An appointment with the Italian health system

Italians are a poorly bunch. The slightest breath of wind can lead to three days of bed rest, air conditioning can cause pneumonia and an overly-chilled drink can kill a man (no, really), and then you have weather systems to contend with. Low pressure is a disaster, but then when the weather changes… havoc.

It’s no surprise, therefore, that doctor’s surgeries here are pretty busy. Back in the UK, my wife and I were always relatively healthy; I think I saw a doctor once or twice a year at most, but since moving here, we’ve both been struck down with what can only be described as Italianitis. As a result, I’ve got to know the Italian health system pretty well…

It all starts with a call to the doctor. But you don’t speak to the receptionist, as there isn’t one, you speak to the doctor. He may be in the middle of a consultation, but he’ll take your call, talk to you about your symptoms and then give you an appointment. This is great when you’re on the end of the phone, but less great when you’re sat in front of the doctor describing your bowel movements in your finest Italian and he keeps answering the phone and interrupting your flow (if you’ll pardon the pun).

Most people don’t bother with appointments though, they just turn up, ask who’s last in the queue and take a seat. Again, no receptionist, there’s just a waiting room. The doctor then somehow combines those who have appointments with those who don’t and everyone magically gets seen.

If the doctor can’t put your symptoms down to a change in weather or an unruly draft (a doctor actually blamed the weather for my wife feeling ill a few months ago. It turned out she was pregnant. I guess you can’t be right all the time…) he’ll write you a prescription. They love to give drugs here. In fact, the only thing they enjoy more than giving drugs is taking blood. Every morning the local hospital has hundreds, if not thousands, of people queuing up with their doctor’s orders in hand, ready to part with a couple of test tubes’ worth of the stuff. Any ailment, it seems, can be cured simply by testing how many red or white blood cells you have.

Getting the results is exciting too. They don’t go to your doctor, you pick them up yourself. You get a couple of sheets of paper listing all the tests that were done, your score for each, and what your score should have been. If you’re out of the range, that probably means you’re about to die, so you run back to the doctor as fast as you can to find out if there’s anything that can be done to save you, only to have to sit in the waiting room for two hours while a succession of 80 year olds get treated for neck ache.


If the drugs and the blood tests can’t do anything for you, then it’s off to hospital to see a specialist. This is where things get really exciting. The first stop is always the CUP, which is kind of a waiting room crossed with Argos where you make and pay for appointments. You have to take a ticket to be served, much like the deli counter, but there are four options. You can pay privately, pay semi-privately, not pay at all, or something else, which I still haven’t worked out. I normally press all four, see what number comes up first, and then play the poor confused foreigner card once I get seen. To be fair, I am a poor, confused foreigner, so I’m not deceiving anyone.

Once you’ve either paid a lot, a bit or nothing, depending who you spoke to, it’s off to the specialist. These guys are good, and you get about half an hour of their time. If they want you to do more tests though, it’s back to the CUP, who’ll then send you to the department who will be doing your tests. There, you take another ticket, get sent back to the CUP and then back to the department again. Then, it’s back to the CUP to pay, before going back to the department to show them that you’ve paid.

Now, having read all this (you have read it all, right?), you might be thinking I’m not particularly enamoured with the Italian health system. But you’d be wrong. Yes it’s occasionally non-sensical, yes, one of the hospitals we had the displeasure of going to was dirtier than an Algerian public toilet, and yes, some of the people in the CUP are astoundingly, comedically unhelpful, but it also works. You get seen quickly, you get to speak to a specialist if you need, you keep your own results so they can disappear into your own filing system rather someone else’s, and some of the hospitals we’ve been to have been incredible; all shiny steel and glass, brand new equipment and even, occasionally, happy staff.

I still don’t entirely understand how it all works. I don’t think anyone does, including the people working at the hospitals, but one way or another everyone, even us foreigners brandishing EHIC cards, gets seen and everyone gets looked after. The Italian health system is really quite good. And that’s a conclusion I wasn’t expecting.


28 thoughts on “An appointment with the Italian health system

  1. ah, the dangers of la colpa d’aria! I have 1 year old twins, and have been testing how dangerous colpa d’aria can be..I leave a door open on each side of the house, and leave them playing in the draft..they seem healthy enough so far! Either it is because they are only HALF Italian..or you need to know that colpa d’aria exists to be affected by it!

    1. Wow, you’re playing with fire there…. I thought deliberately exposing children to a draft was an impressionable offence!? 😉 I’m always amazed that anyone believes it can be harmful, but hearing it from an actual, real life doctor was the final straw for me!

