We were lucky enough to head to Lost Pines to meet up with my oldest and best friends in medicine this weekend. Angela and Brandon Fisher are physicians in Houston—she is in the emergency room at Ben Taub and he is a radiologist working for a large private group. Collectively, we share 51 years in medicine, since first receiving our white coats at Texas Tech Health Science Center in Lubbock, Texas.

As our children shared fun activities together (they are about the same age and got along splendidly!), the parents got caught up on personal things and then the talk drifted as it always does to all things medicine. It is interesting how unique each of specialties is, but simultaneously how different our working days can be. I may treat a lot of warts and acne and eczema, but then do some cosmetic, and then I may see a serious life-threatening rash that takes some thought and time as to diagnosis and treatment. Brandon, the radiologist, sees a lot of normalcy, but then there are times when he sees some really unusual, and serious, conditions. Angela’s typical day (and night) includes a ton of teaching of the residents, some gun-and-knife club issues, and lots of crazy all day long.

It is interesting that we all started out at the same place—a gross anatomy tank—during our first year of medical school. We spent many hours over the cadaver, as well as in study groups, learning about the mysteries of the human body. We went our separate ways when it was time to being residency training, but we have always stayed in touch and remained close, picking up instantly where we last left off as if no time had passed at all.

Medicine is different than when we began—we were so eager to take care of someone and to simply have someone that we could call “patient” and they could call us “doctor”. It is especially difficult in this age of medicine, with constant changes occurring including Obamacare.

But it is not just Obamacare, the patient landscape is changing as well. Patients come in self-diagnosed incorrectly from Dr. Google. Patients are confused and angry with their insurance plans and the little amount of care that is covered and reimbursed compared to their premiums which continue to rise. In addition, there is no individual face attached to the insurance plan—no consistent voice with who to help analyze the best plan of action.

The face they turn to is their doctor, who they know and trust, who they can talk to on a personal level, but  who unfortunately has less influence than the patients when it comes to their managed care plans. I cannot think of any other profession whereby the service provider is not allowed to choose what they will be paid for the services rendered (it is determine by the managed care plan). It is the only profession whereby there is  minimum of 4 weeks delay for the service provider to receive the pre-determined payment (sometimes with denials and delays on behalf of insurance it can be greater than 6 months), before being able to determine what needs to be sought after directly from the patient based on their managed care contract plan.

Despite the good, the bad and the ugly, Drs. Fisher and I can still think of no better profession which we could have chosen to fulfill our God-given talents and abilities. I wake up each day wondering what my day holds, and I feel challenged by the patient problems I am presented with. Each patient is different, allowing for a unique patient care plan that may only work for that patient. Doctors like our work, but it is nice to be able to have a weekend to sit back and enjoy the fruits of our labor, and to catch up with old friends.