Frosinone, Italy – A physician in the province of Frosinone is at the center of a growing controversy after reportedly earning over €35,000 in January 2026, prompting a national debate about Italy’s strained public healthcare system and the use of temporary, high-paid medical staff. The case has ignited scrutiny over staffing shortages, unfilled positions and significant pay disparities within the Italian medical field.
The physician, described as a “gettonista” – a doctor paid per shift – accumulated the substantial earnings while working in hospitals throughout the province. The situation has drawn criticism from medical professionals and politicians alike, highlighting systemic issues within the Italian National Health Service (SSN). The Asl di Frosinone, the local health authority, has acknowledged the payment but framed it as a result of exceptional circumstances and a temporary staffing crisis.
The Asl di Frosinone clarified that the €35,000 figure represents a gross amount calculated based on standard rates for hours worked. January, the health authority explained, was a “perfect storm” – a confluence of a seasonal influenza peak, routine medical staff absences, and a delay in the launch of a new emergency service contract initially scheduled for January 1st, but ultimately postponed. The reliance on temporary doctors, the Asl stated, was the only way to keep the province’s four emergency rooms operational. A recent competition to hire 20 emergency doctors, however, received zero applications, underscoring the severity of the staffing challenges. The Asl reports the situation has stabilized as of February 15, 2026, with the implementation of the new contract designed to create a more efficient model.
Concerns Over Workload and Patient Safety
The controversy extends beyond the financial aspect, with concerns raised about the physician’s workload and potential impact on patient safety. Matteo Bassetti, Director of Infectious Diseases at the Policlinico San Martino in Genoa, analyzed the reported earnings and estimated the doctor worked 442 hours in January – equivalent to approximately 36 twelve-hour shifts. “Working 442 hours in a month means working 6 days for 24 consecutive hours and the other 24 for about 12 hours a day,” Bassetti wrote on social media, questioning whether such a schedule could compromise patient care. Bassetti further questioned if errors could occur with such demanding hours, particularly for a physician over 70 years old.
Pay Disparities Fuel Debate
The case has also highlighted significant pay disparities within the Italian medical system. Bassetti pointed out that a newly hired structured medical officer earns, on average, less than €3,000 net per month, rising to approximately €4,000 for more senior staff. In contrast, the “super-gettonista” earned in one month what a full-time employee might earn in nearly a year. This discrepancy has prompted calls for a national regulation to standardize pay practices and address the reliance on temporary medical staff.
Roberto Burioni, a virologist, echoed Bassetti’s sentiments, stating, “Sante parole” – “wise words” – in response to Bassetti’s analysis. Alessio D’Amato, a regional councilor for Azione, has announced an urgent inquiry to the President of the Lazio Region, Francesco Rocca, demanding clarification on the use of gettonisti and the circumstances surrounding this particular case. D’Amato also indicated plans to file a report with the labor inspectorate and the Carabinieri’s NAS unit (special unit for health protection) to verify compliance with national and European regulations and assess patient safety.
Systemic Issues and Ongoing Reforms
The situation in Frosinone reflects broader challenges facing the Italian healthcare system. The Asl di Frosinone recently reached an agreement with unions and worker representatives regarding personnel planning, particularly in preparation for the opening of twelve community health centers and six community hospitals funded by the National Recovery and Resilience Plan (PNRR). The health authority has confirmed its commitment to internal mobility procedures to staff these new facilities by April 1, 2026.
The reliance on temporary medical staff, while a short-term solution to address immediate needs, raises long-term concerns about the sustainability and quality of healthcare services. The debate surrounding the Frosinone physician’s earnings is likely to intensify calls for comprehensive reforms to address staffing shortages, improve working conditions, and ensure equitable compensation for all medical professionals.
Looking ahead, the focus will be on the implementation of the new emergency service contract and the ongoing efforts to recruit and retain qualified medical personnel. The outcome of the inquiry launched by regional councilor D’Amato and any potential investigations by labor authorities will also be closely watched. The case serves as a stark reminder of the urgent need for systemic changes to safeguard the future of healthcare in Italy.
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