This book represents reflections on a 45 year voyage through Med School, Training and Private group and solo practice. A career of teaching publishing and training doctors is included. For the audience the major issues of cost of education and time involved are addressed. The inevitable changes decade over decade make up a lot of context as you can't know where your journey heads without knowing where you have been. Some of the Changes from the 1970's to the 2020"s have benefitted both providers and consumers of healthcare. Yet some of the changes have definitely gone in the opposite directions. A definite intent in this book is to provide information to any prospective candidate for this career. Informed consent is provided to every patient, as it should also be like and kind for a career choice. I hope this enlightens any prospective candidate. It is, in a way, a caveat emptor.