by InTrieste
A proposed overhaul of Italy’s general practice system is drawing concern from frontline doctors, even as regional officials signal that the reform will move ahead.
“We have listened to all the positions presented by the unions,” said Riccardo Riccardi, the regional councilor for health in Friuli Venezia Giulia, following a meeting in Udine with representatives of general practitioners. “The process will continue, and we will see how it evolves.”
The meeting brought together Italy’s main general practitioners’ unions — including Federazione Italiana Medici di Medicina Generale, Federazione Medici Territoriali, Sindacato Nazionale Autonomo Medici Italiani and Sindacato Medici Italiani — to discuss a national reform proposed by Health Minister Orazio Schillaci.
At the center of the debate is a plan to reshape how family doctors are employed, potentially shifting some from their current status as independent contractors to salaried public employees. Union representatives warned that the proposed “dual track” system — combining both employment models — risks creating practical complications and may fail to attract doctors unless participation remains voluntary and incentivized.
Doctors also stressed the importance of preserving the longstanding relationship of trust between physicians and patients, even as the reform seeks to expand services through Italy’s new community health hubs, known as “Case della Comunità.”
Another sticking point is the requirement, under the proposed system, for doctors entering public employment to hold a formal medical specialization. Many current general practitioners, unions argue, would not meet that threshold, as their existing qualifications are not considered equivalent to hospital-based specialties — raising concerns about staffing shortages and potential discrimination.
Uncertainty also surrounds the future recognition of existing training pathways, particularly the Ceformed qualification. Doctors questioned how current and prospective trainees will be evaluated if general practice is formally reclassified as a specialty, and whether additional training requirements will be imposed.
For now, the reform remains in flux — but the meeting underscored a widening gap between policymakers and the doctors expected to carry it out.
