I know from personal experience that one of the worst things anyone can go through in Italy is having to deal with changing one’s family doctor (medico di famiglia or medico di base).

It is the public general practitioner paid by taxpayers’ money and assigned to locals and foreigners by the Health Ministry based on their residency. 

After being followed by the same doctor since the age of 19, mine just recently retired, vanishing into thin air without saying anything or giving any public notice or announcement.

Not even an email, and my family frequently contacts him for medicine prescriptions. He should have, by law, widely publicised his retirement among his 1,000 patients, but nearly everyone, like me, all of a sudden found themselves doctor-less and without the possibility of continuing their medications. Not even those with chronic diseases.

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When I called him, he apologised saying he had hung a small note at the entrance of his studio a week before leaving, but somehow most patients missed it. He then forwarded the contact of his replacement, a new doctor in town, but she couldn’t take any more patients on board as she had already reached her quota assigned by the health authorities. 

So I had to re-register as a ‘brand new’ patient with another unknown doctor in my area, and to do so I had to go to the local health unit (ASL), queue up for the required paperwork, and then meet the new doctor. That’s when I discovered that there were no pre-existing records nor files about my medicines, as if I had never existed, and my new doctor had to create a new profile. 

This left me totally baffled. It is unacceptable that with modern technology and centralised databases doctors can’t share patient information or leave records when they go.

I wonder what was the whole point of setting up the fascicolo sanitario (health file) to keep track of patients’ data if it appears to be of no use

Unfortunately, there is very little people can do to avoid what I went through, I’m afraid. It’s one of those Kafka-style, typical Italian hassles foreigners often find themselves trapped in. And if it’s a nuisance for Italians, it’s even more so for outsiders to the perverse logics of the Italian system. 

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Unless you’re on really good terms with your doctor and he or she has always told you what their retirement year will be, all you can do is ask them every once in a while if they intend to retire anytime soon. Word of mouth helps, especially in small villages, where everyone knows each other and might also personally know the doctor and what their plans are. Gossiping at the bar, the barber and butcher, or while shopping for groceries, could be a good way to keep up to date with evolving situations. 

But there are no real tips I can give to totally avoid going through the hell of changing doctor in a last-minute emergency and not of your own volition because even the local health units have no clue as to when doctors will decide to retire. 

Italy is a country of old people, doctors paid by the state tend to regularly extend their practice so they get higher pensions when they eventually retire.

However, friends and neighbours can help too. If you hear from reliable sources that your doctor will be leaving their job in a couple of months, it is advisable to change even before he or she retires so as to avoid finding yourself in unpleasant situations. Also, to make it smoother, it’s always helpful to visit the health unit regularly to see if any new, young general practitioner has just arrived in town and has zero patients so lots of space to take you and your entire family on board before the quota is reached. 

I hope that going forward it will be the local health unit that communicates by email to each patient when a doctor retires. 

Do you agree with Silvia? Share your own views about the challenges of changing doctors in Italy.