Thousands of doctors have converged on Berlin, demanding changes to the state health care system.

Nationally about 50,000 surgeries- almost half the total- stayed closed on Wednesday.

The protestors called for better pay in hospitals and private practices.
They also said paperwork was cutting into time that could be better spent caring for patients.

The day of action also included large demonstrations in Munich and Saarbrucken.

The head of the German Medical Association says one in three doctors' practices is economically "endangered," while hospital doctors claim they are working more and more unpaid overtime.

Health minister Ulla Schmidt insists legislation is not the real problem, and has rejected calls for a 30 per cent pay rise.

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About half the 100,000 medical practices in Germany were closed as a nationwide doctors' strike over pay escalated sharply on its third day. (AFP)