Doctors barred in Switzerland: an A-Z list and key info

What is a doctor’s licence to practise?

Anyone who treats patients under their own professional responsibility needs a cantonal licence to practise or operate. This is because from a legal perspective, our balance of interests prioritizes health over economic freedom. In their capacity as health regulators, the cantons are responsible for issuing these licences in order to guarantee patient safety. It also falls to them to caution and fine health professionals and facilities and to revoke their licences if they put patients at risk.

The issuing of licences to practise is regulated in the Swiss Medical Professions Act and implemented by cantonal health authorities. Doctors need a licence from each canton in which they practise under their own professional responsibility. The licence must be renewed every 10 years.

Who needs a licence to practise?

All health professionals who diagnose, treat or care for patients under their own professional responsibility require a licence to practise from the canton in which they work.

Doctors practise “under their own professional responsibility” when they perform an independent activity in a practice or have a leading position in a hospital (e.g. chief or senior physician). This does not apply to doctors who are still in training and under the supervision of a doctor with a licence to practise in the same specialist field.

Other university-trained medical professionals requiring a license to practise under their own professional responsibility include dentists, pharmacists, chiropractors and veterinarians. Non-medical professionals, such as physiotherapists and psychotherapists, also need a licence to practise.

What conditions must a doctor fulfil in order to get a licence to practise?

According to the Medical Professions Act (MedBG Art. 36, link not available in English), doctors can submit proof of the following to the cantonal health authorities in order to obtain a licence to practise:

• Swiss medical degree (or confirmation of recognition by Swiss authorities if the degree was obtained abroad)

• Confirmation of trustworthiness (e.g. extract from the register of criminal records or a certificate of good standing from a health authority)

• Certificate attesting to physical and mental fitness to practise

• Swiss specialist title (or confirmation of recognition by Swiss authorities if obtained abroad)

• Evidence of proficiency in one official language of the canton issuing the licence

Depending on the canton, there may be additional requirements, such as working full-time in a recognized Swiss teaching hospital for three years.

How is it possible for a doctor to continue practising despite being barred?

It is illegal for doctors who have had their licence revoked or denied to continue practising under their own professional responsibility, and they could face criminal charges if they do so.

Research carried out by SRF (Rundschau, 10 vor 10, links in German only) and other news agencies shows there are loopholes that doctors can exploit in order to continue working without a licence. There are three ways to do this:

1. Continue working in a different canton

A doctor is only barred in the canton that issued the barring and not in the rest of Switzerland. This means that a doctor can be banned in one canton but still have a valid licence to practise in another. Although the canton that barred the doctor is obliged to inform the other cantons, this does not always result in the doctor being barred elsewhere.

2. Continue working in the same canton

Barred doctors are not allowed to continue practising under their own professional responsibility. However, it is possible for them to be employed in a role with no professional responsibility. Whether this doctor is then supervised by a doctor with a licence to practise in the interests of patient welfare varies from case to case.

3. Continue working across the border in a different country

In this case, doctors barred from working in Switzerland open a practice in a neighbouring country and target patients in Switzerland, as different licensing rules apply in different countries.

The authority to issue and revoke licences to practise lies with the cantons. They are also obliged to check that the law is being observed. Licences to practise must be renewed every 10 years. In between, there are hardly any inspections, unless a serious breach of duty of care is reported.

Find out more about breaches of duty of care and dealing with medical errors.

For what reasons can doctors have their licences revoked?

Doctors only have their licences revoked if there are sound reasons to do so and they no longer meet the requirements for practising under their own professional responsibility. Fundamentally though, it takes a lot for a licence to be revoked.

Possible reasons for revoking a licence to practise include (following links in German only):

• Series of botched treatments (e.g. in St. Gallen, Lausanne and Aargau)

• Billing fraud and embezzlement (e.g. in Bern and Aargau)

• Endangering patient well-being (e.g. in Zurich and Aargau)

• Sexual assaults on patients (e.g. in Appenzell Ausserrhoden, Basel and Zug)

Where can I check whether my doctor has a licence to practise?

At the beginning of this article, there is a list of doctors whose licences have been revoked or denied. Doctors who do not appear on this list have a valid licence to practise or have never had their licence revoked or denied by a canton.

In the medical directory at comparis.ch, a warning appears on the profile of any doctor whose licence to practise has been restricted, revoked or denied. Some 38,000 doctors practise in Switzerland. According to the Swiss register of medical professions (MedReg), 108 doctors have been barred in one or more cantons.

I received treatment from a barred doctor. What should I do?

If you received medical treatment from a barred doctor, there are both legal and financial aspects to consider.

Legal steps: patients who have been treated by a barred doctor should notify their cantonal authority. They will initiate the prosecution process. The patient organizations Patientenstelle and the Swiss patient organization (SPO/OSP) can support you through this process (both links not available in English).

Financial aspects: health insurers only pay the invoices of doctors who have a licence to practise and a valid paying agent register number (ZSR number). If you received treatment from an unlicensed doctor, you will probably have to pay the bill yourself, as a case involving Visana (only available in German) revealed in 2019.

It is therefore imperative that you find out before your appointment whether a doctor has a licence to practise. So far, cantons have failed to take any consistent action against doctors whose licence has been revoked by another canton. As Erika Ziltener from the patient organization Patientenstelle explained to SRF (only available in German), the cantons should take this responsibility more seriously.

Find out more about breaches of duty of care and dealing with medical errors.

What if my doctor does not have a valid licence to practise in my canton?

If there is no warning on their profile, all the doctors in the Comparis medical directory are permitted to practise either under their own professional responsibility or under the supervision of a doctor with a licence to practise (because they are still in training, for example).

Does a licence to practise reveal anything about treatment quality?

A licence to practise confirms that a doctor satisfies the requirements for treating patients under their own responsibility. This licensing process is designed to ensure patient safety.

A licence to practise therefore confirms that the doctor has completed the relevant training and is permitted to practise under their own professional responsibility.

If you want to find out more about how suitable a doctor is for a particular operation or type of treatment, you could, for example, check whether the doctor has the appropriate specialist titles (see medical directory). You can also ask how often the doctor has performed an operation or carried out a treatment before, and find out how quickly former patients with similar conditions recovered and how sustained their recovery was. After all, a person may have an excellent track record in one field but have very little experience in another.

Note also that the register of medical professions only indicates whether doctors have had their licence to practise revoked or denied. There are no public records of doctors who have received a warning or fine due to malpractice or botched operations, as SRF (only available in German) determined in 2019.

Comparis has compiled some tips on how to find a good family doctor.

Sources (some links not available in English)

• MedReg

• Fedlex

• Federal Office of Public Health (FOPH): frequently asked questions (FAQs) about MedReg

• FMH: the doctor as an employee or employer

• FMH: framework conditions for medical work

• FMH: admission control