Tuscany

Family doctors uncertain about the future, need a push on territorial reform

Three out of four believe in technology and ask institutions for help to improve digital tools, reduce bureaucracy and increase listening

by Paolo Castiglia

5 December 2025

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3' min read

Translated by AI

Versione italiana

Key points

Datanalysis Survey for Communities in Health
Designing agile care networks
Medical reform protagonists

3' min read

Translated by AI

Versione italiana

The majority of family doctors in Tuscany continue to feel marginalised in territorial healthcare: only a part fully recognises themselves in the territorial reorganisation reform envisaged by the DM77, while two thirds (65%) see themselves as possible 'directors' of the assistance network, without however managing to translate this awareness into daily practice.

In detail, then, three quarters of family doctors believe in technology but not in the system. That is, they are willing to use a digital platform to communicate with patients (79 per cent), they consider a network connected to the Electronic Health Record (76 per cent) to be useful, but 75 per cent of doctors still do not believe in bottom-up healthcare, and finally, eight out of ten doctors ask the institutions for help with better digital tools, less bureaucracy and more listening.

Datanalysis Survey for Healthy Communities

These are the scenario data that emerge from a survey of 300 Tuscan family doctors carried out by Datanalysis for Comunità in Salute, a social responsibility project promoted by the Oloshealth Observatory - a union of purpose between Cittadinanzattiva and Associazione Fondatori Cultura Volontariato-AFCV - with the involvement of the Region of Tuscany, AUSL Toscana Centro, social workers and numerous health professionals.

The study was presented in Florence during the 2nd Community in Health conference, open to citizens, doctors, patient associations, professionals and public decision-makers. The project, realised with the unconditional contribution of the Menarini Group, involved over 60 people - including doctors, citizens, nurses and social workers - in 78 hours of work distributed among innovation, empowerment and organisational development workshops, dedicated to exploring critical issues and proposing solutions.

Designing agile care networks

Three key points emerged from the comparisons: overcoming organisational barriers and obstacles, restoring time and value to the human relationship, and designing 'agile care networks' based on aware people, connected technologies and personalised projects.

"General practitioners and citizens have sat down and are sitting at the same table to build together new solutions for territorial care," explains Letizia Bocciardi, director of the Oloshealth Observatory and creator of the project. "Comunità in Salute is a participatory process that starts from real needs and is translated into shared operational proposals, in an 'Open Innovation' logic. These are design laboratories where doctors and citizens work side by side to identify critical issues, propose more effective organisational models, and make care paths simpler, more participatory, and more sustainable. A change of perspective that enhances the skills and experience of patients and doctors as the main actors of care needs, reduces conflicts and strengthens mutual trust'.

"This experimentation is valuable to give a systemic and participatory reading also by the main protagonists to reread the reorganisation indications contained in the DM77 - explains in turn Lorenzo Roti, health director of AUSL Toscana Centro -. It brings to the institutions ideas already shared by citizens and professionals and is a way to reduce the distance with the territories, improve the quality of public decisions, and bring primary care back to the centre of an inter-professional and community-oriented reflection".

Medical reform protagonists

"The project is really interesting because it does not add superstructures to the existing design of the DM77 but optimises and colours essential elements for the achievement of the objectives," Rossella Boldrini, director of social services of AUSL Toscana Centro, then describes. Annalisa Mandorino, national secretary of Cittadinanzattiva explains that all this "does not only mean wanting to be heard, but to contribute with concrete proposals. The citizens of Communities in Health are part of the process of change and not mere recipients of decisions'.

"For us doctors, it has been and will continue to be an opportunity for real confrontation with patients and the care team," conclude Alessio Nastruzzi and Alessandro Bussotti, GPs involved in the project's Working Group, "which helps us to build pathways that are more in line with needs and to overcome misunderstandings that often generate unnecessary conflicts. During the workshops, differences are reduced and dialogue becomes the basis for finding shared solutions".

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