Let me just tell you a little story to illustrate just how Italy works.
…or, DOESN’T work.
Awhile back I decided to get my nose and sinuses checked out. Work started late this year so I took advantage of my time off in September and went to my general practitioner to get a reference for an ear, nose and throat doctor. Cost: Free.
Then, I went all the way to the hospital a few towns over, after being told it had a great doc, to book my appointment at the hospital’s CUP (centro unico di prenotazione). As is the method, I took a number and waited…and waited…and waited. After 80 minutes I was finally able to meet with a teller who arbitrarily gave me a date. See, Italy’s large, stressful, dated bureaucracy still runs on the presumption that people have real, actual contracts. That people actually get hired and that said people can just leave work willy nilly with no consequences or repercussions from their places of business. That is not my experience.
I, personally, am paid hourly and out of all of my friends here, I only have three who have a contract a tempo indeterminato, that is, hired with all the job benefits that come with it (i.e. extreme job protection, possibility to take sick leave, visit a doctor etc).
Instead of getting into all that, I kindly asked the woman if we could book an appointment for a Tuesday morning or a Friday, when I’m sure I can be free. The only option during that time frame was in December, and since none of this is urgent I agreed and left with a red ticket in hand for an appointment at a clinic closer to my house on December 10th.
That is, until Monday November 4th when I found a voicemail left by said hospital. I listened in shock as the receptionist kindly informed me that my appointment had been “anticipated” from December 10th until November 6 – MORE THAN A MONTH EARLY. And on a Wednesday, no less. Surprised and a bit peeved, I went to my meeting and resolved to solve it the next morning.
I called the number back that had called me the next morning, Tuesday November 5th, and was told that it was the central line. For reservations, I’d have to call the hospital’s CUP.
No harm, no foul. On my lunch break I gathered all the necessary documents and information, found the correct number and called the hospital’s main reservation system. I was answered by call center worker no.1 who told me that though he could change my appointment, I’d do better to directly call the clinic near to me, since I’d risk to have to pay for the visit anyway, even if I didn’t fulfill the appointment, since you have to cancel 72 hours in advance. WHAT?!
(A brief explainer: though most things with the public healthcare system are free, visits with specialists do have a cost, though subsidized, and you are expected to pay the “ticket” before you go.)
Let’s pause to sum this up: I got a voicemail at 3:45 pm on November 4th that my appointment is now on November 6th at 11:15 am and if I don’t show up I’ll potentially get a ticket in the mail?! That’s not even 48 hours in advance!
Call center worker no.1 gave me a number for my local clinic though, which I thought was very helpful until I realized it wasn’t the right number. No worries, I found the correct number online and called. This sent me to a directory where I was meant to indicate which doctor I needed to speak to and any efforts to speak with a “nurse” by pushing 0 simply ended the call. Ever resourceful, I saw on my appointment info sheet that the appointment was for room 5. I looked at each individual doctor online and found that though there were two doctors in room 1, there was absolutely no doctor for room 5.
So, back to the hospital’s central reservation system. There, a woman not-very-kindly informed me that though they handled the hospital’s reservations, my local clinic wasn’t considered a part of that. Odd, since my local clinic is considered a branch of the hospital. Used to this hectic, rude Italian system I didn’t give up as easily as my Midwestern roots would have preferred. Instead, I pushed on. After all, the hospital manages all these other branches. It’s all one system. Nevertheless, the woman was not minimally fazed. I meant nothing to her. No matter what I said, we couldn’t seem to understand each other. She shut down each time I brought up the local clinic again. (Remember, I booked the appointment at the local clinic via the main hospital’s reservation system.) She gave me the same number as call center worker #1. In my last attempt to stick up for myself, I told her so: that that number was for a different city and not the hospital’s city and she said that my local clinic was managed by them. There was no picking at this ice witch. I called the number.
A woman with a nice voice answered, but nevertheless I was promptly criticized for calling that number. They are two separate jurisdictions, she said, not at all related and there’s nothing she can do for me.
No officially pissed and fast running out of options. I called back the hospital’s main reservation system. I thought that come hell or high water I’d get someone to help me. But oh how I underestimated the ignorance, the apathy. On my third call I was answered by call center worker no.3 (who I’m not at all convinced wasn’t the same as ccw no.1) who promptly told me that they don’t do appointment changes.
No no no, I told him, on my appointment information sheet it says “to make, modify or cancel a reservation” call this same number. “Eh no,” he said, “we don’t do that.” To which I responded with a passionate, “Then what do you do?!?!” Ccw no. 3 kept his cool though – he didn’t care an iota. Try the hospital’s main reservation system, he replied, this is just a call center.
Guys, I’m not proud of this, but I hung up and promptly lost my shit.
How can you win with a system like this? No one to turn to. No logic. No sense. No easy-to-follow numbers or phones that are actually answered.
The easiest thing would have been to just not show up, but I was terrified by the idea that I’d get the ticket in the mail to pay, and who would I have to call then?!
As with most things in Italy, the only way to fix this mess was in person. The next morning I woke up early and went to the clinic before work, where the woman promptly told me to wait because she “hadn’t even turned her computer on yet.”
My request for a Tuesday morning or Friday appointment was met with a solid “no.” Just like that. My explanation of who I called was met with “lascia perdere” or “just forget about them” noting the call center’s uselessness…
You know, there are a lot of great things about the Italian healthcare system, but the bureaucracy is not one of them.
In the end, I canceled the appointment completely. Next time, I think I’ll go private.