Family doctors: already 5,700 missing and 8,180 more to retire in 2028

According to data provided by the Italian Federation of General Practitioners (Fimmg), between 2025 and 2028 as many as 8,180 white coats have reached or will reach the age limit for retirement, set at 70 years unless an exception is made. The number of retirements varies significantly between the regions: from 10 in Valle d'Aosta to 1,147 in Campania.

Thus, the number of patients per doctor could grow further, leaving entire territorial areas uncovered. According to Sisac data, as of 1 January 2025 the 36,812 GPs were in charge of more than 50.9 million patients, with an average of 1,383 patients per doctor and marked regional differences: from 1,153 in Molise to 1,533 in Lombardy. 'The real picture,' Cartabellotta points out, 'is probably even more critical than these numbers suggest. In fact, with such high saturation levels, the principle of free choice is restricted and it is becoming increasingly difficult to find a doctor available close to home. This is a difficulty that no longer concerns only areas with low population density, such as mountainous and rural areas where calls for tender are often deserted, but also involves many large cities'.

According to the Gimbe Foundation's estimates, the most critical situations are to be found in almost all the large regions: Lombardy (-1,540), Veneto (-747), Campania (-643), Emilia-Romagna (-502), Piedmont (-463), Tuscany (-394) and Lazio (-358). On the other hand, no shortages were found in Basilicata, Molise and Sicily (figure 7). "Considering that the estimates are calculated on the regional average," Cartabellotta points out, "however, it cannot be ruled out that, even in regions where a shortage does not emerge, there may be territorial areas or individual areas without a GP".

Even if all family doctors were to retire at the age of 70 and all the scholarships financed between 2022 and 2025 were assigned and completed, according to the Gimbe Foundation the new recruits would still not be able to cover the retirements expected by 2028 and the shortages estimated on 1 January 2025, with a gap of more than 2,700 GPs. "Moreover," Cartabellotta explains, "since we are dealing with the most optimistic hypothesis, it is clear that in 2028 the gap between retirements and the entry of new GPs will be even wider. On the one hand, in fact, more and more doctors are choosing to retire before the age of 70, and on the other hand the number of doctors who complete the training course is lower than the number of grants funded: not all of them are awarded and at least 20% of those enrolled abandon the training course'.

In recent years, in order to respond to the shortage of GPs, the government and the regions have adopted various stopgap solutions without addressing the root of the problem: raising the retirement age to 72 years, derogations from the increase in the ceiling, and the possibility for those enrolled in the training course in general medicine to acquire up to 1,000 patients. 'The crisis in general medicine,' Cartabellotta comments, 'should instead be answered with an organic reform, capable of making the profession more attractive. Without an overall vision, the government and the regions will continue to field fragmented solutions. And above all, the debate risks becoming polarised once again on the opposition between dependency and convention, while today the real priority is to rethink the role of the family doctor: from training to the organisation of work, to integration with the entire network of territorial and hospital services'.