To: Don Wise, chief executive

From: Paul Servant, assistant chief executive

Re: How hard can it be?

Dear Don

I have just been to another excruciating consultants' committee. I had to sit through the preferential car parking working group's special report calling for spaces to be widened to fit the new Audi S4, followed by the circulation of a petition to re-establish the consultants' dining room.

There was the usual emergency motion to reconsider the bare below the elbows policy until safes have been supplied to all consultants for security of Rolexes and gold cufflinks, and finally there was the usual chorus of "well how hard can it be?" to run a hospital, fiddle the figures or procure an MRI.

Which got me thinking...

Doctors appear to believe they can do other people's jobs without a second thought. Doctors are chief executives, politicians, TV presenters, comedians, businessmen and even terrorists these days. But while scaling every other profession's heights, they operate one of the last and most lucrative closed shops going. How hard can it be to be a doctor?

Granted there's some sophisticated technical stuff that only specialists, überdoctors and surgeons can do, but most healthcare interactions are repetitive, non-invasive and in many cases do not have any evidence base whatsoever. Surely any of us could handle that after a few weeks of correspondence training?

We should create a new profession, the manamedic: part manager, part doctor. They will operate under protocols and be linked to a video call centre where we'll place most of the few consultants that we'll need.

Manamedics will be the perfect hybrid: protocol and target driven, caring and cash conscious, cynical and heartless. They will be more plentiful, cheap and obedient than their former doctor selves, while still retaining the essential qualities of their former profession, shared by management, of despairing of nurses and thinking "well how hard can primary care be?"