I’ll explain why family doctors will be nowhere to be found
“Community houses” should represent the pillar of territorial assistance in Italy, resolve the hyper -specific and fragmentation of care. But what is it about? On paper they are multidisciplinary structures where the citizen finds answers to health needs without having to clog the emergency room. In practice? Too often empty buildings or old polychers renovated without the staff and means necessary to work according to the mission of community houses. That is, that the various health professionals have to revolve around the citizen and not vice versa.
The flop of community houses
The national recovery and resilience plan (PNRR) has allocated 2 billion euros for the creation of 1,430 community houses throughout Italy, with the aim of strengthening territorial health care and offering proximity services to citizens. In June 2024, only 413 Community houses were operational, mainly concentrated in Lombardy (136) and Emilia-Romagna (123). In different regions, including Calabria and Campania, no structure is yet active.
But do the active structures really improve access to care? Still no because the investments have been allocated to the structures and not on the staff intended for the aforementioned structures. The model is virtuous but, often, doctors and specialists are missing. The risk is that they become only a plaque change for old polychers or pre -existing health facilities.
In a nutshell, by painting an old clinic and placing the plaque “community house”, you do not create the sense of a community house: nurses, general practitioners and specialists are needed. The basic problem remains the deficiency of staff and the definition of the National Health Service.
Where the family doctors ended
Without resources, staff and training, he risks being only yet another facade operation. And since the model is not working what has been decided to do? Instead of making the project more attractive for professionals, it was possible to force them to enter community homes. The new national collective agreement (ACN) for general medicine introduces the obligation to presence in the homes of the community for general practitioners.
Forcing family doctors to work there is, in fact, a way to demonstrate that community houses are active, at least on paper. But this choice does not solve the lack of staff since moving doctors does not increase the number of doctors available. If a family doctor manages a study with 1,500 patients, he must now divide the time between the study and the community of the community, without a true improvement in assistance already reduced to the bone.
In addition, the obligation to dedicate 18 of the 38 hours per week to activities in the homes of the community raises doubts about practical feasibility, considering the high number of patients who manage doctors daily in their studies. According to a study by Cergas Bocconi, a family doctor carries out about 75 accesses per day on average, which makes this workload difficult with the new hourly provisions difficult.
Social star doctor resigns: “We white cans are not willing to be martyrs”
In short, without adequate resources, this reform risks being only an illusion, leaving the real problems of territorial health unresolved.