How can I get jaw surgery in Italy?

July 30, 2012 7:29 PM

This is pretty random. I had jaw surgery and it didn't come out as planned. I did some research and found a surgeon who works in Rome and I'm interested in consulting him for a revision. He has decades of experience and a particular technique that I think is the right one to fix it. Also, I was born in Italy and I'm an Italian citizen.

How the heck can I get in touch with an Italian surgeon from the US? It takes months to get walk in appointments, and I can't even make such an appointment without a health insurance ID card that I have to get in person, and it is made via phone operator and one must have a referral of some sort. Can I hire someone to facilitate this? Write a letter? Is it even feasible that I'd get in to see this surgeon, period? Is there some way to get this guy on the phone so I know if he can even potentially help me, before I spend 6 months on the appointment process?

Anyone with advice about Italian medical services would be very appreciated!!

posted by kellybird to health & fitness (4 answers total)

Having worked on the admin side of a surgeon's office, my guess is that you will have great difficulty getting him on the phone if you have never seen him before. I don't know anything about Italy's health care system, though... does this surgeon work on a private or public basis? Even though you are a citizen, unless you become an Italian resident I suspect it would be much easier to see him if he does work privately. Anyway, the following is general advice and has nothing to do with Italy.

The international patients my doctor saw fell into one of the following categories:
- made up for not having a local health insurance ID card or a referral by paying for everything out of pocket
- had a general or direct referral, ideally mentioning the doctor's special technique/research/knowledge, from a Dr in their home country
- ideally: had a referral directly to my doctor from a Dr in their home country who knew my doctor personally through research or past employment in the same place

Writing a letter is probably your last ditch approach (calling his clinic cold or emailing him are not likely to help at all). I don't think a letter is very likely to work, but it's possible.

The best thing to do would be to get a referral from a local doctor, preferably also a jaw specialist. (Assuming that a local doctor would agree with your opinion about the surgical technique likely to be most useful to you...? I hope you have explored this avenue in full and that your opinion about this technique isn't completely your own opinion, but has been backed up by medical advice?) You could send your referral in to the clinic and explain from there that it would be nice to have an idea of whether or not he can help you before you travel to Italy, etc.
posted by snorkmaiden at 8:04 PM on July 30, 2012

If you are a citizen, you should get an health insurance card. To get an appointment, the usual procedure is to get a referral from family doc to specialist. (In case you are not clear on this, a referral is nothing elaborate. It is just a simple piece of paper stating that the family doc office refers you to the specialist. I.e. it's possible to get a referral to the ob/gyn, ENT and the orthopedist at the same time. The family doc listens to your health issues and if it is above her/his expertise or if you request it, you get refered). That way the co-pay is low but waiting times can be a few weeks up to a few months.
If you pay out of pocket, waiting times are shorter.

Wikipedia says: "Surgeries and hospitalization provided by the public hospitals or by conventioned private ones are completely free of charge for everyone, regardless of the income. For the planned surgeries waiting times can be up to many months, especially in the big cities."

- You need to find out if it is possible to request an insurance card in your absence (maybe online/ maybe explain you are temporarily abroad / have a statutory representative act on your behalf). If it is not possible, you should get one in person.
- Call the surgeon's office and ask what it takes to get an appointment - maybe they have experience with 'foreign' patients w/o insurance card. Note I said above one could get an appointment without a referral? This might be the way to go for you if you can pay out of pocket and they accept patients w/o card.
- Connect with relatives. This is a time where one can call up a cousin and ask for some info.
-Plan your trip to Italy. Usually there is an initial visit and then they give you a date for the surgery. I don't know if one can speed up the process so everything happens within a week or whatever. Are you prepared for an extended stay or multiple trips?

If this is a non-medically indicated cosmetic surgery, other rules apply obviously.
Full disclosure: This is only general knowledge. I never used Italian health services.
posted by travelwithcats at 5:35 AM on July 31, 2012

In my (pretty exctensive, 40-year) experience you will not be able to get onto the state health system (SSN, Servizio Sanitario Nazionale), even as an Italian national, without becoming a resident, and becoming a resident takes a couple of weeks until the local cops have come by and checked that you really do live where you stated you do. Even my son, an Italian national, is having problems going through the hoops because he is studying in another country and is rarely long enough in Italy to sort it all out. So you will not have a GP family docctor to provide a referral on the SSN and therefore free (albeit delayed) medical treatment. So on the whole I think your chances of getting free treatment are pretty much zero unless you actually move to Italy to live, at least temporarily, and are looking at privately-paid treatment.
However, many Italian doctors, especialy surgeons, have opted for a system whereby they are allowed to do SSN-insured work for some of their professional time, and private consultancy for the rest of it. And once you are looking at privately paid treatment, I imagine you will have no problem whatever getting the surgeon's attention.
I see you have already identified a surgeon in Rome. If you're having difficulty contacting him/her, memail me and I'll try to get hold of an email address and/or fax number for you. But be aware that much of Italy is now closing down for the summer holidays (I am myself away from Rome base) so things may not go as fast as you might wish.
posted by aqsakal at 7:01 AM on July 31, 2012

I'm blown away by the thoughtful and informative responses. Thank you so much!!
posted by kellybird at 2:12 PM on July 31, 2012