Healthcare Professions Ordinance (GbV) - Scope (GbV)

1. The Regulation

a. * determines the non-university health professions according to § 36 of the Health Act of September 13, 2005[2], which require a professional practice license according to § 16 paragraph 1 of this Act, regulates the professional requirements for these practice licenses, and establishes the specific rights and obligations associated with the practice of the profession for these and the professions that require a license according to the Federal Act on Health Professions (Health Professions Act) of September 30, 2016[3],

b. regulates the details for healthcare businesses according to § 37 paragraph 1d of the Health Act.

2. The professional autonomous practice of non-license-required activities in the healthcare sector is governed by the Ordinance on Non-License-Required Activities in Healthcare of December 16, 2008[4].

3. The professional autonomous practice of psychotherapy by persons who are not physicians is governed by the Psychotherapists Ordinance of December 9, 2008[5].

4. The details regarding the operating licenses for public pharmacies, mail-order pharmacies, private pharmacies, hospital pharmacies, and pharmacies of homes and other institutions as well as for drugstores and establishments that only store blood and blood products are regulated in the Medicines Ordinance of April 28, 2009[6].

5. The admission of professionals and establishments according to this ordinance for providing services covered by the mandatory health care insurance according to the Federal Act on Health Insurance (KVG) of March 18, 1994[7] is governed by the Cantonal Admission Ordinance of November 30, 2021[8].

1. The scope of activities defined in this regulation for other licensed professions in the healthcare sector must not be exceeded.

1. Notification of the commencement, transfer, and cessation of independent professional activity or business operations, as well as any change of name, must be promptly reported to the office responsible pursuant to § 11.

2. Professionals in accordance with § 11 must immediately report communicable diseases as defined by the Federal Act on Combating Communicable Diseases of Humans of December 18, 1970, and epidemics pursuant to the Animal Epidemics Act of July 1, 1966, as well as any suspicion of such diseases and epidemics, to a doctor or veterinarian.

3. For other identified diseases that require medical, dental, or veterinary treatment, they must refer individuals seeking their services to a doctor, dentist, or veterinarian.

3bis. Holders of a license pursuant to the Federal Health Professions Act from another canton, who wish to practice their health profession in the Canton of Lucerne under their own professional responsibility for no more than 90 days per calendar year, must report this in writing to the office responsible pursuant to § 11. The report must be accompanied by a copy of the practice license from the other canton and a certificate of good standing issued by the authority that granted the license. They may only practice their profession once the responsible office has confirmed the fulfillment of the relevant conditions.

4. Nationals of foreign countries, who, based on treaty provisions, are allowed to practice another regulated health profession in Switzerland independently and without a license for no more than 90 days per calendar year, must register according to the procedure established in the Federal Act on the Obligation to Report and Review of Professional Qualifications of Service Providers in Regulated Professions of December 14, 2012. They may only practice their profession once the office responsible pursuant to § 11 has confirmed the fulfillment of the relevant conditions.

1. Professionals pursuant to § 11 are generally required to be present during the operating hours of the practice or business. The competent department in accordance with § 11 may issue directives concerning this.

1. Professionals pursuant to § 11 are required to undertake continuing education in accordance with the demands of their profession. If necessary, the department responsible under § 11 may require appropriate proof of such education.

2. Special provisions concerning continuing education remain reserved.

1. Professionals according to § 11 must have the facilities that are required for the provision of their services according to the applicable principles of their profession.

1. Unless otherwise specified by this regulation, sick and injured humans and animals may only be treated in accordance with the directives of medical or veterinary professionals.

1. Records of professional activities must be maintained. These must include information about the person or animal, the diagnosis, as well as the time and type of treatment. The records must be written in the German language and preserved for at least twenty years.

2. Documentation can be maintained in written or electronic form. The records must be comprehensible, dated, and accessible at any time; modifications must be traceable.

3. ...

1. A person is authorized to act as a representative if they meet the requirements for professionally independent practice. The exceptions according to this ordinance are reserved.

2. Decisions related to a substitution permit fall under the jurisdiction of the offices in accordance with § 11.

1. Only the professional titles mentioned in this regulation are permissible.

2. Professional titles that only cover a partial area of a profession mentioned in this regulation are impermissible.

3. Reserved are professional titles that are approved under federal vocational training law.

4. Academic titles must be used as they were conferred. Titles that may mislead regarding academic qualification may only be used with the inclusion of the name or location of the awarding university or the state of origin.

