Schubert's "Unfinished Symphony" Reviewed

Robert J. Cihak, MD

The Director of Health Care Services in San Francisco County is a community leader, and a great lover of the San Francisco Symphony, to which he has season tickets. Recently, he could not attend a performance, so he gave the tickets to a deputy administrator, in charge of managed care and cost containment. The next day he asked the deputy how he enjoyed the performance. Instead of the usual polite remarks, the seasoned bureaucrat handed him the following memorandum:

The undersigned submits the following comments and recommendations relative to the performance of Schubert's "Unfinished Symphony" by the San Francisco Symphony as observed under actual working conditions.

1. The attendance of the orchestra conductor is unnecessary for public performance. The orchestra has obviously practiced and has the prior authorization from the conductor to play the symphony at a predetermined level of quality. Considerable money could be saved by merely having the conductor critique the performance during a retrospective peer-review meeting.

2. For considerable periods, the four oboe players had nothing to do. Their numbers should be reduced, and their work spread over the whole orchestra, thus eliminating the peaks and valleys of activity.

3. All twelve violins were playing identical notes with identical motions. This was unnecessary duplication. If a larger volume is required, this could be obtained through electronic amplification which has reached very high levels of reproductive quality.

4. Much effort was expended in playing sixteenth notes, or semi-quavers. This seems to me an excessive refinement, as listeners are unable to distinguish such rapid playing. It is possible to use trainees and lower quality operators with no loss of quality.

5. No useful purpose would appear to be served by repeating with horns the same passage that has already been handled by the strings. If all such redundant passages were eliminated, as determined by a utilization committee, the concert could have been reduced from two hours to twenty minutes with great savings in salaries and overhead.

6. In fact, if Schubert had attended to these matters on a cost containment basis, he probably would have been able to finish his symphony.

Dr. Cihak is a member of the Board of Directors of AAPS. His e-mail is

Originally published in the Medical Sentinel 1999;4(4):146. Copyright ©1999 Association of American Physicians and Surgeons (AAPS).