Working with Your GP — Collaborative Care for Chronic Pain

Why team-based care matters for chronic pain

If you live with ongoing back pain, neck pain, or other musculoskeletal conditions, you have probably noticed that no single practitioner has all the answers. That is not a failure of any one profession — it reflects the nature of chronic pain itself. Pain that persists beyond the normal healing timeframe involves a complex interplay of physical, neurological, and lifestyle factors.

Research consistently shows that people with chronic musculoskeletal conditions tend to have better outcomes when their care involves more than one discipline. A 2021 Lancet series on low back pain specifically recommended integrated, multidisciplinary management as a core component of best-practice care. The logic is straightforward: different practitioners bring different skills, and coordinating those skills avoids gaps and duplication.

This is what collaborative care looks like in practice — not one practitioner directing traffic, but a group of professionals each contributing what they do well, with the patient at the centre.

How it works at Gore Street Medical

I consult at Gore Street Medical in Hobart on Wednesdays, alongside GPs, physiotherapists, psychologists, and other allied health practitioners. This is not a formal endorsement arrangement — it is a practical one. Having multiple disciplines under one roof makes communication easier and reduces the friction that patients often experience when coordinating between separate clinics.

When a GP at the practice identifies that a patient might benefit from chiropractic input — for example, someone with persistent low back pain that has not responded to medication alone — they can discuss the case with me directly, or the patient can book in knowing their GP is nearby if questions come up.

It also works the other way. If I am working with someone and I think their condition needs further investigation, a medication review, or input from another discipline, I can communicate that to their GP promptly. Good care depends on good information flow.

What is a CDM plan?

A Chronic Disease Management (CDM) plan — sometimes called a GP Management Plan or Team Care Arrangement — is a Medicare item that your GP can set up if you have a chronic condition that would benefit from a coordinated, multidisciplinary approach.

Chronic musculoskeletal conditions such as persistent back pain, neck pain, degenerative joint conditions, and long-standing headaches commonly qualify. The key criterion is that the condition is ongoing (or expected to be present for at least six months) and would benefit from input from more than one type of health professional.

How a CDM plan works — step by step

1. See your GP. Talk to your doctor about your chronic pain condition and ask whether a CDM plan might be appropriate for you. Your GP will assess whether you meet the criteria.
2. Your GP creates the plan. If suitable, your GP will prepare a GP Management Plan (MBS item 721) and, where relevant, a Team Care Arrangement (MBS item 723) that names the allied health practitioners involved in your care.
3. You receive a referral letter. Your GP will provide you with a referral to bring to your chiropractic appointments.
4. Book your chiropractic visits. Under a CDM plan, you are entitled to up to 5 Medicare-subsidised allied health visits per calendar year. These are shared across all allied health disciplines — so if your plan includes both chiropractic and psychology, for example, the 5 visits are divided between them.
5. Medicare rebate applies. Each subsidised visit attracts a Medicare rebate. There is typically a small gap fee — the difference between the practitioner's consultation fee and the Medicare rebate amount. This varies between practitioners, so it is worth asking about fees when you book.

It is worth noting that CDM plans are reviewed annually, so you and your GP can reassess and adjust the plan each year.

You do not need a referral for standard visits

An important point that sometimes gets lost: chiropractors are primary contact practitioners in Australia. This means you can book and attend a chiropractic appointment without a GP referral at any time. You do not need anyone's permission to see a chiropractor.

A CDM plan is specifically about accessing Medicare subsidies for chronic conditions. If your concern is straightforward — a new episode of neck stiffness, for example, or you want an assessment after a change in activity — you can simply book a standard appointment directly.

If you are unsure whether a CDM plan might be relevant for your situation, your GP is the right person to ask. You can also check our FAQ for common questions about appointments and fees.

What collaborative care looks like in practice

In concrete terms, here is what coordinated care between your GP and chiropractor might involve:

• Shared understanding of your condition. Your GP and I can discuss your history, imaging, and previous treatments so that we are not working from incomplete pictures.
• Complementary approaches. Your GP might manage medication, order investigations, or refer for specialist opinion. I focus on hands-on assessment and manual therapy to address joint and muscle function, movement patterns, and pain management strategies. These are different tools, not competing ones.
• Consistent messaging. When practitioners communicate, you get consistent advice rather than conflicting recommendations — which is particularly important for chronic pain, where uncertainty and mixed messages can be part of the problem.
• Knowing when to step back. Good collaborative care also means recognising when a condition is outside your scope. If something does not fit a musculoskeletal picture, I will say so and ensure your GP is informed.

Is this right for me?

Collaborative care through a CDM plan may be worth exploring if:

• You have a musculoskeletal condition that has been present for several months or longer
• You are already seeing a GP for pain management and want to add manual therapy
• Cost is a consideration and Medicare-subsidised visits would help
• You want your practitioners to be actively communicating about your care

If this sounds relevant to you, the first step is a conversation with your GP. If you are a patient at Gore Street Medical, I am there on Wednesdays. Otherwise, any GP can set up a CDM plan, and I am happy to receive referrals from any practice.

You can learn more about how I practice, or book an appointment if you would like to get started.