5. In announcements, particularly on practice signs and on the internet, professionals with a license to practice must be mentioned by name. In businesses that are not owned by the professionally responsible individuals themselves, the owner of the business must also be specified.

6. Professionals according to § 11 may only advertise in a manner that is objective, meets public needs, and is neither misleading nor intrusive. In particular, they may not refer to the activities of a university-level medical profession or another profession in the healthcare sector that requires a license.

1. A professional practice permit from the Department of Health and Sports is required for individuals who independently practice the following professions

a. Optometrist,

b. Dental Hygienist,

c. Druggist,

d. Midwife,

e. Occupational Therapist,

f. Nutritionist,

g. Laboratory Director,

h. Speech Therapist,

i. Medical Masseuse or Masseur,

ibis. Neuropsychologist,

j. Osteopath,

k. Registered Nurse,

l. Physiotherapist,

m. Podiatrist,

n. Paramedic,

o. Dental Technician,

p. Naturopath.

1bis. A professional practice permit from the Veterinary Service is required for those who independently practice acupuncture and physiotherapy on animals.

1ter. The employment of professionals according to paragraphs 1 and 1bis under professional supervision does not require a permit. The permit holder is responsible for providing professional supervision appropriate to the assistant's abilities. He or she should generally be present.

2. The responsible department is in charge of all decisions related to professional practice permits, substitute permits, and potentially operational permits, as well as for publishing the issued permits, revocations, or other terminations of permits pursuant to § 21 of the Health Act. The operational permit for organizations of nursing and home help pursuant to § 36 paragraph 3 is reserved.

3. For professions requiring a permit according to the Federal Healthcare Professions Act, the Department of Health and Sports is also responsible for

a. Reporting to the Federal Office of Public Health regarding the issuance, refusal, revocation, and any change of the permit for independent professional practice, particularly any restriction of the permit and any disciplinary measures;

b. Exemption from professional secrecy in the sense of Article 321 number 2 of the Swiss Criminal Code.

1. The application for approval must be submitted to the competent authority as specified in § 11.

2. The application must include

a. * proof of the educational qualifications required for the granting of approval,

b. * an extract from the Swiss criminal record or an equivalent document from the country of origin,

c. * ...

3. The competent authority may request additional documents, in particular a certified translation of documents not drafted in German.

3a. Applicants who are not native German speakers must provide proof of good knowledge of the German language, generally in the form of an official language diploma with a language level of at least B2 according to the Common European Framework of Reference for Languages.

1. The authorization as an optometrist requires a Bachelor of Science in Optometry FH. Equivalent to this are

a. * the educational qualification for "optometrist" according to Article 13 of the Federal Act on the Recognition of Professional Qualifications in Health Professions (GesBAV) of December 13, 2019[15],

b. * a foreign educational qualification recognized as equivalent by the Swiss Red Cross.

2. ...

1. ...

2. The authorization permits the sale and manufacturing of eyeglasses and other visual aids, the performance of optometric measurements, as well as the adjustment and independent dispensing of contact lenses.

3. The authorization holders

a. must keep records of eyeglasses and contact lenses made according to medical prescriptions or their own lens determinations,

b. must recommend an ophthalmological examination if they suspect pathological or age-related changes in the eyes,

c. must comply with medical prescriptions,

d. must not perform any medical treatments on the eye,

e. must not dispense medications; excepted are the substances usually provided when fitting contact lenses,

f. must not undertake the initial fitting of contact lenses or the initial determination of refractive error in persons under the age of 16 without prior ophthalmological examination.

4. The holder of the authorization may not manage more than one optician's business in a responsible capacity.

1. Persons who seek to obtain a Bachelor of Science in Optometry from a University of Applied Sciences are permitted, under the supervision of licensed optometrists, to prescribe eyeglass lenses and fit contact lenses.

