Doctors and the State in Italy after 2020: Increased Weakness or Recovery By the Medical Profession?

In Italy, the sociological debate highlighted the creeping loss of power of the medical profession following the NHS managerialization and regionalization. The crisis in medical professionalism was identified in the loss of influence in the seven areas that had characterized its dominance in the past (Freidson 1970; Tousijn 2004): the political arena, the labor market, university education, professional associations, workplace, the system of interprofessional relationships in medicine, the scope of therapeutic relationships (Vicarelli 2017; 2024). Specifically, the low capacity to veto neoliberal policies and austerity policies in healthcare that were adopted in 2010s, was highlighted. This weakness has been interpreted in terms of low presence and limited incisiveness of the medical associations in the government, legislative arena and electoral arenas. However, compared to this scenario, the years of the Covid-19 pandemic have produced some changes in several dimensions of medial dominance, such as the labor market and university education control, as well as the ability to mobilize public opinion and affect policy-making. These ongoing transformations could indicate the beginning of new trends towards a re-assertion of the influence of the medical profession, despite the continuing reduction in health financial resources. The paper investigates this hypothesis by examining each area or dimension of medical dominance by carrying out a documentary analysis which is based on official and non-official sources. This is matched with semi-structured interviews to representatives of the main actors in the Italian healthcare policy arena.