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Emergency planning

The absurd shortage of physicians that has been complained about for years

Mirko Claus

President of FederSpecializzandi 

Federica Viola

Deputy Vice President of FederSpecializzandi 

By December 2020April 26th, 2022No Comments
carenza di medici
Photo by Lorenzo De Simone

At the end of 2020 we can confidently state that the ongoing pandemic put the Italian healthcare on the spotlight and highlighted structural, organisational and technological issues that were being ignored for too long.

The shortage of specialist physicians is undoubtedly one of these issues. Discussions on this topic have been taking place for a while and the challenges that are often described are the struggle of the Accident and Emergency department and the inadequate turnover of jobs that does not compensate the upcoming retirements. In the past few years we only ever saw very timid attempts to deal with the problem. The current global health emergency forced policymakers to think more broadly about the issue and face it.

Unfortunately the inadequate planning that was rampant during this pandemic was already eroding the foundations of a potential solution. We are referring to a decade of linear cuts leading to reforms that on one hand made the system more efficient and on the other did so at the expense of healthcare workers, who- after years of this, plus the pandemic- are now exhausted.

From our point of view it seems evident that the solutions we have been adopting now to fight these challenges cannot and should not become the norm. For example, should the indiscriminate use of newly graduated physicians and postgraduate students, with precarious contracts, in Covid wards become part of the structural framework and exclusively focused on support services would result in the decline of quality of care over the medium to long term.

This is already affecting the training of our young colleagues and there is a real fear that once the pandemic ends the situation will remain as it is. Working amid a crisis means having to finding rapid solutions to any shortages but this runs the risk- as we already saw on many occasions over the years- of improvised and temporary measures becoming structural and final by inertia.

Unfortunately we learned that, once again, there will be a minimal increase in funding to cover the upcoming postgraduate specialisation courses, which is very low when compared to the expected number of newly graduated physicians and the healthcare demand of the population. The training funnel is remaining the absurd- and typically Italian- reality of our system. Training a doctor takes at least ten years and we already demonstrated that we are extremely late in doing this.

The shortage of specialist physicians is therefore not unexpected and is one of the many puzzle pieces of the biggest organisational and management problems we have. We are not just lacking doctors but the right conditions for them to thrive. There is a lack of adequate salaries that would make public services more attractive and a lack of adequate training to meet the current and upcoming demand, not to forget the full valorisation of local services and their role within the National Healthcare service.

Now is definitively the time to act, to give a strong and necessary push towards a better integration of services that focus solely on people.

Now is definitively the time to act, to give a strong and necessary push towards a better integration of services that focus solely on people, as the pandemic demonstrated this is what we really need. News headlines or big announcements are not enough; we need concrete actions and significant efforts to redirect the adequate investments towards quality training, integration of services and policies for workers, in order to guarantee a National Healthcare Service that is able to respond, thanks to its healthcare workers, to the needs of the population.