Meet Torrance: GP
In this Q&A, we speak with Beehyve GP Torrance about how he came to focus on ADHD in his medical practice, and why he takes a balanced “pills and skills” approach to supporting clients. Torrance shares insights from his years in general practice, including how medication, lifestyle foundations, and practical supports work together to help people better understand and manage their ADHD.
Can you share a bit about your background and what led you to focus on ADHD-specific care as part of your work as a GP?
I’ve been working in general practice for around 11 years. Over the last few years, I noticed that a large part of my day-to-day GP work was becoming ADHD-related. That naturally led me to lean into this area more.
About two years ago, I started working with Beehyve, where I focus specifically on the ADHD side of medicine. A big part of that has been collaborating with the wider Beehyve team — learning from each other, sharing knowledge, and continually refining how we support people with ADHD.
Did you have to complete any formal ADHD training or specialisation to do this work?
There aren’t actually any formal ADHD-specific qualifications available for GPs in New Zealand — and there’s very little in Australia either. A lot of what we’ve learned about ADHD in the past three to five years hasn’t just come from formal studies (although those are important), but from lived experience, clinical observation, and seeing what genuinely helps people in practice.
Much of ADHD care involves noticing what works for people, doing more of that, and adapting when something doesn’t. It’s very individual.
You describe your approach as combining “pills and skills.” What does that mean, and why is balance so important?
I didn’t invent the term “pills and skills,” but it’s widely used now because it captures ADHD care really well.
For many people, medication is incredibly helpful and absolutely worth trialling. For a small number of people, medication isn’t tolerated well or causes side effects that outweigh the benefits. But medication is rarely the only thing that helps.
The “skills” side is just as important — things like routines, habits, self-care, and support. Exercise in particular is right up there with medication in terms of effectiveness for managing ADHD, if not equal.
Other foundational pieces include:
Sleep
Nutrition
Social connection
Having hobbies and interests
It all sounds very basic — and honestly, a bit boring — but it really matters.
Many people with ADHD struggle with consistency. How does that factor into this?
This is very common. People often go all-in on something — buy all the gear, do it for three weeks — and then lose interest. The unused equipment ends up in what many ADHDers jokingly call the “hobbies graveyard,” followed by a lot of guilt.
Medication can sometimes help people move away from that boom-and-bust cycle and into something more sustainable. It doesn’t magically fix motivation, but it can create enough brain space to stick with routines for longer.
Exercise can also help medication work better. And importantly, medication tends to be less effective if the foundations aren’t there — things like sleep, nutrition, stress levels, and workload.
For people who feel overwhelmed or stuck, where do medications fit in?
When someone is really overwhelmed or stuck, medication can sometimes be a helpful starting point. It can create enough mental space to begin making changes — and that’s often where coaching, counselling, or therapy becomes really valuable.
Those supports help people understand where they’re trying to get to, how to get there, and how to keep going once the initial motivation wears off.
What’s your advice for people who are nervous about starting ADHD medication or worried about side effects?
This is such a common concern — and a very valid one.
One frustration I have is when people are prescribed ADHD medication without being given proper guidance about what to expect. That’s why we usually book at least 30 minutes when starting medication — to talk through the benefits, possible side effects, and what to do if things don’t feel right.
Some side effects, like reduced appetite, are very common early on but often settle within a week or two. Others may require dose adjustments or trying a different medication.
Ultimately, medication is only worth continuing if the benefits outweigh the negatives. If side effects are equal to or worse than the benefit, then it’s time to problem-solve and look for a better option.
Is there a “right” way to trial ADHD medication?
There’s no one-size-fits-all approach, but generally:
Long-acting medications are often easier to start with because they’re taken once daily and provide more stable coverage.
Short-acting medications can be useful for people who are very cautious or sensitive, as they can start on very small doses and “test the waters.”
For example, someone very anxious about side effects might start with a tiny dose of short-acting medication to see how their body responds. That sense of control can make a big difference.
We can’t predict perfectly who will respond best to which medication — there’s no crystal ball — but with careful titration, most people can find something that works.
What support exists after someone starts medication?
This is an area where the system is still lacking. GPs would love to offer unlimited follow-up and easy access, but time and resources are limited.
That’s why other supports are so important:
Group workshops (like those offered by Beehyve)
ADHD coaching
Psychoeducation — learning how your brain works and why standard advice doesn’t always apply
Group settings can be especially powerful. People learn from each other, share what’s worked (and what hasn’t), and realise they’re not alone.
