“It had been years since I felt so satisfied at the end of the day. The stress accumulated in Italy for my work, especially during the pandemic, almost killed me. Literally. Now I am reborn, I no longer work as a bureaucrat, I only do the thing I have always liked to do: the doctor“. Dr. Francesco Porro he is sixty years old, a wife and two children, he is of Calabrian origins and today he works as a pediatrician in a clinic in Zurich where he moved in September 2021. After thirty years in the Italian health system he found himself in a hospital bed hit by a stroke “Which miraculously left me no permanent damage. I was still recovering when I made contact with a pediatric clinic here in Swissan interview on Zoom and they sent me the contract ”.
His is a story of a “brain on the run” who as a young man did everything to get back from Germany. “At the time I returned as a matter of feeling, selling the life of my parents, emigrants, who always wanted to be able to return to their land”. It is the end of the eighties, Francesco is 25 when he graduates in Modena, vote 110 and praise. “I remember that I went to the order of doctors to look for my first job, but at the time there was no job unless I was recommended”. So he goes back to the area of Stuttgart from parents and finds work in a pediatric clinic associated with the University of Tübingen, in Esslingen. “A simple interview, a few days of probation and I was hired”. But the desire to return to Italy was too strong. “A characteristic of the emigrants I saw in Germany – she says – was often living near the station. This sense of physical closeness was transformed into a mental closeness, of being able to say, that’s when I want to take the train and return to Italy “.
For his return, Dr. Porro tries the way of American military bases. “I went to work in the emergency room of the military hospital in Bad Cannstatt. What struck me were the interviews made by these US military who asked me little about what I actually knew how to do, what would be seen in the trial period, while the questions were about what I thought about the doctor’s task, how I saw my work and etc”. After three years he manages to be transferred to Pisa, in the Camp Derby base clinic; then, in an outpatient clinic a Florence, as a general practitioner while he was on duty at night until 2018. Until, once in the ranking, he can access the convention as a general practitioner. “I had finally had the general practitioner convention. I thought I had achieved peace of mind, a stable job and a regular life ”.
Porro, however, clashes personally with the national health system: “Today as it is set up, with 1500 patients you no longer live. With the AFT (Functional Territorial Aggregation, are the groups of doctors who seven days a week, from eight in the morning to 20.00, must guarantee the protection of the health of patients entrusted by the health system, ed) i medici have become bureaucratswhile the ASL leverage to make you do the things they want: that is to go to savings“. The days spent managing budgets as well as treating patients: “It showed how much each doctor spent, those who spent less received a bonus, and not a little, even 8 thousand euros a year, so you were incentivized to save” , says the pediatrician. “For example you took the goal of reducing the injectable antibiotics prescribed, you took an average of prescriptions, if you were under you took the bonus. Then there are guidelines to follow so it is also a system that is needed – he underlines -, I see it also here in Switzerland. But here are private insurance: a patient thinks and evaluates the urgency together with the doctor, otherwise if you exceed your spending ceiling next year the insurance increases. We are freer to make our own decisions and we are not penalized ”. That his departure wasn’t a question of money the doctor clearly states it: “If I do the math, being the cost of living of Zurich high, although the taxation is al 12% in Switzerland, there are a number of indirect expenses that leave me with 4 thousand francs at the end of the month. In Italy with a little private activity I earned even more after paying taxes ”.
The arrival of the pandemic has only made the situation worse. “Patients called you at any time. I spent most of my time on the phone. It was as if we doctors were an obstacle to overcome with respect to their will. She often insisted on the emergencies, especially those aged fifty and over, because in this way they had the exemption and did not have to pay even if there was no urgency and only clogged the system. Now it’s all about questioning everything, about vaccines, about therapies, less is asked of a mechanic who repairs your car than of the doctor who gives you medicine “. And when the patients weren’t pressing, it was there bureaucracy. “I vaccinated 300 patients last year, and each patient made your life difficult because you had to go through a series of bureaucratic steps that took hours, otherwise the system would not give you other vaccines“.
A working problem, the Italian one, which is felt by many doctors. “The colleagues I feel are all on the edge. In this situation, those who do not go out for a better quality of work try to retire and there is no generational change because they have blocked specializations for years ”. Italy has long had a problem of lack of doctors, not only those of the family, as reported by all the trade associations and trade unions. “If something does not change in our country, the health system will not be able to hold up for long”. Francesco’s is not meant to be a farewell, he still has good intentions for his land: “Florence remains our home, where our friendships are. Despite everything, my idea is to return in a few years and work in Italy until retirement, but with a different awareness that this experience has given me and that I am happy to have done “.