On 5 November 2025, general practitioners participating in the Dreams (National Autonomous Union of Italian Doctors) will strike against the introduction of “unique role”a measure which according to the union acronym “is equivalent to the end of local medicine”.
The decision was formalized with a letter from the national president Angelo Testa to the Government and Regions. Also to Lecco an important part of family doctors will join the protest.
The reasons for the mobilization are explained in detail by the Doctor Laura Rossigeneral practitioner a Cernusco Lombardone e provincial president of Snami Lecco. Before going into the merits, Rossi underlines how the strike is an exceptional tool for the category, a sign of the seriousness of the situation:
“It is not a measure that we use lightly – he specifies – but the risks we run concern not only us professionals, but also patients, who are already often “orphans” of a general practitioner in many regions”.
Doctor, a strike by general practitioners is not usual
Table of Contents
- Doctor, a strike by general practitioners is not usual
- How is this change likely to impact patients?
- You talk about “distortion of the profession”: what do you mean?
- Generational change also seems to be a growing problem
- You have also denounced that digitalisation, instead of helping, has become an obstacle. In what sense?
- What prospects do you see if the current approach does not change?
- An increasingly critical national picture
- The methods of the strike on November 5th
“It’s true. The idea of the strike was born after our last National Congress, held at the beginning of October, from which the desire to proclaim a general strike emerged. It is a rare event for general medicine: to find a precedent we have to go back to over twenty years ago, in 2003, and it concerned very technical issues, such as dual-channel pharmaceuticals or the rules on availability. Today, however, the very identity of our profession is at stake”.
What are the reasons that push you to this form of protest?
“The central point is precisely the so-called “single role”foreseen by our latest contract with the public sector. In fact, it transforms the family doctor into a administrative gearcompletely distorting the profession.
While formally remaining a freelancer, the doctor would be obliged to complete an hourly basis based on the number of patients treated at the reference facility.
I’ll give you an example: if a doctor has 1,500 clients, he should guarantee six hours a week in a public facility, which could be a community home, a school or something else. But it is not specified where and how. Nobody yet has a clear idea of how we should be employed in these extra hours.”
How is this change likely to impact patients?
“Human resources and times remain the same. We already work many hours every week between the clinic, home visits, bureaucracy and training. If I also have to cover the completion hours, I will have to cut somewhere: from the clinic or from home visits. But this means for the patient less availability, less continuity of care and loss of the relationship of trust. We cannot be everywhere at the same time, and every hour taken away from clinical activity is an hour taken away from treatment.”
You talk about “distortion of the profession”: what do you mean?
“It means that we find ourselves halfway between a shift worker and a freelancer, with all the disadvantages of both and no protection. There is no protection for maternity, illness or disability, in a profession that today is mostly female. In practice, we have the obligations of an employee without his guarantees, and the expenses of a freelancer without true freedom. It is a situation that has become unsustainable. Added to this is the lack of planning and one recognized university specialization: the title of general practitioner is not equivalent to a specialty school, and this makes it not very usable even in the academic or competitive field”.
Generational change also seems to be a growing problem
“Absolutely yes. If a young doctor looks at our work today, he sees an unattractive path: rigid contracts, constraints, poor protection, no growth prospects. It is natural for him to choose other specialties. Furthermore, the obligation to keep the clinic open every day, regardless of the number of patients, entails very high costs. Rent, utilities, supplies, dressing materials: everything is paid for by the doctor. If you have few patients, the expenses remain, but the profit drops. It’s a model that no longer holds up.”
You have also denounced that digitalisation, instead of helping, has become an obstacle. In what sense?
“We live in an era of hyper-digitalization, but paradoxically technology today is more of a barrier than a help. The IT systems do not communicate with each other, the platforms do not communicate, and we often have to manually re-enter patient data for each individual practice. It is a huge bureaucratic overhead, time taken away from treatment. According to a recent study, about 30% of this work is done at night, on holidays or weekendswithout any recognition.
More than 38 hours a week: the family doctor works well beyond that, but without this being seen or valued.”
What prospects do you see if the current approach does not change?
“The prospects are very gray. The number of doctors is already decreasing for demographic reasons, and with these conditions general medicine is no longer attractive.
The family doctor, who is now called “primary care doctor”, risks disappearing. Yet we are the first treatment facilitythe point of reference for citizens. Already today, especially in regions such as Lombardy, many patients no longer have a GP. If nothing is done, this situation will worsen, and local medicine will lose its most important function: that of proximity, trust and continuity.”
An increasingly critical national picture
Furthermore, in 2024, the 15% of training grants remained uncovered, with peaks of 40% in some areas. For the president Nino Cartabellottathis is not just a numerical deficiency but “a structural crisis of basic medicinemarked by retirements, low turnover and unsustainable workloads.”
The methods of the strike on November 5th
Lo Dreamsonce the time for the conciliation procedures had passed, proclaimed the national strike of 5 November 2025broken down by sector:
- General practitioners (single role with choice cycle): closing of the studios from 8:00 to 20:00. Only urgent home visits, assistance to terminally ill patients and integrated home care (ADI) services will be guaranteed.
- Doctors with a single role with hourly activity: abstention from 8.00pm to 12.00am.
- Territorial emergency doctors: strike for the whole day (00:01 – 23:59), with a guarantee of urgent relief.
- Doctors of local services: stop from 8:00 to 20:00, with continuity of essential services (addictions, public hygiene, fiscal medicine).
- Prison doctors: abstention for the whole day, guaranteeing only urgent healthcare and presence in trials with detained defendants.
The trade union action is motivated by four central points:
- Defense of local medicine: the single role “erases professional autonomy and breaks the doctor-patient relationship of trust”.
- Protection of maternity and parenthood: calls for real leave, guaranteed replacements and gender equality.
- Programming and training: a university specialization in general medicine and national needs planning are required.
- Sustainable digitalisation: technology must be a tool at the service of care, not a bureaucratic obstacle.
In the absence of responses from the Government, I Dreams has already announced that other days of strike will follow.
