Esther Wiesendanger, co-manager of the Permanence Winterthur practice, faces a major funding challenge following a Swiss Federal Court ruling prohibiting additional fees for medical services provided during evenings and weekends. This decision impacts practices that already cover a significant portion of emergency services, as it complicates their financial viability due to high operating costs. As practices adapt by altering their opening hours or strategically managing fee structures, the need for updated tariff regulations based on current operational realities becomes increasingly apparent, with new payment structures expected by 2026.