David Clancy, in a speech to Wodonga's health summit, reflected on the high hopes that greeted the dawn of the cross border health service and how they had not fulfilled.

"The expectations were set when Albury Wodonga Health was created, the economies of scale, we could be finally recognised and not ignored as being at the arse end of both states," Dr Clancy said.

"The roles and responsibilities we expected to be delineated ... it was exciting.

"What's the outcome, we're still ignored.

"It was the drunken one-night stand where no one wants the baby, there's lack of accountability but what it manages to get done for this community, despite that, is magic.

"As a friend said, 'it's held together by sticky tape and goodwill'."

Dr Clancy challenged the audience to see health on the Border as a blank canvas and push for change.

"Why are you here?" Dr Clancy asked the audience which included mayors such as Kylie King (Albury) and Sophie Price (Indigo) and politicians including his brother Justin Clancy (Albury MP) and former federal health minister Sussan Ley (Farrer MP).

"Are you here because you want to help, are you here because you want to make a difference or are you here just to report back to the office or to make sure that you're not embarrassed by not being in the room?"

Dr Clancy applauded volunteers from Better Border Health for campaigning for a greenfields hospital saying they had believed when no one else would.

But he added he had a duty as a medico to raise concerns, particularly with patient safety.

"Here's the paradox, we're damned if we don't speak up," Dr Clancy said.

"If we don't speak up for a patient in a hospital and an outcome (that is bad) happens, the coroner will ask you why, so if you (don't) want that, then you've got to accept we have to speak up."

Underlining the lack of understanding from states, Dr Clancy pointed to the NSW Treasurer not being aware Albury hospital is administered by Victoria and patients being directed to Wagga for treatment.

"The NSW ministry still directs NSW ambulances to pick up people in the northern half of Albury and drive them to Wagga if they know they're having a heart attack, when we have a cath lab, that if you funded it, we could do it within 15 minutes," Dr Clancy said.

Nevertheless, Dr Clancy said "it's not too late" to revisit the hospital upgrade decision.

"Lets look to the opportunities and not the barriers," he said.

Rural Doctors Association of Australia president Peta Rutherford, who was raised in Wodonga, told the summit that the Twin Cities had much to offer but the health service culture was crucial.

She said doctors were the "biggest gossips" and they would tell others where that was amiss.

"It's about the team and how everyone works together, but the culture is so, so important," Ms Rutherford said.