Doctors without permits in Switzerland: a worrying trend

Context

TL;DR

• 36 doctors banned in Switzerland in 2022, but a third still practice.
• Cantonal fragmentation allows banned doctors to practice elsewhere.
• Switzerland lacks access to the EU's IMI registry for doctor checks.

Key facts

• Number of banned doctors: 36 doctors banned in Switzerland in 2022.
• Case of Nicholas: A 22-year-old patient died due to a medical error by an unrecognized doctor in Aargau.
• Conviction date: Two doctors were convicted in February 2025 in La Chaux-de-Fonds.
• MedReg registry: Created by the Federal Office of Public Health to verify doctors' authorization.
• EU IMI registry: Switzerland does not have access to the EU's IMI registry for doctor checks.
• Cantonal responsibility: Authorization to practice is granted by cantonal doctors, who are responsible for checks.
• Doctor shortage: Switzerland faces a shortage of doctors due to the numerus clausus.
• Transparency issue: Patients cannot always verify their doctor's qualifications due to system limitations.

In 2022, 36 doctors banned in Switzerland, but a third continue to practice. The cantonal fragmentation of controls facilitates these deviations.

The case of Nicholas

The story of Nicholas, a 22-year-old patient who died following a medical error in an Aargau hospital, shook German-speaking Switzerland. At the heart of the case: an overdosage treatment prescribed by a doctor whose diploma was not recognized in our country. In February 2025, two doctors were convicted in La Chaux-de-Fonds.

Gaps in the system

"There have been several investigations that have shown the existence of various gaps," explains Baptiste Hurni, Neuchâtel State Councillor and Vice-President of the Swiss Patients' Organization. "A regulated profession only works if you trust the administration that controls it."

Cantonal responsibility

Authorization to practice is granted by cantonal doctors, who are therefore responsible for the checks. "There are several documents that professionals must provide us with," specifies Alessandro Cassini, cantonal doctor of Geneva. "Among these is the good standing, a declaration of good conduct from the doctor, but also the criminal record and other documents."

The problem of fragmentation

However, some doctors struck off in one canton can find themselves practicing elsewhere in the country. "It is unacceptable," denounces Michel Matter, president of the Association of Doctors of the Canton of Geneva (AMGe). "In Switzerland, if you have your right to practice revoked, you can go to another canton."

The MedReg registry

For eight years, there has been a registry, MedReg, created by the Federal Office of Public Health, which allows patients to verify if their doctor has the right to practice. However, the tool has its limits. A doctor without authorization is not necessarily a bad doctor. "It may be, for example, a doctor in training or a doctor whose diploma is in the process of being recognized," specifies Baptiste Hurni.

The shortage of doctors

The shortage of doctors worsens the situation. François Consolini, a retired doctor, sums up the dilemma: "There is a lack of Swiss doctors due to the numerus clausus. You take what you find. We have no choice. You have to make do with whoever comes along."

Switzerland excluded from the European registry

The European Union has its own control tool: the IMI registry (Internal Market Information System). This alert system allows member countries to exchange information on doctors who have been struck off or who have falsified their diplomas. Switzerland does not have access to it.

Random reports

Jean-Philippe Haesler, president of the Swiss Society of Dentists, has paid the price for this gap. "Two years ago, we were reported the case of a person who had falsified their diploma. It had been proven in a neighboring country, but this person was practicing freely in Switzerland." A second case emerged shortly afterwards. "A person struck off by the medical order of a neighboring country was practicing in several Swiss cantons," recalls Jean-Philippe Haesler.

Awareness of the authorities

Jean-Philippe Haesler informed the Federal Office of Public Health and Federal Councillor Elisabeth Baume-Schneider. "She did not promise me anything, but she confirmed that she takes the situation seriously. She has become aware of it."

Operational details

Implications for Cross-Border Workers

The phenomenon of doctors practicing without permission in Switzerland has significant implications for cross-border workers residing in Ticino and working in Switzerland. The lack of centralized control and limited access to the European registry make it difficult for patients to verify their doctors' qualifications.

Trust in the Healthcare System

Trust in the Swiss healthcare system is fundamental for cross-border workers. The possibility of unauthorized doctors practicing can undermine this trust. 'We trust the doctors. Often, their diploma is displayed in the waiting room. We see that they have studied. But beyond that, we can't know,' observes Raymonde Girard, a patient in Le Locle.

Control Procedures

Control procedures vary from canton to canton. 'If we see something that doesn't add up, we investigate with all the tools at our disposal, even by summoning the person,' continues Alessandro Cassini. However, enforcing the ban is complex. 'How do you do it? If tomorrow I lose the right to practice and on Monday I hold consultations, how can anyone notice? You would need to put a police officer in front of every practice,' asks Dominique Bünzli, a member of the Neuchâtel cantonal medical society.

The Need for Legislative Change

'Of course, the different administrations talk to each other, but there can be multiple procedures, up to the Federal Court. The law needs to be changed,' states Michel Matter. Legislative change could improve the situation, but it requires time and coordination among the cantons.

Practical Challenges

Even when authorization is not granted or is revoked, enforcing the ban is complex. 'We assume the person will respect the decisions. It's like with a driver's license: if it's revoked, you're not supposed to drive anymore. But some people continue until they are caught.'

Consequences for Patients

The consequences for patients can be severe. Nicholas's story is a tragic example of what can happen when controls are inadequate. 'A doctor without authorization is not necessarily a bad doctor,' clarifies Baptiste Hurni. However, the risk is real, and patients must be aware of the system's limitations.

Possible Solutions

A possible solution could be Switzerland's access to the European IMI registry. This would allow for more effective information exchange between member countries and Switzerland. However, this requires negotiations and bilateral agreements.

Collaboration Among Cantons

Collaboration among cantons is essential to improve controls. 'The different administrations talk to each other, but there can be multiple procedures, up to the Federal Court,' states Michel Matter. A more centralized and coordinated system could reduce current gaps.

The Importance of Transparency

Transparency is fundamental to maintaining patients' trust. The MedReg registry is a step in the right direction, but it needs to be improved. 'We can't know if our doctor is good,' observes Raymonde Girard. Greater transparency could help patients make more informed choices.

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Key points

What to Do If You Suspect a Doctor Is Practicing Without a Permit

If you suspect that a doctor is practicing without a permit, it is important to act promptly. Here are the steps to follow:

1. Check the MedReg registry: Verify if the doctor is registered on the Federal Administration of Medical Professions website. 2. Contact the cantonal authority: If the doctor is not registered or there are doubts, contact the competent cantonal authority. 3. Report the case: Provide all available information to the competent authority. 4. Monitor the situation: Follow the evolution of the case and ensure that the authorities take the necessary measures.

How to Protect Yourself

To protect themselves, patients can take some precautions:

1. Verify qualifications: Always check the doctor's qualifications on the MedReg registry. 2. Ask for information: Do not hesitate to ask about the doctor's training and experience. 3. Cross-check information: Compare the information provided by the doctor with that available on the registry. 4. Report any doubts: If you have doubts about the doctor's qualifications, report it to the competent authorities.

Useful Tools

For further information and to verify doctors' qualifications, you can use the qualification verification calculator and consult the MedReg registry.

Conclusion

The phenomenon of doctors practicing without a permit in Switzerland is concerning and requires immediate action. Cross-border workers must be aware of the risks and take the necessary precautions to protect their health. Authorities must improve controls and ensure transparency to maintain patients' trust. Use the qualification verification calculator to ensure that your doctor is authorized to practice.

Source: rsi.ch