Problems with the Red Cross: Swiss osteopaths fight for their existence

There is a risk of a complete professional ban

Daniel Piller from Bern studied physiotherapy and then trained as an osteopath for five years while working. In 2012, he completed his master’s degree at Innsbruck University of Applied Sciences and began practicing in Switzerland. By his own assessment, he is better trained than most osteopaths practicing in Switzerland. Now he is threatened with a total ban on his profession due to a change in the law. From 2025, only those who have studied in Switzerland or have an equivalent educational qualification will be allowed to practice osteopathy in Switzerland. The latter is denied in the case of Daniel Piller.

Many osteopaths in Switzerland look like Piller. The reason is simple: training for this young form of alternative medical therapy has not been available in Switzerland for very long. The Freiburg University of Health has only been offering the Bachelor of Science in Osteopathy since 2014. The annual number of participants is limited to 30; the first graduates graduated in 2019.

“Very protectionist recognition practice”

Most active osteopaths therefore have a foreign educational qualification. The Association of Academic Osteopaths Switzerland (Vaos) estimates the number at several hundred.

The Swiss Red Cross (SRK) is responsible for examining foreign diplomas. But there is a big problem when it comes to approvals: the SRK recognizes virtually no foreign master’s degrees: in 2021 there were only three approvals, in 2020 none at all. In a position paper, Vaos speaks of a “very protectionist recognition practice” of the SRK.

The SRK does not consider the master’s degrees of the Innsbruck University of Applied Sciences, such as that of Daniel Piller, comparable to the profession recognized in Switzerland. But with this assessment, the SRK was rejected by the Federal Administrative Court. The lawsuit was filed by Emanuel Diekmann, who runs a naturopathic practice in Chur and, like Piller, has a master’s degree from Innsbruck University of Applied Sciences. During the recognition process, the SRK refused to even investigate the equivalence of this diploma. Reason: In Austria, neither the profession nor the training are regulated. The Federal Administrative Court saw it differently. The judges ruled that Diekmann’s diploma was a state-recognized training certificate. The SRK therefore had to go through the books again.

SRK refuses again

The responsible SRK committee has again rejected the recognition. This time with a different argument: the job profile of the osteopath in Austria is not comparable to that in Switzerland. In Austria, a doctor must refer the patient to an osteopath. In Switzerland, osteopaths can also work as so-called first responders. A medical referral is not necessary. This allows osteopaths to make a medically sound diagnosis.

So you need to determine whether the symptoms can actually be cured by osteopathic therapy – or whether the patient would be better off with conventional medical treatment. Due to these differences, the SRK came to the conclusion that it was not the same or a comparable profession. The application for recognition was therefore not even processed.

Violation of the prohibition of discrimination?

An expert report comes to a different conclusion. It was written on behalf of the Osteopathic Association by Astrid Epiney, who teaches European law at the University of Freiburg. She examined the conditions under which an application for recognition must be submitted. Their conclusion: the comparability of professions can only be denied if there are very large differences between the areas of activity involved; The ‘primary care nature’ of an activity alone is not sufficient.

And even if the similarities were not significant, it would have to be assessed whether refusing recognition would violate the prohibition of discrimination enshrined in the Agreement on Free Movement of Persons. A ‘general’ refusal to respond to an application for diploma recognition is not admissible if parts of the activities in the home country and the host country overlap. “The SRK’s argument therefore does not seem convincing,” says Epiney in summary.

The SRK does not wish to comment on the Diekmann case due to the ongoing procedure. “We must adhere to the applicable legal principles in the recognition process. Adjustments to these laws do not fall within the SRK’s area of ​​responsibility,” says a spokeswoman for the SRK.

The Federal Administrative Court has the final say

The final word once again lies with the Federal Administrative Court. It is quite possible that the case will then be sent back to the Red Cross for reassessment. Time is running out for the affected osteopaths. They must have a recognized diploma by February 2025 at the latest. At the rate the SRK and the courts have shown so far, this is an impossibility.

Patient Sofie Lehner has no understanding of the legal wrangling. «Daniel Piller guided me medically and personally through a difficult time. For me, his competence is beyond question. I find the idea that he would be banned from working due to a lack of specialist knowledge and skills absurd.”