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HEALTH

EXPLAINED: How to make a doctor’s appointment in Italy

Sooner or later, every foreign national living in Italy will need to see a doctor. Here's a guide to making your first appointment.

GP speaking with patient
Making an appointment with an Italian GP can be quite tricky, especially if you’re not acquainted with how the Italian public healthcare system works. Photo by Pascal POCHARD-CASABIANCA / AFP

Making a doctor’s appointment is usually thought of as a fairly uncomplicated task but everything gets a little harder when you’re in a foreign country.

And in Italy, the process can turn out to be surprisngly tricky, especially if you’ve just relocated to the country and are not yet familiar with how the Italian healthcare system (Servizio Sanitario Nazionale, or SSN) works.

READ ALSO: Who can register for national healthcare in Italy? 

On top of that, Italian doctors and other healthcare staff are rarely fluent in English and only very few sections of the SSN’s website provide information in languages other than Italian. 

So to make things a little easier, here’s what you need to know about making a doctor’s appointment in Italy.  

Who can make an appointment to see the doctor?

Only people who hold a valid Italian health card (tessera sanitaria) or an equivalent, i.e. a European Health Insurance Card (EHIC) or a UK Global Health Insurance Card (GHIC), can access public health services, including visits to a general practitioner or family doctor (medico di base).

For emergency treatment, the Italian health service provides care to anyone in need regardless of their nationality or immigration status and without asking for upfront payment.

In a medical emergency, call 118 for an ambulance or head to the emergency ward (pronto soccorso) of the nearest hospital.

READ ALSO: Who to call and what to say in an emergency in Italy

A GP making a prescription

Only people that hold a valid Italian health card or a EU equivalent can access public GP’s services. Photo by Thomas SAMSON / AFP

How to register with a doctor

In order to make an appointment (visita) with a general practitioner (medico di base) within the SSN, you must first be registered with that particular doctor.

While in some countries you may call the local doctor’s office and book an appointment with any doctor on duty, that is not how things usually work in Italy and you’ll be under the care of one particular professional.

However, registering with an Italian doctor isn’t nearly as straightforward as it should be. 

Firstly, patients are expected to view the list of doctors operating within the area covered by their local health authority (Azienda Sanitaria Locale, ASL). 

Though in some cases these lists can be found online, in others residents will have to directly ask their ASL to be sent a copy, or visit the ASL office in person to see it.

Then, taking the location and office hours of the listed professionals into account, patients are asked to pick the doctor that’s best suited to their needs and communicate their choice to the ASL.

READ ALSO: Tessera sanitaria: How do you apply for or renew your Italian health card?

While in some areas this can be done online, most ASLs ask that patients turn up in person at their Scelta e Revoca (Choosing and Cancelling) offices and show an ID card, a valid Italian health card or equivalent (EHIC or GHIC) and a certificate of residence

Registrations are generally processed immediately and the doctor’s contact info and booking details are emailed to the patient right after.

How to book an appointment

Once you’re registered with a family doctor or GP, you can go ahead and book your first appointment. 

A booking can generally be made via phone, email or, in some cases, online.

However, as previously mentioned, healthcare staff, including receptionists, are rarely fluent in English, so email or online bookings might be the better options if you’re not really proficient in Italian – if this option is available.

Doctor speaking on the phone

Patients can book an appointment with their GP via phone, email or, in some cases, a designated online booking platform. Photo by Nicolas TUCAT / AFP

During the first appointment, patients are usually handed a form to fill out with general information about themselves and their overall health. 

Due to these formalities, the first appointment might last a little bit more than normal appointments, which are usually around 15 to 20 minutes.

READ ALSO: Five essential facts about Italy’s public healthcare system  

It’s also worth noting that, though they provide patients with a set appointment time, Italian doctors’ clinics tend to run a little late, so be prepared for a wait once you arrive.

All consultations with an Italian GP, including the first appointment, are free of charge.

Referral to specialists

GPs can refer patients to a specialist for further diagnostic exams or medical procedures.

However, unlike in other European countries, people choosing to see a specialist through the SSN cannot select the doctor they will be referred to as they will be given the earliest available appointment.

The referral comes in the form of a red prescription (ricetta rossa) with letters P, D, B and U indicating the different levels of urgency associated with the consultation – P marks the lowest priority level, whereas D is for consultations that must take place within 72 hours from the time of prescription.

The ricetta rossa allows patients to book their appointments online, in person or over the phone by calling the relevant Regional Central Booking Office (Centro Unico di Prenotazione Regionale, CUP).

Nurse looking at X rays

Patients choosing to see a specialist through the public healthcare system cannot select the doctor they will be referred to. Photo by Alberto PIZZOLI / AFP

Again, foreign nationals with a poor command of Italian may find that online bookings are the best available option given that most operators are not fluent in English.

Private doctors 

As in other European countries, Italian residents can choose to see private GPs or specialists.

Private healthcare is of course provided at a fee – typically anything from €40 to €160, depending on the type of service required – and, in most cases, fees must be paid upfront. 

