Head and neck surgeons have the unique opportunity to engage with humans in life and death situations. We are confronting cancer, cure, failure, self-image, and most of all, a bond with the patient and family. We would like to view our expertise in head and neck surgery and the world of caring for our patients much like a Brigadoon. However, we daily are confronted with ever-changing and evolving approaches to health care that do not involve the physician or the patient. What kind of world is healthcare without a physician-patient interaction? Yes, there is the government-supported electronic medical record, which is here to stay (until our electrical and/or wired network fails). Yes, there is new technology, including robotic surgery and telemedicine and efforts to link these to our cell phones and applications, making care and expertise more available across long distances. And yes, there exist goals to extend care beyond the physician to other health care professions as the buffer between the physician and the patient, sometimes to reduce cost and sometimes to make care more ubiquitous. However, an Internet search will show that most say that the only constant in healthcare is change. I propose that the ultimate constant in healthcare is the physician-patient relationship.