Riccardi (Simeu): "Nearly 7 000 doctors are missing". Buffer solutions? Gettonists, double shifts and missed rests

The summer crisis in emergency departments has worsened, with nearly 7,000 doctors missing from Italian emergency rooms during peak season. Alessandro Riccardi, president of Simeu (Italian Society of Emergency and Urgency Medicine) and director of the emergency department at the Santa Corona Hospital in Pietra Ligure, highlighted the severity of the situation. He stated that the shortage of medical staff is critical, especially during the heatwave months when patient inflows increase significantly. The lack of personnel, combined with mandatory vacation periods for healthcare workers, exacerbates the strain on already overburdened systems. The problem is particularly acute in large cities and tourist areas, which experience a surge in population during the summer months. These regions maintain the same number of staff and facilities despite the increased demand. With the arrival of annual holidays for doctors and nurses, the existing challenges become even more pronounced. To address this, hospitals increasingly rely on temporary workers, often referred to as "gettonisti", to cover shifts. However, these measures remain a stopgap solution rather than a long-term fix. Riccardi emphasized that without structural reforms addressing economic protection and working conditions, the situation will not improve. He pointed out that compensation differences for those working in emergency departments have not yet been adequately addressed. Additionally, there is a call for recognition of the physically demanding nature of the job and additional rest periods for emergency and urgent care professionals. Without such changes, he warned, the public sector's appeal as a career path will continue to decline, despite its strong protections. According to data from Simeu, updated through 2026, approximately 5,000 emergency and urgent care doctors are currently missing nationwide. During the summer months, this figure rises to around 6,000, peaking at nearly 7,000 in August. Similar shortages affect nursing staff, who often resort to overtime, double shifts, and missed breaks to manage the workload. The situation is compounded by the fact that many patients require emergency care due to chronic illnesses and aging populations, who are left alone in urban centers without family support. Pierino Di Silverio, secretary of the Association of Hospital Doctors (Anaao Assomed), noted that emergency room visits increase by at least 15% during the summer. This rise is attributed to elderly individuals remaining isolated in cities without familial assistance. As a result, hospitals increasingly depend on external personnel, including retired doctors and gettonisti, to fill gaps. Despite being identified as a temporary measure following the pandemic, outsourcing has become a permanent feature of Italy’s healthcare system, far removed from its initial role as an emergency response. A recent investigation by the Federation of Hospital Internists (Fadoi) revealed that over half of emergency departments rely on external staffing to sustain operations. Often, these workers are not specialists in emergency medicine and are paid per shift. Public financial records further indicate that the issue persists, contradicting claims made by Health Minister Orazio Schillaci in 2023 that the phenomenon would be eradicated within two years. From 2024 to 2025, public entities and companies within the National Health Service (SSN) allocated over one billion and 64 million euros to hire temporary staff. As the summer progresses, the pressure on emergency services continues to mount. Hospitals face the dual challenge of managing rising patient numbers while dealing with reduced workforce availability. Temporary solutions, though necessary, highlight deeper systemic issues that require comprehensive reform. Until structural improvements are implemented, the reliance on external workers will likely persist, underscoring the ongoing struggle to ensure adequate care for all patients.