Naples Family Doctors Push Back Against Single Role Model, Citing Staff Shortages and Declining Morale

Naples, Italy – Family doctors in the Campania region are voicing strong opposition to the “Single Role” model for general medicine, arguing it has contributed to a growing crisis in primary care access, particularly in internal areas. The Italian Doctors Union of Campania is advocating for a new pact for general medicine to rebuild trust in the doctor-patient relationship and restore the clinical focus of the profession.

The Debate Over the Single Role

The “Single Role” concept, originating around 15 years ago with the Balduzzi Law, aimed to unify the services of Family Doctors (MF) and Continuity of Care (CA) – formerly Medical Guard – to improve coordination of territorial medical services. However, critics argue this unification never materialized, instead leading to a duplication of doctors functioning as Family Doctors. The union contends that the intended cooperation between MF and CA, through Territorial Functional Aggregations (AFT), was deliberately not implemented.

Growing Concerns Over Staffing and Burnout

The resistance to the Single Role comes amid increasing concerns about the sustainability of general practice in Campania. More young doctors are leaving the profession, and experienced doctors are seeking early retirement. In December 2025, a regional call for general practitioners in lacking areas of Campania received applications for less than half of the 704 available positions. Il Mattino reported that approximately 700 new doctors are expected to be assigned in Campania, exceeding the current ranking of 450.

Impact on Internal Areas

Internal areas of the Campania Region are disproportionately affected by the shortage of general practitioners. The situation is particularly acute in the ASL Napoli 2 Nord District 38 Marano of Naples, where many citizens are currently without access to a regular doctor due to unsuccessful recruitment efforts. A public assembly is planned in Marano to address these critical issues, focusing on the Single Role and generational turnover in the profession.

Union Calls for a New Approach

The Italian Doctors Union of Campania is firmly rejecting the Single Role model and is committed to supporting doctors in reasserting their role as clinical references within the community. They advocate for a system that allows doctors to maintain their own clinics and focus on direct patient care. Cronachedellacampania.it reported that approximately 150 family doctors protested at Palazzo Santa Lucia in September 2025 against a regional supplementary agreement they believed would transform them into “de facto employees, without protection or autonomy.”

Broader Issues in Campania Healthcare

These concerns are part of a wider context of challenges facing healthcare in Campania. Cronachedellacampania.it highlighted issues with the 118 emergency service in Naples in December 2022, citing a lack of incentives and staff shortages. The ongoing debate reflects a broader need for reform and investment in primary care to ensure access to quality healthcare for all residents of the region.