A Communication From Our CEO

To:  All Employees of Semi-Gargantuan Medical System

From:  The Overlord, CEO Dr. I-make too-much

The year is winding down and once again I come to you with desperate tidings.  In spite of continuing efforts to reduce costs, namely flexing those that care for our patients leaving less staff to do more work, we are still having financial difficulties.  I applaud your ability to work short and do what is needed to maintain our valuable cadre of upper-level management.  I wanted to let you know that us at the Head Orfice have been trying to do our part as well and flexing out early for 2-3 hour lunches and not using the expense accounts for our golf trips.  I know that your hard work is making things on our multiple vice-presidents easier.

But times are tough.  Our revenues are down, mostly due to a change in our payer mix and as the economy here in our section of the country is slow to respond they will probably stay that way.  We have been looking at opportunities to grow our business lines, but unfortunately the only ones coming to our hospitals these days are folks who can’t and will probably never pay their bills.  In order to cover some of these cost we are passing them on to our employees, who in addition to caring for these folks now get to foot the bill as well.  I know a lot of you are upset that we raised premiums (again) this year and changed co-pays and reduced the amount of things we will pay for, but it is a rough world out there and at least you still have health insurance.

I have been sitting down with the Vice-Presidents and they will shortly begin having meetings with upper-level management who will then be meeting with middle-management, who then will meet with your unit managers to work on the operating budgets for the next fiscal year.  Sacrifices will have to be made at one point.  We’re hoping this doesn’t include layoffs, but instead we will flex and cancel people so that they have a de facto pay cut since they no longer work their scheduled hours.  We’re all doing it.  In fact I am taking off time this month as well, flexing.  Of course, my salary isn’t remotely effected.  We here at the Head Orfice do appreciate your sacrifices, but are asking for more.  We need you to do more with less.  Our new operating budgets will reflect that.  There are going to be hard decisions to make in the next year and I hope that our staff will be willing and able to make the changes needed and if not I’m sure there are plenty that will.

On a high note, we passed our Joint Commission survey, but in light of the new programs the Joint Commission will be rolling out in the next couple of years we have decided to hire a new group of compliance experts instead of bedside staff.  More paperwork is the answer to cure any Joint Commission issues, not staff.  So these colleagues will be finding new and inventive way to build checklists, peer-reporting, new charting screens and more compliance workshops (it’s mandatorily voluntary) to keep us in line for the next audit.    Please welcome these folks onto your units so they will be able to further criticize your practices, fulfill their duties and create a blizzard of paper.

In this light I would also like to welcome two new Vice-Presidents to our cadre.  Jenny Smith, MBA, BS in BS, MDiv, PhD, MPH will be our new Vice-President of Monotonous Paperwork.  All of the compliance checklist folks will be reporting to her.  Also, please welcome Bob Smith, MD, MBA as our new Vice-President of Vice-Presidents.  His job will primarily be the identification or creation of need for new Vice-Presidents and the recruitment of those folks.  If you have questions about this, please wait until the New Year as all of the Senior Management will be on vacation thanks to the generous bonuses they received this year.  I know you all have enjoyed the special holiday dinner and ornaments we provided in years past, and are sad we canceled them this year,  but the bonus money had to come from somewhere.

Last, but not least, we are going to be building a new completely un-needed hospital in the near future and this will be the kick-off of a fund raising drive where you the employees will contribute to the building cost.  This is voluntary of course, but your very own co-workers will be soliciting you for “donations” to this new facility.  The preliminary plans look great as there will be a full Italian marble facade and flooring in the main areas of the hospital, a waterfall and a place for a piano player.  The patients rooms though are of no import as of yet, but we’ll get back to you on that.

So before I finish to go on a  month long trip to Hawaii, I want to wish each and every one of you a Happy Holidays!  See you next year!


I-Make-Too-Much, MD, CEO

***if you think I’m only joking, remember, the funniest things are funny because they are partly true***



  1. I swear to god I thought this was a real-life memo from one of the a-holes I used to have to work with — it’s scary how accurate it is.


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