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No wonder that the New York Monthly listed the Park among the "top ten" hospitals in the greater metropolis.

Although the Park Hospital in this story is purely a concoction of my imagination, there are numerous facilities across the US just like it.

As with any hospital in America, the New York Park is a micro cosmos—a small almost self-contained political and financial system. Although the hospital is formally designated as a "non-profit" institution, the chief ambition of those who govern it is to make it as profitable as possible—and not, of course, for altruistic reasons.

Michael Howard, a lanky Irishman with a small skull impelled over a stooped six foot, seven-inch frame, was the hospital's almighty president. An astute financier and health care administrator, he also served as chairman of the State's Association of Hospital Presidents and was elected by a leading financial journal as the most successful Hospital President in the city. Howard ran the hospital with the help of a small army of Vice-Presidents. The only physician among them was the Senior Vice-President for Medical Affairs, Dr. Albert Farbstein, a late sixty-something internist who was born, raised, educated, trained and promoted in Brooklyn. White haired, balding, bearded, eagle-nosed, and very short, he looked as if he'd jumped straight out of a Nazi propaganda caricature.

As the CEO, Howard held the keys to the hospital's purse, and he knew that the fatter the purse the bigger the bonus to be added to his already high six-figure salary. Naturally, Farbstein also had a financial interest in the well being of the purse. The more doctors and nurses he employed for the money, the more generous Howard would be with him. From any management's perspective a hospital is a business: a large factory that employs doctors and pars-medical staff. A factory that processes patients.