In the latest Grey's Anatomy episode, viewers got a hint of what is to come at Seattle Grace.
The hospital was informed that its insurance company denied coverage for the accident victims. Read: "Can Docs Bankrupt Seattle Grace?"
A court judgment of $15 million for each doctor affected must be paid by Seattle Grace.
It has no way to do that without financial adjustments that take the form of cuts to services and staff. It still might not be enough and that became clear at a meeting.
A consultant arrived, played by actress Constance Zimmer who fans of Entourage may remember as Dana Gordon.
We learn that she was a surgeon and studied under Dr. Webber as she followed the staff around for a few days and announced the first recommendation --- close the ER.
The reason wasn't surprising. The majority of patients come in the door without emergencies, under insured or without insurance and the high priced talent to treat them is a money losing proposition.
The shock and anger began immediately.
"This is ridiculous," Derek Shepherd said. "You can't close the ER. You went to med school. You have to ask yourself..."
He was cut off by Miranda Bailey.
"Do you have a better idea? Because the way i see it, this woman is trying to keep the hospital from closing. In which case there would be no patients, we'd have no jobs and some of us don't have a few million to fall back on, so unless you have a better idea why don't you just sit there and listen to what she has to say."
Shepherd's face registered the shock and hurt you'd expect. Dr. Bailey was not on the airplane that took a leg from Arizona Robbins and killed Mark Sloane and Lexie Grey.
She is not one of the recipients of $15 million in damages and the divide that exists became apparent to Derek.
Others around the table realized the gauntlet had been thrown down and had no retort after absorbing the body blow Bailey threw.
In the closing scene, as Derek and Meredith sit in their custom built home on a hill, sipping wine and going over the events of the day, Meredith addresses the issue.
"Bailey had no business calling you out on that." Derek replied in a kind manner. "She's nervous. We're all nervous. Everybody should be nervous."
Meredith Grey zeroed in on the dilemma that faces the recipients of the money. "It's not our fault. Is it?"
Dr. Derek Shepherd finds the key fact that will eat at the victims as this plot line continues. "It sure feels like it."
What other cuts and down sizing are in store for the hospital? No one knows for sure, but the pressure on Arizona, Callie, Derek, Meredith and Cristina has only begun.
ABC airs new episodes of Grey's Anatomy each Thursday night at 9 ET/8 CT. Image: Kevin McKidd and Constance Zimmer ABC/Grey's Anatomy