Comunità professionali e percorsi strategici: il caso della nefrologia

The diffusion of multidisciplinary departments as the main organizational units in hospitals; the changing status of health professions and nursing in particular; the needs for new forms of integration between hospitals and primary and secondary care; the pressure for outsourcing services are the main forces changing the perspectives for the development of medical specialties. The research explores some critical areas for the future of the professional community of nephrologists and analyzes three different strategic options that can cope with the increasing demand for nephrological services, on the one hand, and the expected shortage of nephrologists in the near future, on the other. The article suggests a strategy based on a strengthening of the scientific position of the discipline, the devolution to other professions and/or organizations of non core activities, the diffusion of network forms of organizing.