The family doctor and booking appointments in Italy

The family doctor has reception hours in his surgery (ambulatorio) during the week, and often works without appointment at set times in the morning or evening, or by appointment by phone, app or message depending on the doctor.

• Bring your health card and your medicine list, and describe your symptoms and their duration clearly.
• The visit is short, so write your symptoms in advance.
• The doctor visits patients at home in limited cases (visita domiciliare).
• And he renews chronic prescriptions and writes sickness certificates (certificato di malattia) through the electronic system.
• Ask for an interpreter or bring a trusted friend if your language is limited, and some centres provide cultural mediators.
• And if you are not satisfied you can change the doctor at the ASL.

Since digitalisation most prescriptions are issued electronically (ricetta dematerializzata) with an NRE number sent to you by email, message or the electronic health record (FSE) app, so you go to the pharmacy with your health card or the number.

• Tests, x-rays and visits to a specialist require an impegnativa specifying the requested test and priority (U urgent, B short, D deferred, P programme).
• A ticket is paid after or before the test depending on the service.
• For chronic illness, pregnancy and disability you may have an exemption (esenzione).
• Chronic prescriptions are sometimes renewed without a visit.
• Keep the prescription number and your test reports, and always tell the doctor about your medicines and allergies.

After you get the referral you book the appointment through the unified booking centre CUP: by phone or by attending the ASL or the hospital's booking centre or the pharmacy (many book for you), or through the region's website or app with the health card or SPID.

• You are given an appointment by priority, and lists may be long for non-urgent cases.
• Ask about the waiting list and the possibility of booking at another hospital in the region.
• If the appointment is unavailable within the priority period you have the right to submit a complaint or request an alternative route.
• And do not forget to cancel the appointment if you cannot attend so that others benefit.
• And some accredited private centres (accreditati) provide an appointment with the same ticket.

For an urgent case not life-threatening outside your doctor's hours at night or at the weekend or on holidays the guardia medica or continuità assistenziale works, which you call by a regional number (often 116117) or go to its headquarters, and it examines you or visits you.

• For serious cases call 112 or 118 or go to the pronto soccorso (emergency) at the hospital, and cases are classified by triage colours (red, white, green, blue) by seriousness, so you may wait hours if yours is less serious.
• Bring your card, ID and your list of medicines.
• And you are treated without being asked about legal status.
• For some non-serious cases in emergency a ticket is paid (ticket per codici bianchi).

Your medical file is confidential and your employer, the police or any party is not informed of your condition without your consent.

• You have the right to understand what is said to you and to give informed consent to treatment (consenso informato), to refuse it, to request a second opinion and to see your file and request a copy through the electronic health record.
• Do not be shy about asking for a female doctor for gynaecological examinations, which is often met.
• There are family centres (consultori familiari) that provide free care for women, family, children and reproductive and psychological health.
• For complaints go to the public relations office (URP) at the ASL or hospital.
• And free screening campaigns are available (breast, cervical and colon cancer) for age groups so register for them.

Who is the first gatekeeper of the care system?