Healthcare crisis: more than 10,000 doctors and nurses leave Italy in less than two years
Amsi, Association of Doctors of Foreign Origin in Italy, Umem, Euro-Mediterranean Medical Union, within the International Movement United to Unite, in a very delicate moment for the Italian Health System, present the updated data on the flight of health professionals abroad, through accurate investigations and information tools available, including Radio-Co-mai Internazionale and Web TV Unione per l’Italia (we are present in over 120 countries in the world with our corresponding representatives). The alarming data on the exodus of doctors and nurses who seek legitimate economic and career rewards outside our country, which have been lacking in Italy for some time, come, as always, through the voice of Prof. Foad Aodi, leader and founder of the aforementioned associations and expert in global health.
«From January 1, 2023 to August 31, 2024, over a period of 20 months, more than 10,320 healthcare professionals have officially applied and requested to learn about the methods and opportunities for working abroad, with a presentation and a communication sent via email to the secretariats of our associations, of which 54% are doctors, 31% nurses, 10% physiotherapists and the rest other professionals in our healthcare system, such as podiatrists, speech therapists, psychologists, dieticians, radiology technicians», Aodi begins.
English: «In the two-year period 2021-2022, there were only 4,700 professionals who submitted a request to Amsi to leave our health system, also because we were in a very delicate period in which it was not easy to move around Europe and the world, given that we were emerging from the Pandemic. It is therefore possible to understand the nature of this data. It should be remembered, however, that already in the period 2015-2016, there were already 2200, in the period 2018-2018 there were 3100, in the period 2019-2020 there were 1200 professionals who contacted Amsi, in order to obtain information aimed at leaving our country. In what was already a particular historical moment, in which the crisis of our health system was beginning to weigh heavily on the serenity of professionals, according to our investigations, the flight of doctors and nurses abroad, both Italian and of foreign origin, had in fact begun. Most of the professionals of this last period are young figures and therefore at the beginning of their career, but already deeply dissatisfied with their daily experience in our healthcare system. 82% of these people work in the public sector, and among the departments of our hospitals, from which most of the requests for emigration come, the emergency-urgency areas are in first place, then emergency rooms, followed by anesthesia, orthopedics, neurosurgery, plastic surgery, traumatology, pulmonology, gynecology, pediatrics, dermatology.
The regions at the top of the list for requests to escape, received by Amsi, they are Lazio, with the Rome area in first place, and then Veneto, Lombardy, Tuscany, Sicily, Sardinia, Campania, Calabria, Umbria and Trentino. As regards the preferences of the countries where to evaluate the possibility of working, consequently requesting, to us at Amsi, information on the offers present, 95% of the requests concern, in the last few years, the Gulf Countries, followed by some European countries where clearly the salaries are at least double ours.
The reasons that induce professionals who interact with Amsi to consider leaving the Italian healthcare system are mainly fatigue, the scourge of defensive medicine, poor economic security, weak career prospects and the increasingly concrete risk of being attacked, with 55% of professionals declaring that they have suffered physical or psychological violence at least once. As always, our analyses, continues Prof. Aodi, are never ends in themselves, but are accompanied by concrete proposals.
We make a heartfelt appeal, in this sense, and it is certainly not the first time, to the President of Fnomceo, Dr. Filippo Anelli, to Minister Schillaci and to all the representatives of the Meloni Government. It is necessary to put on the agenda, concretely and urgently, all the possible solutions and synergies to resolve the numerous critical issues that have long afflicted our health system.
The solutions and actions to be taken are not few and simple, since we are faced with numerous eternally unresolved deficits, which we have been dragging around for years and which have worsened more and more, day after day, due to the obvious inefficiency of our health policies. The path to take is well known, and is there for all to see, as is the battle in favor of the decriminalization of the medical act.the need to implement adequate tools and regulations to protect and defend the sacrosanct psycho-physical safety of health professionals, faced with attacks that only last August reached the incredible average of one episode per day from North to South, and to involve professionals more in decisions and paths that concern the evolution of their future and their career, fully supporting their talents, skills, and the strength of ideas. We must work, with concrete projects, on training and on making professions more attractive, consequently incentivizing study paths and restoring credit to the role and figure of doctors and nurses.
