Italy’s Pediatrician Shortage: Regional Gaps and Future Risks
Italy is facing a critical shortage of at least 497 primary care pediatricians, with nearly 80% of these gaps concentrated in Lombardia, Piemonte, and Veneto. According to a GIMBE Foundation report, this crisis is compounded by 1,547 upcoming retirements by 2029 and a systemic struggle with medical waiting lists that left millions of visits delayed in early 2026.
Why is there a pediatrician shortage in Northern Italy?
The shortage stems from a gap between the available workforce and an optimal care ratio of one pediatrician per 850 patients. GIMBE Foundation data from January 1, 2025, reveals a total deficit of 497 pediatricians of free choice (PLS).
The crisis is heavily skewed toward the North. Lombardia, Piemonte, and Veneto account for 78.7% of the shortfall, with 186, 109, and 96 missing doctors respectively. Some areas have already pushed past the maximum limit of 1,000 patients per physician.
While five regions—Abruzzo, Emilia-Romagna, Lazio, Puglia, and Umbria—currently report no shortages, the overall trend is sliding. In January 2024, nine regions were shortage-free; now, only five remain in that category.
How does the transition from pediatric to general care work?
The role of the pediatrician of free choice (PLS) is to protect the health of children and adolescents from ages 0 to 13. ISTAT data shows that as of January 1, 2025, over 2.4 million children aged 0-5 were mandatorily enrolled with a PLS.
Between the ages of 6 and 13, parents have a choice. They can keep their child with a PLS or move them to a general practitioner (MMG). This group includes over 4 million minors, whose care depends on parental preference and local doctor availability.
Care typically ends automatically at age 14. However, extensions are possible up to age 16 for children with documented disabilities or chronic pathologies.
How will upcoming retirements impact child health?
The system faces a looming “generational cliff.” Data from the Italian Federation of Pediatricians (FIMP) indicates that 1,547 pediatricians will retire by 2029 as they hit the age limit of 70. There’s currently no certainty regarding a new generation of doctors to replace them.
This shortage could clash with new policy goals. The “Schillaci Reform” suggests that extending pediatric care up to age 18 would require over 3,500 additional pediatricians to maintain adequate care standards.
Nino Cartabellotta, president of the GIMBE Foundation, warns that regional averages often hide deeper pain. Local shortages could be even more critical in mountain areas, internal regions, or within large metropolitan cities.
Why are medical waiting lists still growing?
Despite reports from the National Agency for Regional Health Services (AGENAS) suggesting a general trend toward improvement, the numbers tell a harder story. In the first four months of 2026, nearly 2 million visits and exams were delayed.
The delivery rate is particularly low. Only 50% of prescribed first visits and 54% of exams are actually performed, meaning roughly one out of every two prescriptions is lost.
Some regions are failing to show any progress. These include Abruzzo, the Autonomous Provinces of Trento and Bolzano, Piemonte, Sardegna, Sicilia, and Valle d’Aosta.
What solutions are being implemented to fix the system?
AGENAS has introduced a new monitoring platform to track these delays. Success has been seen where multiple tools are used at once, such as centralized agendas and financial incentives for doctors to work extra hours.
Other strategies include opening diagnostic services on weekends and using “recall” systems to contact the 20% of patients who book appointments but don’t show up. AI software is also being used to optimize schedules and fill empty slots.
However, AGENAS warns that simply increasing the supply of appointments could create a vicious cycle of exponential demand. A possible next step is focusing on “prescriptive appropriateness” through the RAO (Homogeneous Waiting Groupings) model and using teleconsultation between general practitioners and specialists.
Frequently Asked Questions
What is the optimal ratio of patients to pediatricians according to GIMBE?
The optimal ratio is one pediatrician of free choice (PLS) for every 850 patients.
Which regions have the highest shortage of pediatricians?
Lombardia (186), Piemonte (109), and Veneto (96) concentrate nearly 80% of the national shortage.
What percentage of prescribed medical exams are actually delivered?
According to AGENAS data, only 54% of prescribed exams are translated into delivered services.
Do you think integrating AI into medical scheduling is the best way to reduce healthcare waiting lists?