomingsoon, #websitedevelopment, #websitelaunch, #websites,   #logotype,   #websitedesign,   #websitedesigner,    #desainlogo, new, NewsLeave a comment

New Logo – Who Dis?

October 14, 2020 by Dr Nick Tellis, posted in #justagp, General Practice, Glenelg, GP, News, PartridgeGP

NEW PartridgeGP Website COMING SOON

✅easier to make an appointment
✅easier to see what we do
✅easier for you

Keep an eye out!

Thanks Nicknack

Tagged #designlogo, #logo, #logodesigner, #logodesigns, #logoinspiration, #logoinspirations, #logos, #logotipo, #newwebsite, #website, #websitebuilder, #websitecomingsoon, #websitedevelopment, #websitelaunch, #websites,   #logotype,   #websitedesign,   #websitedesigner,    #desainlogo, new, NewsLeave a comment

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T1/670 Anzac Highway
Glenelg
SA 5045
0882953200
M-F 830-5
Sa 830-1230

Dr Nick Tellis

Dr Nick Tellis
Follow partridgegp on WordPress.com

Dr Nick Tellis

Dr Nick Tellis

Hours / Info

PartridgeGP
670 Anzac Highway
Glenelg
SA 5045
0882953200
0830-1700 M-F
0830-1230 Sa

Recent Posts

  • An overview of the safety, clinical application and antiviral research of a novel repurposed therapeutic for the Omicron (B.1.1.529) COVID-19 variant
  • PartridgeGP is seeking wonderful Medical Receptionists
  • Vaccination – the best vaccine is the one in your arm
  • Farewell Dr Eli and Dr Abby; Welcome Dr Margriet Breytenbach to PartridgeGP
  • 3 things to do this weekend

Recent Comments

Caitlin on Thoughts on Homeopathy
Dr Nick Tellis on Public Cervix Announcement 
Dr Nick Tellis on Public Cervix Announcement 
Eli on Why do Men taking Viagra get M…
Dr Nick Tellis on Telefarce

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