Moreover, the new data on enrollment in the admission tests speak clearly and certify, in the last two years, a dangerous decline and a disaffection that must be treated at the root, since the constant increase in the population’s need for care requires an indispensable generational change. The new blood is lacking, they are needed like bread, says Aodi again.
Targeted actions and commitment from everyone are needed to induce associations, professional orders and unions to come together and collaborate profitably for the good of professionals and the community, nipping in the bud the counterproductive divisions and internal fractures that take us nowhere, indeed, says Aodi, they only slow down the progress and growth of our healthcare system, to the detriment of the quality of care for citizens, who are already in deep trouble.
Those who work in the public sector and in healthcare facilities, namely the Health Director and the General Director, have the duty to protect and involve healthcare professionals more, encouraging specializations above all, fighting defensive medicine and continuous aggression, streamlining bureaucracy, especially related to admission tests, abolishing the obligation of citizenship for competitions in the case of professionals of foreign origin, extending, as we have been requesting for some time, the expiry date of 31 December 2025 of the Cura Italia Decree. In these last 15 years we have only heard slogans and empty promises, but before our eyes there are no concrete steps forward in a healthcare system, both public and private, increasingly in the midst of the crisis.
We have only witnessed chatter from pseudo experts, but there has been no improvement to at least partially stem the flight from the public which, in fact, in the last two years, has even increased by 35% with professionals who feel increasingly disadvantaged and abandoned to themselves, just as the escalation of aggression towards all healthcare professionals, both men and women, knows no respite, with percentages of increase of 44% in Italy and 45% in the world. In the last 5 years, more than 7 thousand agencies and “pseudo experts” have been born, with their Facebook pages and their social channels, which claim to be specialized in the recruitment of healthcare personnel in the world, qualifying themselves as prestigious employment and mediation agencies. There has been no shortage of our complaints as Amsi: we must be careful, 60% of agencies and 70% of individuals are in reality “smoke sellers”.
Many hospital managements in the Gulf countries have approached us for clarification, publicly stating that they have never initiated internal staff searches.
For this reason, we always warn professionals to be wary of these agencies, following, for the job search, only and exclusively the institutional channels. For this reason, we have been asking for some time, the Ministry of Health, the Federations of all health professionals, the Regions, on behalf of Amsi, Umem and Uniti per Unire, to open a table of consultation and dialogue with us, to find suitable solutions not only to stem the flight abroad, creating together the conditions to convince professionals to remain in our country, but also to clarify the appropriate channels to turn to if you really want to emigrate.
We fully support the appeal of Minister Schillaci, who raised the alarm on the flight and lack of personnel from emergency rooms and emergency departments, where, as we have said, there is currently the greatest lack of professionals.
Now that we have reached a point of no return, for 15 years we have been denouncing these deficits that are getting worse day by day. We need finally far-sighted health policies to economically and contractually valorize all professionals and especially those who, in these delicate areas of hospitals, are subjected, more than others, every day, to the stress of the battles to save human lives and often to the fight against death, as well as to grueling shifts. These people pay on their own skin, more than others, for the lack of colleagues. It is therefore essential to act to invest in the high skills at our disposal, fighting disorganization, promoting hiring and therefore raising the quality of their daily work, in all departments, both in the public and private sectors”.
Thus concludes Prof. Foad Aodi. President of Amsi and of the Movimento Uniti per Unire and of UMEM, Euro-Mediterranean Medical Union, expert in global health, correspondent from Italy for prestigious foreign newspapers as well as member of the Aisi Board of Directors, Association of Independent Health Enterprises, health director and spokesperson for USEM and the National Team of the Kingdom of the Two Sicilies, correspondent from Italy for Press Agencies, newspapers and TV of Arab and Gulf countries, as well as professor at the University of Tor Vergata and already 4 times Councilor of the Order of Rome and member of the register of experts of the Fnomceo, and also health director of the Iris Italia Medical Center together with Dr. Nadir Aodi Podiatrist coordinator of the New Generations Commission of Amsi and Uniti per Unire and vice secretary general of USEM.
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