Chronic disease management
Living well with a long-term condition, with a plan that fits.
Coordinated, bulk billed care for diabetes, heart disease, lung conditions, arthritis and more, with regular reviews and the right team around you.
Coordinated care for long-term conditions.
Living with a long-term health condition is easier with a clear plan and a team that works together. Your GP helps you set goals, manage treatment, arrange tests and referrals, and review how you are going over time.
Rutherford Doctors is a Medicare Bulk Billing Practice in Rutherford with 4Cyte Pathology in the same building. Chronic disease management consultations are bulk billed for Medicare-eligible patients.
Living with a long-term condition? Let's make a plan.
How we can help.
Choose a topic to learn what is involved and when to see a GP.
Care plans
GP chronic condition management plans.
From July 2025, GP chronic condition management plans replaced GP management plans and team care arrangements.
Goals, treatment, tests, reviews and referrals.
May give access to up to five rebated allied health sessions a year.
Heart and blood pressure
Heart disease, high blood pressure and high cholesterol.
Regular blood pressure and cholesterol checks.
Reviewing medicines and side effects.
Activity, eating, alcohol and smoking support.
Lung conditions
Asthma and COPD.
Written plans for everyday care and flare-ups.
Breathing tests to track lung function.
Flu, pneumococcal and other vaccines.
Arthritis and pain
Osteoarthritis, rheumatoid arthritis and chronic pain.
Physiotherapy and exercise physiology.
Options to manage pain and stay active.
Referral to rheumatology or pain services if needed.
Kidney and other conditions
Kidney disease, thyroid conditions and more.
Regular blood and urine tests.
Reviews to keep medicines safe.
Working with your specialists.
Something else on your mind? Our GPs can help.
Conditions we help manage.
Common long-term conditions and how a plan can help.
Metabolic
Type 2 diabetes
A plan brings all your checks together.
See our Diabetes care page for more.
Heart
Heart disease
Managing risk factors and medicines.
Cardiac rehabilitation may be recommended.
Heart
High blood pressure
Lifestyle changes and medicines.
Home blood pressure readings can help.
Lungs
Asthma and COPD
Keeping lungs healthy and preventing flare-ups.
Pulmonary rehabilitation can help with COPD.
Joints
Arthritis
Staying active and managing pain.
Weight and activity support can help.
Kidneys
Chronic kidney disease
Protecting kidney function over time.
Blood pressure and diabetes control matter.
Every plan is tailored to you. Your GP will recommend the checks and team that suit your needs.
Ready to make a plan?
Getting a care plan.
How chronic condition management works at Rutherford Doctors.
Allow time
Longer appointment
Care plans need a longer appointment. Ask reception when you book.
MyMedicare
Registered patients
If you are registered with us, your plan is prepared and reviewed by our practice.
See your GP sooner if
- Your symptoms are getting worse
- New symptoms appear
- Side effects from medicines
- Call 000 in an emergency
Step by step
- 1Assessment
Your GP reviews your health, conditions and medicines.
- 2Goals
You agree goals that matter to you.
- 3Plan
Treatment, tests and referrals are set out in your plan.
- 4Team
Your GP refers you to allied health or specialists as needed.
- 5Review
Regular reviews keep your plan up to date.
Book a longer appointment for your plan.
Home Medicines Review
Your GP can refer you for a pharmacist to review your medicines at home.
Practice nurse support
Our nurses can help with health checks and care plan preparation.
Costs
Care plan consultations are bulk billed for Medicare-eligible patients. Allied health and specialists set their own fees.
Book a care plan appointment
4Cyte Pathology collection is in the same building, so blood tests and other samples can often be collected straight after your appointment. Most pathology is bulk billed.
Where are you up to?
Select your situation.
Book a longer appointment.
Our GPs.
Seeing your regular GP keeps your care connected.
No preference? Book the first available GP.
Chronic disease management questions.
What is a chronic condition?
A health condition that has lasted, or is expected to last, six months or more.
What replaced GP management plans?
From July 2025, GP chronic condition management plans replaced GP management plans and team care arrangements.
Is a care plan bulk billed?
Yes, for Medicare-eligible patients with a valid Medicare card.
How often is a plan reviewed?
Your GP will recommend how often, based on your needs.
Can I see allied health with a plan?
A plan may give access to up to five Medicare-rebated allied health sessions a year.
This page provides general information about chronic disease management services at Rutherford Doctors. It is not a substitute for advice about your own health. Please book an appointment to discuss your situation. In an emergency, call 000.