1. A license as a dental hygienist shall be granted to anyone who

a. holds the federal certificate of competence as a certified Dental Hygienist HF or a certified Dental Hygienist HF or a foreign certificate of competence recognized as equivalent by the Swiss Federal Office for Vocational Education and Technology, or

b. has obtained a diploma from a school recognized by the Swiss Red Cross or a diploma recognized as equivalent by this authority, and

c. provides evidence of two years of employment as a dental hygienist under the supervision of a licensed dentist in Switzerland.

1. The Authorization Entitles the Holder to

a. Perform dental cleanings and tartar removals as well as local fluoride treatments,

b. Advise and instruct patients on oral hygiene and prophylaxis,

c. Use, within the scope of professional practice, those pharmaceuticals designated by the Health and Sports Department.

2. Dental hygiene services that exceed the scope of paragraph 1, particularly periodontal therapeutic services, may only be provided by the dental hygienist upon prescription by a licensed dentist or physician. Such services may only be provided to the extent that these treatments do not require dental professional expertise.

3. In the event of suspected complications or diseases of the teeth or oral cavity, a dentist must be consulted, or the patient must be referred to such a specialist.

4. Dental hygienists are not permitted to treat medical risk patients, make diagnoses, perform conduction, local, and surface anesthesia, or operate X-ray equipment.

1. A license as a druggist is granted to anyone who has obtained the federal diploma as a certified druggist HF.

1. The authorization entitles the holder to

a. keep in stock, manufacture, and supply to the public medicinal products of dispensing categories D and E as well as active substances and preparations,

b. manufacture and supply house specialties to the public,

c. keep in stock and supply medical devices to the public,

d. keep in stock and supply chemicals and poisons to the public,

e. fulfill medical prescriptions within the scope of dispensing competence.

2. Druggists must particularly observe the legislation on medicinal products and chemicals in their activities.

1. The druggist may, in the event of illness, during vacation, or in other justified temporary absences, be represented by a druggist with a certificate of competency in accordance with § 18. He or she must obtain prior approval from the Department of Health and Sport. The approval must be limited in duration. It may be extended.

2. Upon the death of a druggist, the Department of Health and Sport may authorize a druggist with a certificate of competency in accordance with § 18 to temporarily continue the operation of the drugstore.

1. The authorization as a midwife requires a Bachelor of Science in Midwifery (FH). Equivalents to this are

a. educational qualifications for "midwife" pursuant to Article 11 of the Health Professions Accreditation Ordinance,

b. a foreign educational qualification recognized as equivalent by the Swiss Red Cross.

c. ...

2. ...

3. ...

1. The authorization entitles the holder to

a. attend to and advise pregnant women,

b. prepare for and conduct births,

c. treat perineal tears, provided the requisite expertise is present,

d. care for postpartum women and newborns,

e. administer those pharmaceuticals in the course of professional practice that are designated by the Health and Sport Department.

2. Midwives are required to

a. consult a doctor in the event of complications during pregnancy, childbirth, or the postpartum period,

b. refer patients to a hospital in emergencies,

c. report the births attended annually to the Health and Sport Department.

3. The Health and Sport Department may restrict the authorization to care during pregnancy and postpartum care.

1. The authorization to practice as an occupational therapist requires a Bachelor of Science in Occupational Therapy from a University of Applied Sciences. Equivalent qualifications include

a.* Educational qualifications for "Occupational Therapist" in accordance with Article 10 of the Healthcare Professions Recognition Ordinance,

b.* A foreign educational qualification recognized as equivalent by the Swiss Red Cross.

c.* ...

2. ...

1. The authorization entitles the treatment of the sick, injured, or disabled with the aim of improving or maintaining their physical or mental independence.

2. The treatment is generally carried out following a medical prescription.

3. The Department of Health and Sports may authorize occupational therapists with the appropriate expertise to apply the dry needling method.

1. The authorization to practice as a nutritionist requires a Bachelor of Science in Nutrition and Dietetics from a University of Applied Sciences. Equivalently recognized are

a. * the educational qualifications for "Nutritionist" according to Article 12 of the Health Profession Recognition Ordinance,

b. * a foreign educational qualification recognized as equivalent by the Swiss Red Cross.

c. * ...

2. ...

1. The authorization permits advising patients with illnesses, according to Article 9b of the Federal Ordinance on Compulsory Health Care Insurance Benefits of September 29, 1995, based on a medical prescription.

