General practitioners make up roughly one half of state-employed doctors. They are the guardians of public health at the grass-roots level, and in many places they are increasingly assuming the role of the old-style district doctors, which were done away with by Law no. 833/78.
At present, candidates can access family medicine after a traineeship of two years, which they enter by passing a nation-wide multiple-choice exam based on the number of vacancies submitted by each Italian Region. Assignments are appointed according to the lists and the vacancies. More than 88% of family doctors are men. Female family doctors are a rather recent development.
The National Health Service (NHS) agreement allows each general practitioner a limited number of patients; the limit is currently 1500, except for Bolzano where there are particular local conditions. The optimal ratio of 1000 patients per family doctor is currently being raised by inter-regional agreements towards the maximum limit, for which reason in recent years only a small number of doctors were enlisted as general practitioners by the NHS. Veneto is the Region where doctors have the highest average number of patients, followed by Sardinia and Sicily.
The lowest average numbers of patients are in Basilicata and Latium. Although they have fewer patients, family doctors in the south of Italy make more visits than doctors in central and northern Italy, and they request fewer admissions to hospital.
According to the newspaper Il Sole-24 Ore, in Europe only Austria (1.03) and France (1.05) have more than one doctor per thousand inhabitants than Italy (taken as 1), while England, Switzerland, Portugal and Denmark have as few as 0.06 and Ireland is barely at 0.04. Traslat. by Interpres