Swiss doctor abandons practice over billing system frustration after 40 years

After decades of blending conventional medicine with acupuncture, Dr. Armin Koch has closed his practice in Sarnen, canton Obwalden. The 70-year-old physician, known for his unorthodox methods and occasional oversight with needles, cited frustration with Switzerland's new billing system as the final reason for stepping away.

Koch's path to medicine was unconventional. Initially a ski instructor and secondary school teacher, he later followed his father into the profession. His fascination with alternative healing led him to Sri Lanka, where he trained in acupuncture with his wife and young child. Upon returning, he built a career merging Western and Traditional Chinese Medicine, viewing both as tools to activate the body's natural healing.

Patients remembered him for his dedication—and sometimes for his lapses. One woman discovered a forgotten needle in her hair days after treatment. Koch acknowledged such incidents but remained convinced that acupuncture, when practiced carefully, could complement modern medicine. His decision to retire came abruptly last week. The tipping point was the upcoming TARDOC tariff, set to replace TARMED in 2026. While most clinics adapted, Koch refused, calling the new system overly bureaucratic. Hospitals now face delays in billing outpatient services worth 13 billion CHF annually, but his smaller practice struggled with the transition. Rather than adjust, he chose to walk away. To the end, he saw his role simply: to create the right conditions for healing, whether through prescriptions or needles. His departure leaves a gap in Obwalden's medical community, particularly for those who sought his blend of Eastern and Western care.

The closure of Koch's practice marks the end of an era for his patients. Those who relied on his mix of acupuncture and conventional treatments must now seek alternatives. Meanwhile, the broader challenges of TARDOC's rollout continue, affecting how Swiss doctors and hospitals bill for services in the years ahead.