You choose your family doctor, and you can change them whenever you want
Registering with the National Health Service gives you the right to choose a family doctor: it is free, visits at their surgery cost nothing, and they are the one who writes prescriptions and referrals for tests. Changing doctor requires no explanation.
Redazione Bahay 4 min read
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When you register with the Servizio Sanitario Nazionale (SSN, the National Health Service) you do not only get a card: you choose a doctor. In Italy the role is called medico di medicina generale, and everybody calls them medico di famiglia (family doctor) or «medico di base».
This is the person you go to first when you are unwell, and you need them when you are perfectly well too: they write prescriptions for medicines, they issue the impegnativa (referral) for tests and specialist visits, they sign sick notes for work. With no doctor assigned to you, every one of those becomes a private paid visit.
Visits at the surgery are free
Visits to your family doctor, at their surgery, are free: the National Health Service pays, not you. You pay the ticket (co-payment) on the tests and specialist visits they prescribe — not on the visit itself.
Some things the doctor does are not covered by the Health Service and may carry a fee: certificates for sport, for insurance, for a driving licence. In that case they must tell you the price beforehand.
How you choose
You choose at the ASL — the local health authority — at the desk almost everywhere called «Scelta e revoca» (choice and revocation). In many regions you can also do it online, through the Fascicolo Sanitario Elettronico (electronic health record), logging in with SPID (the Italian public digital identity) or with the electronic ID card.
They give you the list of available doctors in your area and you pick one. Do not pick at random: you can ask where the surgery is and what hours they see patients — the two things that actually matter when you work.
One limit worth knowing: each doctor has a maximum number of patients. If the one you wanted is «full», it is not rudeness — they cannot take you, and you have to choose another.
What to bring: your health card or codice fiscale, an identity document and your residence permit. If you have not registered with the National Health Service yet, choosing a doctor comes after registering: how to do that is in Registering with the National Health Service: for most people it is free.
Children have a paediatrician
Children do not go to the family doctor: they have a pediatra di libera scelta (paediatrician), who follows the child from birth until the age of 14. You choose them at the same desk, in the same way.
At 14 the child moves to an adult family doctor. This is a step you have to take: it does not always happen by itself, and it is worth asking for it when your child turns 14.
Changing doctor requires no explanation
If the doctor does not suit you — the surgery is far, the hours clash with your work, you do not get on — you can change, at any time, without saying why. It is called revoca, you do it at the same «Scelta e revoca» desk or online, and it is immediate: you choose the new one and from that moment they are your doctor.
You must change, and should do it straight away, when you move house to an address under a different ASL: the doctor is tied to the area where you live.
One detail that applies only to non-Italian citizens
Registering with the National Health Service and choosing a doctor is worth 4 credits towards the accordo di integrazione (integration agreement) you signed with your first residence permit. One more reason to do it and to keep the paperwork.
When the surgery is closed
Your family doctor works set hours, not at night, not on Saturdays and Sundays. Outside those hours there is the guardia medica — now called continuità assistenziale — a different service with its own number, which changes from area to area. Ask your doctor for it and save it before you need it: looking for it at night with a feverish child is the worst possible moment.
For real emergencies the number is 112, free from any phone.
If they tell you that you cannot
You may be told that «without residency it is not possible». If you hold a residence permit and are registered with the National Health Service, you are entitled to a doctor: registration is done in your municipality of residence or, if you are not resident yet, in the one of the actual domicile stated on your permit. If the desk insists, get help from a patronato, a municipal immigration desk or an association, and ask for the refusal in writing.
