Thursday, January 31, 2019

United We Fall

drawing by Suzanne Dunaway
Doctors have professional organizations in both Italy and the US, but their purposes are light-years apart. Where the American Medical Association is basically a lobbyist for doctors, the equivalent on this side of the Atlantic, the Ordine dei Medici, is more like a police force. I’ve visited their Rome office exactly five times, and I remember every one:

 1)    In 1979, to find out how to get my American internal medicine specialty recognized. That didn’t take long: “You can’t.”

2)    In 1998, to peddle an old pulmonary function testing machine by tacking up a For Sale notice on the Ordine’s cork bulletin board. No buyers materialized, but some employee with nothing better to do noticed the words “Diplomate, American Board of Internal Medicine” on my letterhead, and sent me a registered letter enjoining me to remove them. Turns out you’re not allowed to mention foreign specializations. I took the appropriate action for any old Italy hand, i.e. I did nothing whatsoever. The ABIM is still on my letterhead – they never followed up.

3)    In 2004, to buy passes to drive into the center of Rome, a prerogative reserved for residents and for docs on house calls. We had always had free dashboard permits, but suddenly City Hall announced it would start charging for the privilege. I lined up at the Ordine dei Medici along with hundreds of other colleagues dumb enough to take the initiative seriously, forked over a 10 euro note that they said would be good for ten single entries, and received a receipt that stated the passes would come in the mail. Did any passes come in your mail? No? Well none arrived in mine either. Good thing I hadn’t thrown out my old dashboard permit.

4)    In 2005, to try putting my first Aventino Hill office on a more formal legal footing. My two partners and I partners trooped over to the Ordine for an hour-long briefing from their lawyer, taking careful notes on his advice. Fortunately we didn’t act on it – we learned later from unimpeachable sources that he had been wrong from A to Z.

5)    In 2010, to defend my second Aventino Hill office, soon after we moved in. Our neighbors sicced the Ordine on us, after sending around the Carabinieri, the Health Department, and the Lazio Region, as part of their unsuccessful campaign to kick us out of the building. (The one agency they never snitched to was the IRS – fearful of drawing attention to their own tax returns?) The Ordine called us in for interrogation, and then mailed a ten-point accusation in impenetrable legalese to which we promptly, humbly, and painstakingly replied. A year later, when we hadn’t heard back, we phoned to make sure they’d dropped the charges. No, they just hadn’t gotten around to looking at our letter yet. They finally did read it, and grant their absolution . . . in 2013.


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  1. I was there with you the last two times!

  2. Oh, boy, were you ever!!! And you were the one who figured out that the lawyers didn't know what they were talking about, and you were the one who wrote that endless letter in reply to the Ordine's accusations!

  3. I hope you don't pay dues to this organization!!

    1. One hundred fifty smackeroos! To be fair, though, it does include the permit to practice medicine. The New York State medical license I kept up for 3 decades after I moved here currently costs $600 every two years.

  4. Hilarious (in a sad way)

    I remember the university bureaucracy in Padova

    In order to take the national boards exam to try and transfer back to the states, one had to have a form filled out by the school registrar to prove you were enrolled in an overseas medical school--In the US, that form and ONLY THAT FORM would be accepted as proof of enrollment

    However Italian law (we were told) says no paperwork (or exams) are allowed to be done in any language but Italian (I think, but don't really know, to prevent use of local dialects)

    What I ended up doing was get a notarized translation of the American form on a carta bollata, stapling it to the original form, and then sought out a sympathetic clerk who would consider signing it with the University seal--crying helped (In retrospect, I was a rather cute 20enne--that probably helped too)

    A letter of explanation accompanied the stapled forms. It worked. And I did eventually transfer back to the U of Michigan medical school

    1. ha! The irresistible force meets the immoveable object! I wonder whether you would have been as successful in wheedling the American side into being so flexible…