From 2015 to 2022, medical managers' pay in Italy declined by 6.2%, while spending on permanent contracts fell by 2.8%. This is the conclusion drawn from the European Federation of Salaried Doctors (Fems) analysis, which was presented in a White Paper. The analysis is based on data provided by labor unions and medical groups in 21 European nations. In terms of purchasing power, Italian doctors in specialist training rank fifth lowest in Europe, trailing only Spain, Greece, the Czech Republic, and Slovakia. On the contrary, countries like the Netherlands, Germany, Austria, and Sweden invest heavily in salaries from the start of their careers in order to attract and retain experts. This analysis revealed an interesting fact: in addition to traditional leaders such as Germany, France, Austria, and the Netherlands, other countries are investing significantly in healthcare, with the goal of countering professional flight and preventing a health personnel shortage.