When Swedish health authorities investigated more than a dozen cases related to one doctor, they found he had inappropriately administered medication to multiple patients, causing one of them to suffer a double lung collapse.<\/p>\n
Citing inadequate medical knowledge and patient safety risk, authorities revoked the doctor\u2019s license in 2021, and immediately filed an alert to the Internal Market Information System (IMI).\u00a0<\/p>\n
That alert went out to the other 29 countries that make up the European single market. Norway followed suit, revoking the doctor\u2019s license there and sending a second alert a few months later.\u00a0<\/p>\n
By then, the doctor was practicing in Cyprus. But authorities in that country didn\u2019t read the warnings \u2014 a common issue, according to data obtained by reporters, which shows that only about one third of the jurisdictions open the alerts.<\/p>\n
In Cyprus\u2019 case, authorities didn\u2019t access the alerts until this past October \u2014 the day after OCCRP and media partners published Bad Practice<\/a>, which exposed how doctors are able to hop jurisdictions and keep working despite losing their licenses for serious offenses.<\/p>\n Now, journalists have obtained IMI alert records that contain access logs, confirming which authorities opened the warnings.\u00a0<\/p>\n An analysis of more than 500 alerts issued about doctors in 2024 and 2025 reveals a troubling pattern: While only a third of jurisdictions open the warnings, even fewer take the extra step to access personal data, which includes the identity of the disciplined doctor.\u00a0<\/p>\n Even worse, half of the states that are part of the IMI didn\u2019t open any of the alerts filed for \u201csubstantial reasons\u201d last year \u2014 including Cyprus.<\/p>\n The Bad Practice investigation also found that some countries rarely or never file alerts about the disciplinary actions, which they\u2019re obliged to do under EU rules.<\/p>\n Under EU regulations, member states are not required to consult the IMI alerts. But the data analysis showing that many health authorities don’t look into the warnings raises questions about the effectiveness of the system. The findings also bring up serious concerns about patient safety.<\/p>\n \u201cIt is clear that the countries that have not yet used the available functionality in IMI need to change both their attitudes and actions in order to contribute to increased patient safety in Europe,\u201d said Sjur Lehmann, director of the Norwegian Board of Health Supervision.<\/p>\n \u201cIn addition, the IMI system itself should be improved, making it easier to use,\u201d he told\u00a0OCCRP\u2019s Norwegian media partner, VG, in an email.\u00a0<\/p>\n \u2018Inefficient\u2019 System<\/p>\n Lehmann’s suggestion that the system needs improvement appears to be shared by others who find it cumbersome to use.<\/p>\n The national IMI coordinator for Cyprus told OCCRP\u2019s Cypriot member center, CIReN, that the emailed alerts are redacted due to data protection. Therefore, a recipient must take further steps to establish the full content and relevance of the alert.<\/p>\n Cyprus is not alone in describing the process as burdensome. Other authorities have admitted to not reading the alerts for similar reasons.<\/p>\n Belgian authorities told OCCRP\u2019s media partner De Tijd that they don\u2019t proactively open warnings about healthcare providers. They added that the emailed alerts don\u2019t contain the name of the medic, and that the system is not synchronized with national databases to help identify relevant alerts about doctors working in their country.<\/p>\n \u201cThe only way to process all those alerts would therefore be through manual control, case by case, which is labor-intensive, inefficient and difficult to achieve,\u201d said Federal Public Service Public Health spokesperson Annelies Wynant.<\/p>\n