1. An authorization as the head of a laboratory for medical-chemical, hematological, histological, cytological, or microbiological examinations is granted to anyone who meets the requirements of Articles 53 and 54 of the Federal Ordinance on Health Insurance.

1. License as a Speech Therapist is granted to anyone who meets the requirements of Article 50, Subparagraph b of the Federal Ordinance on Health Insurance.

1. The authorization entitles the holder to treat disorders of linguistic communication abilities, specifically concerning spoken and written language, articulation, voice, the swallowing process, and the fluency of speech.

1. Certification as a medical masseur or medical masseuse is granted to individuals who have obtained the federal professional certificate as a medical masseur or medical masseuse, or a foreign qualification recognized as equivalent by the Federal Office for Vocational Education and Technology.

1. The authorization permits the performance of passive physical therapies, provided that the treatment method does not require medical, chiropractic, or physiotherapeutic expertise.

1. The Authorization as a Neuropsychologist Requires One of the Following Qualifications

a. a recognized degree in psychology and a federal or equivalent recognized postgraduate qualification in neuropsychology according to the Psychology Professions Act (PsyG) of March 18, 2011[17] or

b. a recognized degree in psychology according to the PsyG and a specialization title in neuropsychology from the Federation of Swiss Psychologists.

1. The authorization permits the performance of diagnostic neuropsychological services according to a medical prescription.

1. Authorization as an Osteopath requires a Master of Science in Osteopathy FH. Equivalently recognized are

a. the educational qualification for "Osteopath" according to Article 14 of the Health Professions Recognition Ordinance,

b. a foreign educational qualification recognized as equivalent by the Swiss Red Cross.

1. The authorization entitles the holder to make osteopathic diagnoses and to treat patients independently or upon medical referral in the field of expertise.

2. The Health and Sports Department may authorize osteopaths with the relevant expertise to apply the dry needling method.

1. The authorization as a Registered Nurse or Registered Midwife requires a Bachelor of Science in Nursing from a University of Applied Sciences (FH/UH) or a diploma as a Registered Nurse or Midwife from a Higher Technical College (HF). Equivalently recognized are

a. educational qualifications for "Registered Nurse" or "Registered Midwife" according to Article 8 of the Health Professions Recognition Ordinance,

b. a foreign educational qualification recognized as equivalent by the Swiss Red Cross.

2. ...

3. ...

1. Healthcare professionals are responsible for health and nursing care at home.

2. They may perform diagnostic and therapeutic procedures only upon a doctor's order.

1. The authorization as a physiotherapist requires a Bachelor of Science in Physiotherapy from a university of applied sciences. Equivalent qualifications are

a. * the educational qualifications for "physiotherapist" according to Article 9 of the Health Professions Recognition Ordinance,

b. * a foreign educational qualification recognized as equivalent by the Swiss Red Cross.

c. * ...

2. ...

1. The authorization entitles the holder to implement measures in accordance with Article 5 of the Federal Ordinance on Benefits in Compulsory Health Care Insurance.

2. The Health and Sports Department may authorize physiotherapists with the appropriate expertise to apply the dry needling method.

1. Authorization as an Animal Physiotherapist or Therapist is granted to those who have obtained the Swiss Federal Diploma of the Advanced Professional Examination from the Swiss Association for Animal Physiotherapy or an equivalent diploma.

1. The authorization as an animal physiotherapist entitles one to treat functional disorders in the bodies of animals using recognized physical healing methods.

**1. A License as a Podologist is Granted to,**

a. * anyone who has obtained the federal diploma as a Podologist or a foreign certificate of competence recognized as equivalent by the Swiss Red Cross and can demonstrate two years of practical experience with a licensed podologist, or*

b. * anyone who holds a federal certificate of competence as a "Certified Podologist HF," a diploma recognized by the Swiss Association of Podologists, or a foreign certificate of competence recognized as equivalent by the Swiss Red Cross.*

1. The authorization permits work on the foot, particularly on its epidermis, toes, and toenails. Measures may be implemented to protect, maintain, and improve the mobility of patients.

2. The measures include

a. the treatment of epidermal and ungual diseases that hinder physiological walking and the painless wearing of shoes,

b. the elimination of complications from certain systemic diseases,

c. complementary services for surgical and physiotherapeutic treatments of the musculoskeletal system.

