As we all know the University of Michigan Medical Center has experienced a combination of shrinking intake of funds coupled with growing expenditures. This has placed us in the unfortunate situation of having to dip into interest on capital reserves in order to cover costs. Clearly, if this institution is to stay competitive in a health care industry migrating towards health organizations and managed care, we will need to engage in an aggressive strategy of right-sizing. To this ends I present to following suggestion: The Self-Serve Hospital The aim of this strategy is to eliminate an estimated 92%-98% of our staff without adversely effecting the quality of medical care available. Many other business sectors including banking, automotive fuel, and food service have made the successful move from labor intensive full-service to a more economical, technology driven self-serve approach. Here is how the self-serve hospital will be implemented in certain key areas. Self-Serve Emergency Room - This has long been one of the highest stress locations for staff. Thanks to the increased exposure that the general public has received from the media and television shows like Chicago Hope and ER the techniques and procedures used in the ER are becoming public knowledge. This combined with new machines such as the coin operated Mr. Cast, HeartStart(tm) auto-deflibrillator, and U-Pump stomach content removal system allow the ER to run on its own 24 hours a day with little or no supervision. Self-Serve Radiology - Airport security X-ray conveyors have been modified to allow the patient to view the screen as they pass underneath the scanner. This makes the detection of broken bones a cinch. (See also self-serve MRI) Chemotherapy machines now are being designed with the same simple controls as the already familiar microwave oven for added ease of use. Self-Serve ICU - Name now stands for Independent Care Unit. Self-Serve Surgery - There are huge cost savings to be had here. Not only do we eliminate some of the highest paid specialists in the hospital, but the self-serve OR also eliminates extremely high malpractice insurance rates. After all, the patient has no one but himself to blame for any screw-ups. Self-Serve Pharmacy - Patients write their own prescriptions. Very popular with customers. Self-Serve Blood Bank - Select your blood type and make automated deposits or withdrawals. Don't know your blood type? Try O. Self-Serve Physical Therapy - Monitors display looping tape of Sweating to the Oldies. Self-Serve Morgue - Clearly the subject will not be able to perform their own autopsy, but relatives, friends, and neighbors can try their hand. Amateur M.E.s can check their theories against a helpful chart of the top 100 causes of death. Self-Serve Psychiatric - There are now very sophisticated versions of the artificial intelligence psychoanalysis simulator ELIZA which can surely help patients with neurosis in lieu of a trained professional. There are also a number of padded rooms for those who feel uncomfortable with the dangers of the outside world. While it is hard to put on a straitjacket by yourself, it is not impossible.