HIGH GARDA. Mario is 86 years old, lives in a town in the Lower Sarca, would like to change doctors. For a few days now, his clinic has no longer been available in the local clinic but rather in the nearby one. For him, who walks a little with difficulty, even if his health is good, traveling to the nearby town for a visit, a consultation, a prescription is cumbersome: it is much more convenient to stay in his town, where he can go to the doctor feet.
He’s not a complainer, Mario: he went through the war as a child, hid in a tunnel during the bombings, went through hunger and boarding school, then rolled up his sleeves and made the family business flourish ; a few years ago he lost his wife and so he cooks, washes and irons… If there is a problem you find solutions, that’s how he is.
In this case, therefore, he wants to take another doctor who receives in his country: «What will it take? – he thinks – in five minutes the game will be done: it will be enough to go to the town hall or at most to the health authority, to the former Incompiuta di Riva, now the headquarters of the valley community». He is used to the efficiency of public offices and the humanity of the people who work there. He didn’t know about the cumbersome online bureaucracy that now looms everywhere.
So go toProvincial health company in Riva where they tell him that the doctor he wants already has the maximum number of patients. Mario asks to be put on the waiting list, they tell him that there are no waiting lists but that every day he has to look on the health company website to check if a place becomes available with the desired doctor.
They give him, an 86-year-old pensioner, a web address, that of the health company’s website, but the general one, apss.tn.it, not the precise one for the choice of doctor, like saying: “Go to Milan” but not they give the street and number of the shop where you should go. And here the daughter-in-law and a son come into play who begin to support Mario in what seems to be shaping up as one of the epic climbs of Everest, now typical of Italian, or rather Trentino-style, bureaucracies. Thanks to her daughter-in-law, she found the right page on the health company’s website.
Mario, who fortunately, in addition to the car which he still drives very well, also has a computer, checks every day if the desired doctor is accepting new patients. The problem, however, is that when a position becomes available he should run to the healthcare company in Riva and hope that no one precedes him. Another problem is that, damned government and Trentino restrictions, after Covid you can no longer go there normally, you have to book and to book at the registry office of the Riva health authority you have to wait up to nine days… In short, it’s starting to suspect that you will not be able to change your doctor.
The daughter-in-law, who works in a municipality, hears the secretary of the desired doctor who advises them to log in to Trec, the online service of the health authority, so as soon as a place becomes available, he, wow!, will enter his request and will get the longed-for doctor: “You know – says the secretary – there are people who get up at 7 in the morning to do it”. Mario, reluctant to digital practices when once it was enough to go to a counter and everything was done with a smile, despite himself decides to try to access the I pass.
Meanwhile, think about the times when in your town for decades there was a family doctor who even came to your home. The daughter-in-law, working online, is unable to get him into Trec: the health card must be activated and therefore Mario will have to go to the town hall. The following day he goes there with his son, they activate his card. They return home and try to access Trec but fail. They call a friend in another municipality and she explains that they need the QR code that is issued in the municipality.
They return, get the printed QR code and the code to activate it by email. They return home and follow the instructions step by step but at the end, after scanning the QR and entering the code received by email, the writing appears: “The following problem has been detected: your session has expired, log in again”. Yet they did everything within the prescribed time following the instructions. They try again thirteen times. In vain.
The son searches on the company website for a toll-free number: he calls, they answer but they don’t know how to help, they say to call thehealth registry. At the health registry number, 26 minutes of music on the speakerphone, at the end the disconsolate switchboard operator apologizes because they don’t answer at the registry office, and says to go to the company counter in Riva; you have to book, however, and the first free place will be in nine days.
Mario will therefore have to go to the health registry to try to activate the Trec without a reservation… but the prospects are not the best: a friend meanwhile warns the pensioner who has seen a note on the health authority website which reads: «Critical issues in the functioning of the portal and the TreC+ app. The technicians are at work.” The note is from November 3, 12 days ago. The son writes an email to the support of the company website explaining the case. Ulysses and Mario could exchange opinions on their respective adventures. In the end, only thanks to the courtesy of an official does he solve the problem and Mario can finally wait for a free position from the new doctor.
Now a new challenge will begin: whoever arrives first can reserve a place as soon as it becomes available.
Moral of the story: years ago everything was done in a short time and you could always find someone who could give answers and solve problems. Today, with digital technology, three people, Mario, daughter-in-law and son, have wasted hours and hours and only after days were able to enter Trec to see if they could get a change of doctor. It is an emblematic case of the dehumanization of the public service: the triumph of the smart, where hardly anyone takes care of the person.
If there’s a snag you’re left out. Mario found an official with a heart and after days he partially solved his problem. PS: Mario would have liked his name and surname to be put in the article and his real country of residence but it would be too simple for the health authority to resolve the case of the retired Mario and not that of all the Marios and Marias from Trentino.
How have recent reforms in the Italian healthcare system influenced patient-doctor relationships and the quality of care in Trentino?
Can you tell me more about the current state of the Italian healthcare system in Trentino?
As a professional website editor, I read with great interest the article you shared about Mario’s experience trying to change his doctor. It seems like this is a challenge that many people are facing in Trentino, Italy. From your perspective, how have recent changes in the Italian healthcare system affected people’s ability to access care and navigate bureaucracy? How have these changes impacted patient-doctor relationships and the overall quality of care? Additionally, could you expand on some of the specific challenges that Mario faced during this process, such as the lack of clear information and guidance from healthcare providers, the cumbersome online bureaucracy, and the long waiting times for appointments and support?
