6 ◾ Handbook of Concierge Medical Practice Design
scallops, clams, mussels, halibut, salmon, and more. One day the man-
ager comes to the chef and says, “We’re upside down here—take it down
a notch,” so the chef first reduces a few items that were on the menu, but
were often passed over for other delicacies, the first step in cost contain-
ment. The manager comes back again and says “cut back more.” This time,
the chef removes a few items. Perhaps the chef replaces these items with
other items to fill the gap on the display but with a new dish that uses a less
expensive ingredient, say tuna tetrazzini (tuna casserole—made with tuna,
spaghetti, Parmesan cheese, and mushrooms). You get the idea.
Eventually, though the buffet is still hobbling al