Why No One Wants to Be a Family Doctor

There are more vacancies than candidates in the competitions. Low salaries, a huge amount of work (if you don't limit yourself to writing prescriptions), and too much bureaucracy.

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Why nobody wants to be a family doctor in Italy

Emada Meco, a family doctor in Fiano Romano, in the province of Rome, Lazio, summarizes her normal workday this way. She treats 1.800 patients, starts at 8 a.m. and finishes at 8 p.m., and wastes two hours a day on paperwork, including three signatures required when requesting a refill of diapers and/or incontinence pads.

Emada's case is symptomatic of the distress of an entire profession, increasingly less appealing to new generations due to uncertain earnings, but above all the enormous amount of work, growing responsibilities, and a series of bureaucratic obligations that make this work increasingly unsustainable.  

Thus, family doctors in Italy are disappearing. A huge waste for citizens, who risk finding themselves with a black hole at the base of the National Health Service, while the usual recurring rhetoric informs us that "we need to strengthen community care" (a nice discovery, but who will benefit from it, if the doctors aren't there or are doing something else?).

Italy has lost 7 family doctors in the last 10 years (in 2013, there were 45.203; in 2023, there were 37.983), and a third of those currently employed will retire by 2035. Bottom line: already today, 5 million Italians don't have a family doctor, and those who are seriously employed could film a remake of the famous film "The National Health Service Doctor," starring the brilliant Alberto Sordi. In a few years, the number of Italians without a family doctor will rise to approximately 8 million, if generational turnover isn't ensured. This figure will be added to or overlap with the 3 million Italians who forgo medical care because they can't afford it.

The "Italian-style cunning" family doctor, very different from Emada Meco, doesn't want any trouble; he simply signs and distributes prescriptions. He then requests tests and investigations, even when they aren't necessary, so as not to expose himself too much with a diagnosis (perhaps he doesn't know how to make one), which would further waste public money.

The disappearance of such an important profession, if we truly want to achieve sustainable development, which includes health and well-being for all at all ages (goal number 3 of the UN 2030 Agenda for Sustainable Development), should be addressed seriously. Yet, we have reached the point where, absurdly, there are fewer candidates than available positions in competitive exams for family doctors: this is the case in seven Italian regions. In Lombardy, for example, 306 candidates applied for 390 available positions. And the conclusion is disarming: family doctor is a job no one wants to do anymore.

What to do when your family doctor retires

What should you do when your family doctor retires? Over the past seven years, approximately 10 percent of retired general practitioners have not been replaced. One more reason to get involved when your family doctor retires.

  • The Local Health Authority usually gives notice 15 days before retirement. So there's time to go in person and request the transfer. Perhaps choosing a trusted doctor.
  • Alternatively, you can also choose your new doctor online. The choice must be made through the Electronic Health Record, or with the portal or app of the region where you live.
  • In a possible period of vacatio, between the time the family doctor retired and the new one has not yet taken over, you can contact temporary doctors' offices.
  • Get advice from the outgoing doctor, if you had a good time.

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