SELLEST OSAST
The weight of the healthcare system has been sitting heavy. Our practice officially dropped UnitedHealthcare after they offered a 0.8% rate increase, and I’m feeling genuine empathy fatigue for the first time since I came back to clinic after my cardiac arrest. I talk about what that feeling actually is, how to spot it, and what finally helped me through it last time. Also, Dr. Oz is pushing to eliminate modifier 25, which would effectively end same-day procedures in private practice.
Then some actual good news: the 2026 Nobel Prize in Physiology or Medicine went to Peter Hegemann, George Nagel, and Karl Deisseroth for optogenetics. I walk through the 2021 Nature Medicine case of a man with 40 years of retinitis pigmentosa who regained the ability to locate and touch objects after an AAV-delivered opsin was injected into his retinal ganglion cells. It’s mutation-agnostic, it’s low-resolution, and it’s one of the most exciting developments in vision science in a long time.
Takeaways:
- After years of negotiation, Will’s practice has fully dropped UnitedHealthcare over a 0.8% rate increase offer against a 3% request.
- Empathy fatigue is real, often follows personal medical trauma, and requires time off, honest conversations, and self-awareness to work through.
- Dr. Oz and CMS are pushing to eliminate modifier 25, which would effectively end same-day E&M visits combined with procedures and devastate private practice.
- The 2026 Nobel Prize in Physiology or Medicine went to the discoverers and developers of optogenetics, which has already shown promise restoring partial vision in retinitis pigmentosa.
- Optogenetics is mutation-agnostic because it installs light sensitivity in surviving ganglion and bipolar cells rather than repairing dead photoreceptors.
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