3. Surgical interventions are prohibited.

4. The independent provision of services for at-risk groups, the creation of professionally complex treatment plans, and the interpretation of professionally complex medical diagnoses and prescriptions are reserved for authorization holders who meet the requirements pursuant to § 40 paragraph 1b. The term "at-risk groups" follows the definition of at-risk groups by the Swiss Association of Podiatrists.

1. An authorization as a paramedic is granted to individuals who

a. possess the Swiss federal certificate of competency as a certified paramedic HF or a certified paramedic HF, or a foreign certificate of competency recognized as equivalent by the Federal Office for Professional Education and Technology, or

b. have obtained the diploma from a school recognized by the Swiss Red Cross or a diploma recognized as equivalent by this entity.

2. ...

3. ...

4. ...

1. The Authorization Entitles

a. To conduct preclinical non-physician and physician-delegated rescue measures on emergency patients under the supervision and responsibility of a doctor,

b. To use, within the scope of professional practice, those medications designated by the Health and Sports Department.

1. A license as a dental technician is granted to an individual who

a. has obtained the Swiss federal certificate of competency as a qualified dental technician or a recognized foreign certificate of competency deemed equivalent by the Federal Office for Professional Education and Technology, and

b. demonstrates two years of practical experience under supervision with a licensed dental technician in Switzerland.

1. The authorization permits

a. The fabrication of artificial dental prostheses,

b. The manufacturing of devices for correcting tooth position and for orthodontic purposes,

c. The production of jaw fracture splints and epitheses.

2. Dental technical work may only be performed on models and must be based on a dental prescription, with the exception of repairing broken dentures and replacing lost or broken teeth of prostheses.

3. Work on patients, particularly taking impressions for artificial dentures or repairs, as well as bite registrations and relines, is prohibited. Dental technicians may independently conduct try-ins with the consent of a dentist.

1. The authorization as a natural health practitioner requires the federal diploma as a natural health practitioner in one of the following specializations and potential focal areas

a. Ayurveda Medicine,

b. Homeopathy,

c. Traditional Chinese Medicine (TCM)

1. Focus areas in Acupuncture/Tuina, Acupuncture, or Tuina,

2. Focus in Chinese Herbal Therapy,

d. Traditional European Naturopathy (TEN).

2. The authorization is granted for the specialization with the potential focal area in which the diploma was obtained or the recognition was granted.

1. The authorization entitles the holder to practice naturopathic methods that are part of the specialty and any potential focus within the specialty.

2. The use of non-prescription complementary medicine products and medicinal products in dispensing category E is permitted in the course of professional practice without a special license.

3. The dispensing of non-prescription complementary medicine products requires a license to operate a private pharmacy from the Department of Health and Sport. Exempt from the licensing requirement is dispensing in emergencies that do not require medical, dental, or veterinary treatment, and during house calls.

1. Practice under the professional supervision of a licensed naturopathic practitioner as part of the practical training necessary to obtain the federal diploma does not require a permit.

2. Individuals undergoing the necessary professional practice under mentorship to obtain the federal diploma require a special permit from the Health and Sports Office. The special permit is granted if

a. the applicant holds the certificate from the Organization of Alternative Medicine Switzerland (OdA AM), and

b. the mentorship is conducted by a mentor accredited by the OdA AM.

1. The Veterinary Service establishes guidelines for the professional minimum requirements for granting authorization to practice to individuals who perform acupuncture on animals.

1. An authorization from the Department of Health and Sports is required for

a. Organizations of Occupational Therapy,

b. Organizations of Nutrition Counseling,

c. Organizations of Midwifery,

d. Organizations of Speech Therapy,

e. Organizations of Physiotherapy,

f. * Transport and Rescue Companies,

g. * Organizations of Neuropsychology,

h. * Organizations of Podiatry.

2. Organizations of Nursing and Home Care (Spitex) require an operational license from the municipality in which they are based. Spitex organizations not based in the Canton of Lucerne must be authorized to operate according to the law of their canton of residence in order to conduct activities in the Canton of Lucerne. Municipalities must notify the Department of Health and Sports of the issuance and revocation of licenses.

