Much has been written about the negative impacts of the new bulk-billing incentives on general practice — from increasing financial pain, to the not-so-subtle branding of participating practices as arms of government.

But equally important is the impact on the very patients they are meant to help, including a deterioration in their health and quality of life.

Take my long-term patient Gary,* for example.

He had come in for his three-monthly review of his diabetes.