      1. wonder if that was the same doctor that told my boss it was ok to smoke during her pregnancy..but only a maximum of 2 cigarettes a day – wouldn’t want to be irresponsible!

  2. Richard, it’s a question of mentality. I give you an example : having worked for many years for the no 1 flexible packaging Brit firm, in case of a customer emergency for a quick extra delivery or something to do with the quality of the delivered goods, invariably the reply was it can not be done or our Quality Control says the goods are perfect. In similar circumstances, the Italian firms would do anything to help with a quick delivery at any cost or they would send immediately their agents or go themselves to sort out the situation possibly due by machinery or climatic situations and not by their product. We are not able to say no. We must convince ourselves that it is really impossible to sort out any situation, but more than anything, we must know that our conscience is clean after having done all the possible to help. This applies in any part of our life, health included. What a good description! Yours. B

  3. A spot on post. If when you have to go to the hospital, take a pack lunch. The first time I went with Mrs Sensible we sat for an hour in the waiting room at 9 I asked Mrs Sensible “Sorry what time was your appointment ?” 8 she replied.
    “mm hmm” I said. “they must be running late, ask the old biddie next to you what time her appointment was”
    “8” she replied
    Really! Yes everyone in the room has an 8 o clock appointment
    All 50!!!

    1. Haha… that sounds about right. I’m not particularly good at being pushy but you soon learn in hospitals that if you don’t stick up for yourself you never get seen, especially if everyone has the same tie appointment! Every trip is an adventure…

      1. Link excused because it’s hilarious! I’m constantly trying to start a revolution… not much luck so far but I’m sticking with it. My wife lives in constant fear of trips to the hospital at the moment, far too much nudity involved. One of her cousins advised her to just be prepared to let go of all our dignity. How very un-British!

      2. What a great idea, and thanks for inviting us! Unfortunately (or fortunately, depending how you look at it) we should have a very new baby by spring, assuming all goes to plan, so being realistic I just don’t think we’ll be able to come along. Nice idea though, and thanks again!

  4. Well, its good to know that your system is much the same as ours here in Tuscany. And yes, whilst it can be a little frustrating being in the blood sample queues, it does help you to slow down and catch up on your reading. I also agree that the system does actually work; our results arrive in the post within 48 hours and then we go back to our lovely doctor to talk about rock music for half an hour; the results are a ‘by the way.’ The doctors here, do give injections and keep an eye on your blood pressure. Its a good idea to get to know when are the quieter times at the doctor’s surgery, like now is excellent because 90% of patients are al Mare!

    1. Yep, we’re finding that now is a great time to get everything done… I wish it were always August! It’s certainly a very different system to the UK and it takes a while to work out what tickets you need, what queues to join and what times to be in certain places, but once you get your head around it all, it works surprisingly well!

  5. An Italian friend of mine is often struck by un colpo di freddo alla testa, which lays her low for quite some time. I thought she was joking when she first offered it as an excuse not to do something she had promised, but I soon learned this is a terrifying thing that most Italians fear constantly.
    I have been involved through a friend with the hospital system and even though it had us scratching our heads in wonder (at one point we were all rushed outside while there was a drug bust) I have to admit
    that it all worked well in some crazy way…much like the rest of Italian life.
    I think being a chemist in Italy would be very lucrative, especially since it is a closed shop, where your father and grandfather had to be chemists before you can own one.

    1. My wife’s current thing is to ask Italians in the car whether they would like the windows open or the air conditioning on… both can apparently cause dreadful ailments, so it’s a tough choice!

      You;re right, being a chemist would be great. Pharmacies are constantly busy and everyone seems to be on drugs for something!

  6. When I was reading about the “causes” for all the ailments that are possible for a person to have, I could hear my own mother’s wise words of why we are sick. The “colpo d’aria” is always top of the list! She is convinced that a cross breeze will cause instant death! God forbid that you should have 2 opposing windows open in the car…and before the days of AC in cars, this non-movement of air was horrible!!! But I’ve never figured out why it was ok to zip through Lago Maggiore on a motoscaffo, getting all sorts of wind, but not to have a cross breeze in the car! And of course, if you have a stomach ache or a cold, it’s because you don’t eat right, or you were in a drafty environment! The passing of germs from one another never seems to factor into the disease – it’s always because you did something stupid!! Now I know where she gets it from – it’s just from growing up in Italy!

    1. Exactly! I’d always heard that people believed this stuff in Italy, but hearing doctors say it too is just incredible! And it’s always great to challenge an Italian in a hot car as to whether they would prefer the windows open or the AC on. Both can apparently kill..

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