Emergency care in distress, 'nearly 7,000 doctors shortage by August'

Emergency rooms across Italy are facing severe strain during the summer months, with rising patient numbers and a critical shortage of medical staff. According to updated data from the Italian Society of Emergency and Urgency Medicine (Simeu), as of 2026, there is a shortfall of around 5,000 emergency physicians nationwide. However, this number increases significantly in the summer, reaching approximately 6,000 in June and peaking at nearly 7,000 in August. This comes at a time when emergency room visits often rise due to heatwaves and increased tourist activity. The situation is exacerbated by seasonal absences, particularly during the summer vacation period. Alessandro Riccardi, president of Simeu, explained that only 31% of emergency departments have adequate staffing levels, while 70% face shortages ranging from 25% to 70% of their required personnel. The problem is especially pronounced in facilities that rely heavily on freelance doctors, known as “gettonisti,” who are not bound by the same organizational constraints as salaried employees and do not adhere to agreed-upon vacation schedules. This makes planning for summer coverage even more challenging. Pierino Di Silverio, secretary of the Anaao Assomed medical union, noted that emergency room visits increase by at least 15% during the summer months, primarily driven by chronic illness patients and elderly individuals left alone in cities without family support. At the same time, medical staff availability drops by up to 20% due to vacations. This issue compounds existing structural staffing shortages, which affect 70% of emergency departments, with gaps ranging from 25% to 70% of the planned workforce. To mitigate these challenges, hospitals increasingly depend on external personnel, including retired doctors and freelance practitioners. Di Silverio emphasized that the temporary solution involves greater reliance on such workers to cover shifts. Additionally, the management of vacation periods has become problematic, with many doctors forced to skip or delay their holidays. On average, only about 60% of accrued vacation days are actually taken. Similar issues are reported among nurses. Claudio Delli Carri, secretary of the Nursing Up Piemonte and Valle d'Aosta union, stated that the implementation of summer vacation plans reduces active workforce participation in shifts by an average of 25-30%. To keep services operational, healthcare organizations are compelled to request additional work hours, overtime, and frequent shift changes for staff already on duty, pushing workload levels to unsustainable limits. The growing crisis highlights the urgent need for systemic reforms to attract and retain professionals in emergency medicine. Riccardi called for immediate action to make emergency care careers more appealing, aiming to draw back those who have left public health for private practice. Without addressing these underlying issues, the pressure on emergency services is likely to continue intensifying, affecting both patient care and the well-being of healthcare workers.