In the future, I’d love to see more peer-support models for ADHD, similar to what exists for other chronic health conditions.
This year, GPs are able to diagnose ADHD. What impact do you think this will have?
Overall, I think this is a positive change. It will:
Reduce waiting times
Improve access
Lower costs for many people
That said, ADHD isn’t something that can be diagnosed in a quick 15-minute appointment. It’s lifelong, complex, and overlaps with other conditions that can look similar.
We need to be careful not to diagnose ADHD purely based on symptoms without considering other factors — and not everyone benefits from stimulant medication.
I don’t expect every GP to start diagnosing ADHD immediately. It’ll likely be a gradual shift over the next few years as GPs upskill and gain confidence.
Importantly, this change will also free up psychiatrists to focus on more complex cases, while GPs manage mild to moderate or more straightforward presentations.
ADHD isn’t static — people often cope well until something changes. Injury, burnout, parenting, stress, or loss of routine can suddenly make symptoms much harder to manage.
Making diagnosis and care more accessible is a crucial step. But support, education, and understanding how ADHD shows up across different stages of life are just as important as the diagnosis itself.
How do you work alongside someone’s regular GP or psychiatrist?
A big part of my work at Beehyve over the last few years has been filling in gaps that can get missed along the way.
Often that means explaining ADHD again — but in a different way. In many cases, there simply hasn’t been time in a standard GP appointment, or a psychiatrist has understandably focused more on getting the diagnosis right than on education.
A lot of tailored support is really just collaborative problem-solving. People might come in with a list of things that aren’t working, and we work through them together. Sometimes those things haven’t been mentioned before because the person didn’t realise they were relevant.
For example, someone might casually mention that they’re “just clumsy,” or that they’ve had their hearing tested even though everything came back normal. That can open up conversations about things like coordination differences or auditory processing challenges — where hearing is technically fine, but processing sound into meaning is difficult.
A lot of this work is about helping people connect the dots, understand their brain better, and realise that many of these challenges have explanations — and workarounds.
Sensory needs come up a lot for people with ADHD. What do you see in practice?
Sensory differences are extremely common.
Many people with ADHD also have autistic traits — not always enough for a diagnosis, but enough to influence sensory experiences. Some people are sensory-avoidant (for example, unable to tolerate background noise), while others are sensory-seeking (loving loud music, movement, or stimulation). Sometimes people are both, depending on the context.
Working with an occupational therapist or coach can help people understand their sensory profile and make sense of lifelong patterns — food preferences, clothing choices, noise sensitivity, or environmental needs.
Often, simply realising this is a thing is incredibly validating. It reframes years of self-judgement into self-understanding.
For someone newly diagnosed — or just starting to question ADHD — what’s the most important first step?
Learning, reading, researching, and hearing from others with similar brains is incredibly powerful. Social media can be helpful — not all of it, but a good portion — especially when content is created by clinicians, coaches, or therapists.
Talking to friends, family, or colleagues who seem to think in similar ways can also be validating.
From there, speaking with a coach, counsellor, therapist, or GP can help clarify whether a formal diagnosis or further support would be useful.
Some people with ADHD are actually managing very well — they’ve found work that suits them, supportive relationships, and routines that work with their brains. Others are struggling and need more support. There’s no single “right” path.
That’s why a multidisciplinary team works so well — GPs, occupational therapists, coaches, and counsellors who know each other’s strengths and can guide people in the right direction.
About Torrance:
Dr Torrance Merkle is a 'GP, Special Interest' who cares deeply about supporting those with ADHD. Alongside his own General Practice, he provides ADHD-specific services through Beehyve to complement the care people have through their own doctor.
Torrance knows first-hand the challenges in achieving your dreams with ADHD in a world that is not always set up to help. For him, it's about problem-solving and drawing on the 'skills and pills' that are appropriate. He knows the power of tailored support to support each person's situation.
Torrance can help you with managing your ADHD medication as well as understanding how you can combine this with other therapies and wellbeing support for ADHD. He prioritises awareness, self-care, agency and connection.
Torrance can prescribe medication if you have a Special Authority from a psychiatrist. He can refer you for an ADHD assessment and diagnosis, but does not complete them himself. At Beehyve, Dr Torrance only provides ADHD-specific support; you'll need to keep seeing your regular doctor for all your other medical needs.