If smaller practices' financial sustainability becomes an issue, the larger primary health care providers may need to take over their operations, it said.
It recommended investigating a corporate model of primary care provision in the Counties Manukau region.
Dr Andrew Chan Mow is the clinical director at South Seas Healthcare in Ōtara and has worked as a general practitioner in South Auckland for the past 20 years.
He was on the frontline of the pandemic in 2020, working at a Covid-19 testing centre in Ōtara.
"I agree with what the report says in terms of the stress GPs are facing and it's been a tough battle with Covid-19. We are tired, but in some ways it has strengthened our resolve," he said.
Chan Mow said a lot of people with poorly managed conditions, who haven't been to see a doctor in months due to the lockdown, are now coming to primary health care providers for treatment.
"That has added to the burden for some practices," he said.
"I'm proud to say at South Seas we didn't have to lay anyone off in 2020, in fact we are set to take on some more GPs because of the demand for our services.
"But generally speaking a lot of my colleagues in other practices have felt the burden of a really tough year and my heart goes out to them."
Chan Mow said he doesn't think using a more corporate approach is the solution to problems faced by primary healthcare providers.
He said moving to larger primary health care providers might bring certain advantages in terms of IT support and management, but the real issue is how primary health care is funded, which was a problem before the pandemic.
Under the current funding model district health boards fund the primary health organisations in their area, which then fund primary health care services, mostly through general practices.
Royal New Zealand College of General Practitioners president Dr Sam Murton agreed GPs are under more pressure than ever and Covid-19 has added to their problems.
"As more and more illnesses get treated in the community rather than in hospitals it does make our jobs more complex," she said.
But Murton said the report's proposed corporate restructure for Counties Manukau is disturbing and investing more in primary health care is what is needed.
Health Minister Andrew Little said in December that persistent problems with access to primary health care, as well as ongoing pressures on the country's hospital emergency departments, highlighted the need for major reform of the health system.
He said more details on what changes were planned would be announced this year.