3. Health professionals working independently in an authorized establishment require a professional practice license.

4. Distribution centers for supplies and equipment used for examination or treatment may operate without an operational license.

1. Applicants must designate a responsible professional in their application who holds authorization for the professionally independent practice of the particular health profession in the Canton of Lucerne in which the establishment provides services.

2. The application must include

a. a business plan giving information about the services offered, personnel, and facilities, as well as quality assurance and hygiene measures,

b. an extract from the debt collection register of the applicant,

c. a declaration by the applicant ensuring that the therapeutic independence of the health professionals practicing independently within the institution is guaranteed.

3. The authority responsible for granting approval may, in order to assess the operational approval conditions,

a. request additional necessary documents; these must be translated into German and officially certified if required,

b. conduct an inspection of the establishment.

1. The permissible scope of activity for the operation is determined by the healthcare profession in which it provides services.

1. Sections 2, 3 Paragraphs 1-3, 7, 8, and 10 apply mutatis mutandis to operations requiring approval.

1. Transport and rescue organizations must demonstrate, in addition to § 45f, that they meet the minimum requirements of the guidelines set by the Inter-Association for Rescue Services (IVR) for the recognition of rescue services.

2. The Department of Health and Sports may exempt transport organizations from the licensing requirement if they generally do not transport individuals who are in vital danger or individuals where vital danger is likely during the transport.

1. No authorization is required for First Responder Groups whose activities are limited to providing first aid in the event of a cardiac arrest through cardiopulmonary resuscitation (CPR) and the use of automated external defibrillators (AED). The Health and Sports Department grants approval for the connection of these groups to the emergency medical dispatch center if their operational plans meet the standards of the IVR. To this end, it seeks the recommendation of an IVR-certified rescue service that holds authorization under this regulation.

1. Anyone who intentionally or negligently violates the provisions of §§ 2-4, 6-8, 9 paragraph 1, 10 paragraphs 1 and 2, 11, 14, 15, 17, 19, 20, 22, 26, 28, 29, 31, 33, 33b, 35, 37, 39, 39b, 41, 43, 45, 45b, 45c, 45e, 45g, and 45j or aids in their violation shall be punished with a fine, unless specific penal provisions are applicable.

1. Licenses granted before the entry into force of this regulation shall remain valid, unless otherwise provided by legislation.

2. Rescue organizations that were already operating in the canton of Lucerne before the entry into force of this regulation must meet the requirements of § 42 paragraph 2 within five years from the entry into force of this regulation.

1. Authorizations granted for the independent professional practice of acupuncture prior to the amendment of this regulation on January 5, 2021, remain in force. The holders

a. of unlimited authorizations may, upon request, receive an authorization as a naturopathic practitioner in Traditional Chinese Medicine (TCM) with a focus on acupuncture,

b. of limited authorizations may apply for an authorization as a naturopathic practitioner in Traditional Chinese Medicine (TCM) with a focus on acupuncture no later than six months after the expiration of the limitation.

2. Persons who, prior to the amendment of this regulation on January 5, 2021, were listed with the following methods and method groups in the Experience Medicine Register (EMR) and were practicing in the canton of Lucerne, can apply for a corresponding registration as a naturopathic practitioner within six months of the amendment's enactment

a. Ayurveda (EMR No. 22): Naturopathic Practitioner in Ayurvedic Medicine,

b. Classical Homeopathy (EMR No. 91): Naturopathic Practitioner in Homeopathy,

c. Naturopathic Practices (EMR No. 131): Naturopathic Practitioner in Traditional European Medicine (TEM),

d. TCM (EMR No. 185) Area Amno/Tuina (EMR No. 9): Naturopathic Practitioner in Traditional Chinese Medicine (TCM) with a focus on Tuina,

e. TCM (EMR No. 185) Area Phytotherapy (EMR No. 146): Naturopathic Practitioner in Traditional Chinese Medicine (TCM) with a focus on Chinese Herbal Medicine.

1. The following decrees are hereby repealed

a. Regulation on the Health Care Professions of December 17, 1985 [18],

b. Regulation on the Practice of the Profession of Dental Hygienist of February 27, 1970 [19],

c. Regulation on Responsibilities in the Health Sector of December 9, 2008 [20].

1. The regulation enters into force on June 1, 2009. It is to be published.