At twenty years since the National Health Service we can acknowledge that the engagement of reformers can be deemed carded out: finally in Italy it has been warranted a physician for all Italians. But what a pity, it concerns `a' physician not Yhe' physician. If would seem only a grammar distinction, but between the two articles there's a great difference. Other than a dispute concerning'.the public medicine and the private one as the several publie opinion meddlers are crying out. Unfortunately nobody is aware of the fact that when an ill person needs to be cured he does not apply to anyone physician, maybe the one who lives next door or has the enrolling number 747 of the district where he lives or if he writes letters by computer, or has a pretty secretary and applies to the letter the eighty restrictive notes of the Drug Unique Commission orthat, when prescribing, he rigidly attends the several states or pathologies exemption categories or the enlightened bureaucratic norms related to the operating within national health practise. The patient does not search a physician, but he asks for the physician, he wants the physician he can trust, who has the scientitic, cultural and human background that makes him able to accept him, understand him, follow him and interpret his symptoms in a correct way since he has already had the chance to deepen or because he wants do deepen every matterconcerning the pathology affectíng him. To be cured by the physician he trust he is willing to go all the paths are needed, even if he does not live next door orin his district or in his Usl orAsl zo or whatever you want to call it He does not asksurely for the doctrine training that young physicians show at the end of their theoretical studies in ouruniversities, óuthe wants the practice training that cn be got on field, atter and accurate appreniiceship in operating theatres or in the Hospital wards, in First Aids or in the different specialist wards, where the good physician can be trained. While in the mazes of the Ministry of Health are being studied the criteria to succeed in standardising at the utmost the medical performance, what the operating within the national health service physícian must do within the frame oí union trust and political agreements and that warrant the tutelage of the healthy people health, ill persons search desperately `the physician'chargingtheirproblems, readyto ~ suffer with them and able to exactly understand for them which is the pathology thaf affects them and whom they can trust. To solve the Italian medicine problems first it would be necessary to take a sponge and to delete from mind all the currentlegislativenormsconcerning physician performances. It is necessary. to work it again writing all starting from scratch, from common sense and from the basic rules ofa good medicíne: just today! It is necessary to revise the feaiures of performances to be supplied, warranting.a continuos updatingofphysicians who mustbe well paid on the basis of the engagement involving their intellectual work-done and not on the basis of the number of patients on charge or of ihe money the Health budget can save or the number of cigarettes they are able to make their patients not to smoke (the last clever idea of the ASL ). The standardization of the physician's work cannot bring anywhere but to his demotivation and to the compleie undoing of medicine. It's already indispensable to gei out of this tunnel that brings only to a bad State medicine and that will never become a good medicine since two differentmattersare under discussion: fhey are not the same topic.

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