From frontline care to sustainable practice models
Dr Patrick Gough (MediBetter) shares how clinician-led billing and funding tools can strengthen the sustainability, accessibility, and future viability of general practice.
Can you please give a brief overview/bio of your career to date?
I began my career as a paramedic, working across South East Queensland, Far North Queensland, and remote communities. Growing up in the country shaped my desire to make a real difference in primary care, particularly in preventing the chronic diseases that often lead to emergency situations. After years of attending crises when it was often too late, I realised I could have a greater impact by becoming a GP – helping people live healthier, happier, and longer lives.
I completed my medical degree at the University of Wollongong, a rural GP-focused program, then undertook my junior doctor years at The Tweed Hospital. There, I became deeply involved in quality improvement – identifying inefficiencies and redesigning systems to support better patient care. This included securing additional funding through clinical coding optimisation to bring to the table when fighting to improving resources and staffing.
Around that time, my sister was managing a rural general practice facing the challenges of MBS funding limitations. I’ve long believed that GP-centric health systems provide the strongest return on investment and generate real economic and social benefit. My motivation evolved from improving outcomes for the patients in front of me to improving primary care funding and accessibility for all Australians.
I’ve always had an entrepreneurial streak, but shifting from a clinician mindset to an innovator mindset took time – and a stint with the London Ambulance that burned me out enough to push for change. Today, as a GP registrar and Medical Director of MediBetter, I’m committed to ensuring primary care remains affordable, accessible, and an attractive career for the next generation of doctors.
What is the product/work you are leading?
MediBetter simplifies MBS billing for clinicians by embedding support directly into their existing workflow.
Our core product – BOSS (Billing Optimisation and Support Software) – interprets consult notes and suggests relevant MBS item numbers, including many that are under-utilised. Although there are more than 1,000 GP-eligible item numbers, most GPs regularly bill just 10 to 20. BOSS unlocks missed opportunities and provides compliance guidance so clinicians can bill confidently.
We designed MediBetter to work anywhere a clinician works. We offer:
- Chrome and Microsoft Edge browser extensions that automatically interpret notes from digital scribes
- A standalone web app for copying/pasting notes or using our smart dictation billing tool, which listens to consults and suggests billing items with one click
- In-progress integrations with major EMRs and scribe platforms to further streamline workflows.
We also offer MIA – an AI chatbot trained specifically on GP-related item numbers, directing users to source references on MBS Online.
Our additional tools include Skin Logic, enabling rapid selection of excision item numbers – no dense flowcharts required.
Image provided by MediBetter
What do you see as some of the enablers and barriers to health innovation in primary care in Australia?
The enablers to health innovation in primary care are the rapid growth of AI, a diverse clinician base with an increasing number of doctors who also have business and tech skills, a vibrant startup community within the Australian healthcare tech space (increasingly clinician-led), more supportive environments for startups from a government perspective (e.g. Services Australia sharing by default), improved standardisation (FIHR), regulatory and advocacy bodies (e.g. ADIH) and ground work laid from innovators that have come before us (often standing on the shoulders of giants).
However, there are still significant barriers holding the sector back. The high cost of living and operating a new company in Australia places pressure on founders and limits their runway. Funding support remains patchy, with few grants tailored specifically to health-tech startups.
What do you think the future of general practice looks like?
In the not-too-distant future, GPs will act as conductors of a more integrated digital health ecosystem.
Patient-generated data – from wearables to apps – will flow seamlessly into clinical care. AI will help interpret trends, trigger recalls, and guide decision-making. Routine administrative tasks – check-ins, note-taking, observations – will be automated. A patient might:
- be recalled because AI noticed a deteriorating glucose trend
- check in digitally and have automatic observations recorded
- receive a personalised care plan directly in their app
- be prompted to complete follow-up pathology or stick to behaviour goals.
The GP will maintain the pivotal role – applying clinical judgment, nuance, and human care – but supported by tools that enhance safety, efficiency, and patient engagement.
With exponential change coming in the next 5–10 years, clinicians must stay engaged in shaping how these technologies are used in practice.
Images provided by MediBetter
Why is it important GPs are involved in health innovation/new technology design?
As clinicians, we go to work each day focused on our patient care. We are trained to work with the tools that we have and deliver our care to the best of our abilities with these tools.
Our day is full of problems, but we work to address these problems using our existing tools. We rarely stop and think: “Could I build something to solve this problem?” And of the few who do stop and think that, where do you start?
Having worked in the startup space I have come to realise that there are a lot of people out there looking for problems to solve, and doctors are often in a unique position that their job is awash with problems that need solving and their domain expertise is so valuable because it’s so hard to become a doctor. For example, if you have gone through the bother of becoming a doctor, then you are too busy being a doctor, to go and build a solution for your unique problems.
Healthcare is slow and conservative, and for good reason; we want things to be well established and safe before we consider exposing them to patients. However, this means that innovation and adoption often lag behind other industries. Innovation that could improve patient care and patient outcomes. Companies need clinicians to highlight their problems and guide development to build these tools. Failure to have clinicians as the forefront of health innovation runs the risk of being overtaken by innovation in the health and wellbeing space with services that may not be as evidence-based.
What would you say to early-career doctors about general practice/primary healthcare?
Learn the MBS early in your career. A solid understanding of the MBS helps set you up financially and will keep you safe in the event of an audit. Also build up a network of specialists you trust, like and can call on when you need.
