The Italian Medical Association: history, purpose and function.

In 2015 an ample and challenging discussion regarding professional associations is under way in Italy. Professional associations are self-government institutions that control and monitor the correctness and quality of the activities of the professionals registered in professional records recognized by the law. Professional associations have to prepare and update both their official registers and their deontological codes (1). A number of Italian professional associations were born between the end of the nineteenth century and the beginning of the twentieth century, and their rise represented the adaptation of ancient corporations to the structure and role of the modern Italian State. Professional associations were founded to define precisely the social functions of different professionals and, principally, to guarantee specifically the rights of individual citizens and to safeguard the interests of the whole community (2). The Italian Kingdom was established in 1861 and, a year later, the Italian Medical Association was founded. From this association the Italian surgical association and the Italian hygiene association derived, while in 1874 general practitioners of the time founded the national association of municipal physicians. The latter institution established in 1875 a retirement fund for its affiliates. The national federation of health orders, including the delegates of every Italian medical association, appeared in 1898 (3). The Italian association of physicians, pharmacists and veterinarians was constituted by law 445 of 1910, and the regulations for this law were published in 1911. This law foresaw that practising physicians should be registered in a provincial record elaborated and updated by the corresponding medical association. In 1912 the federation of Italian medical associations appeared and, four years later, this federation achieved the objective that all practising physicians had to be registered in this medical body. During the fascist period, in 1923, the Italian medical association, with law 563 of 1926, was formally established as a fascist medical trade union. This union was called upon to guarantee the role and interests of medical associations, while deontological issues and the preparation of medical registers were left to professional associations (4). With decree number 184 of 1935 professional associations in Italy were abolished, and their tasks and functions were taken over by the medical trade unions. After World War II, Italian medical associations were re-constituted by decree number 233, 1946 of the Provisory Chief of State, and the national federation of medical associations was reconstituted. The decree of 1946, together with decree number 221 of 1950 of the President of the Italian Republic and law 409 of 1985 (which officially instituted the health profession of dentists) are to be considered the fundamental normative references for Italian medical and odontoiatric professions (4-6). In the twentieth century, first, the medical associations of single towns (with Sassari and Turin among the first), and then the national federation of medical associations, prepared various editions of the Italian code of medical ethics, dating back to 1903, with successive editions roughly every ten or fifteen years to 2014 (3). In recent times decree number 137, 2012, of the President of the Italian Republic has provided a regulation reforming Italian professional associations,