For Hurstville GP Rosa Criniti, the changing medical landscape reflects a society where the line between commerce and medicine has become increasingly blurred.

"Some of these centres are run simply as a business, not as a traditional general practice,'' Dr Criniti said.

"Running a medical practice can be a balancing act, if you give up expanding you give up your ability to offer a range of services.''

Dr Criniti, who has been in practice for 30 years, said patients needed to be better educated about who they are seeing and what services they are getting.

Any good practice will see doctors working under the same roof share notes so that even if a patient has to see a different doctor there is some level of consistency, she said.

"It takes time to build up trust with a doctor and people need to feel safe,'' she said.

Dr Criniti singled out new medical centres opening across Sydney's south that acted on a more co-operative basis as being more indicative of how a medical centre should function.

One GP, who asked not be named, said some doctors had sold their practices to large medical centres only to find the lucrative payout was compromised by long working hours and the expectation they would see as many patients as possible in a given time.

"They end up working 60 hours a week, which could affect the level of care they provide their patients,'' he said.

And while some members of the public who spoke to The Leader questioned the need for foreign-trained doctors, the feeling outside of urban areas is just the opposite.

Rural Health Workforce Australia CEO Dr Kim Webber said overseas-trained medical graduates were an essential way of addressing the doctor shortage in rural and remote Australia.

Responding to calls by the Australian Medical Association for the Federal Government to abandon its policy that international medical graduates work in rural areas for up to 10 years, Dr Webber said there was a shortage of doctors in country areas.

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