Unlike public health authorities, private providers do not require patients to have a tessera sanitaria or a valid equivalent.  

Aside from the above distinctions however, booking an appointment in the private sector is no different than booking one within the SSN, with patients being allowed to book via phone, email or a designated online platform. 

If you’re looking for an English-speaking doctor, the US Embassy in Rome and the Consulates General in Milan, Florence and Naples provide lists of English-speaking professionals available for private consultation. These can be downloaded here.

The UK government provides a similar list

Essential vocabulary and useful sentences

  • SSN (Servizio Sanitario Nazionale) – National health system
  • ASL (Azienda Sanitaria Locale) – Regional health unit
  • Medico di base – General practitioner 
  • Ricetta – Prescription
  • Visita – Appointment 
  • Specialista – Specialist doctor
  • Farmaco – Medicine
  • When booking by email or phone, a useful phrase is: Vorrei fissare una visita alle ore X di X (I would like to schedule an appointment for [day] at [time]).
  • Should you need to cancel the appointment, you could say: Purtroppo, devo cancellare la visita.
  • To ask to reschedule it, you could say: Sarebbe possibile spostare la visita?

To describe your illness, you can check out our terminology guide for the most common ailments.

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HEALTH

How bad is Italy’s north-south ‘healthcare gap’ really?

Despite recent improvements, stark regional differences in healthcare provision persist in Italy and the problem seems to be here to stay, writes Silvia Marchetti.

How bad is Italy’s north-south ‘healthcare gap’ really?

Italians have a sad saying: ‘health is a right in the north, and a hope in the south’. 

Despite recent improvements, regional differences in healthcare standards continue to plague the country, telling a ‘tale of two Italies’ with the country divided in half, and featuring a trend of southerners travelling north for treatment.

The south-north healthcare gap of the past has of course significantly shortened. Things are very different now from the days when Turin doctor Carlo Levi wrote ‘Cristo si è fermato ad Eboli’ (Christ stopped at Eboli) in 1945, when he talked about the shock of seeing poor children in Matera, the capital of Basilicata, with flies in their eyes and infections. 

Today, Basilicata leads southern regions on healthcare performance. And there are significant differences in standards between southern regions, with Calabria and Molise lagging behind Sicily, Puglia and Campania for treatment and services.

READ ALSO: Five essential facts about Italy’s public healthcare system  

But differences remain, and the pandemic has worsened the outlook according to a recent report by the government’s CNEL agency.

Public healthcare expenditure is at a national average of 1,838 euros per person per year. But the figure is much higher in northern regions than in the south: for example, it’s 2,255 euros in Bolzano versus 1,725 euros in Calabria. 

This translates into lower investments in healthcare in the south, ranging from research in medicines and therapies to top doctors and avant-garde treatments. 

The Policlinico A. Gemelli Hospital in Rome. Italy’s capital is home to several highly-rated hospitals and clinics, but some residents still travel north in search of better or faster treatment. (Photo by Filippo MONTEFORTE / AFP)

Waiting lists in the public healthcare system for checks and surgeries are longer in the south than in the north, where all the best doctors tend to be. I’ve met many southern doctors who, after studying abroad, ditched their native regions for Rome or Milan where most of the top-rated clinics and hospitals are located.

Lombardy, Piedmont and Emilia Romagna have always shone when compared to Sicily and Calabria. And even Rome, despite being the capital, lags behind Milan.

However there have been a few improvements in southern standards lately, and the situation varies depending on the type of treatment.

According to the 2021 public hospitals performance report (PNE), even though the north is showing better results in terms of treatments for cancer and orthopaedics, the poorer southern regions are raising standards in some areas.

For instance, among the top 10 facilities with higher proportions of primary angioplasty guaranteed within 90 minutes, a good index of appropriateness and timeliness, seven are based in the south.

READ ALSO: Who can register for national healthcare in Italy?

Still, the gap has led to a type of ‘health tourism’ within Italy. There are no statistics, but I’ve met many southern people who have had to fly to the north for particular treatments, access to top doctors and cutting-edge surgeries, for example for knee and hip replacements. 

They rented apartments or stayed at hotels for weeks after their surgery to undergo rehab and physiotherapy, at considerable extra expense. 

I’ve met others who had to fly from Salerno and Puglia to Millan and Bologna for hip, shoulder and knee joint reconstruction or replacement, with all the hassle of the journey in poor health and the extra transport and accommodation costs it entails. 

It was striking to find that many Romans are among those who regularly travel to Milan for heart and orthopaedic checks and surgeries. Rome does have a few top-rated clinics, but apparently not as many as Milan.

Meanwhile many doctors from Milan, Padua and Bologna come ‘fishing’ for desperate patients in Rome and Naples who have failed to find a surgeon willing to operate on them due to their complex conditions. 

READ ALSO: The parts of Italy with the best (and worst) quality of life in 2022

This healthcare gap in my view will never completely disappear, despite the incoming European funds through the pandemic recovery plan aimed at shortening it.

It will be further reduced in time, but not in the near future, particularly if all the good doctors continue to flee north for higher salaries, prestige and a more promising career.

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