At Beth Israel Hospital, Andrienne Lapsley, senior coordinator of ambulatory services, said, "I think it's going to be a lot of layoffs. That's not good for the staffers here...It's not altogether unexpected, but it is very scary."

Some, like Dr. Sherwin V. Kery, director of the blood bank at Children's Hospital, said people need not be so worried about their jobs.

"It's not a matter of if you move six people and two labs together, people are going to lose their jobs. There may be new labs that are open or other places in the hospitals people can transfer to. Children's Hospital has always been very benevolent when it comes to employees."

Even among the employees who feared for their jobs, there were some who thought increased collaboration was necessary.

Chris H. Hitchcock, who does billing for surgery at Brigham and Women's, said she thinks increased collaboration is "a good idea. It's trimming the fat, so to speak."

"There's a growing mentality in favor of consolidating," Hitchcock said. "For everyone to have the kind of health care they want, we need to do it."

Hitchcock says she is worried about her job, nonetheless.

"My husband isn't working right now. It used to be you never worried about your job in this field--everyone gets sick, right?"

But with the onset of First Lady Hillary Rodham Clinton's health care reform proposals, the worrying has begun.

From the lowliest hospital employee to the loftiest hospital trustee, everyone is aware of what Kay calls "a whole new era" for the health care industry.

While some hospital employees fear for their jobs, others fear that the quality of care will be adversely affected by an increase in cooperation between or a consolidation of the five Harvard teaching hospitals.

Elizabeth Rabinowitz, administrator in the radiology department at Brigham and Women's, said she worries about the imperfections of central planning, and about the impersonal service offered by large hospitals.

"You can't apply standard guidelines to someone who is sick," Rabinowitz said.

"They're out of their minds," Rabinowitz said. "Ten years ago, they consolidated four hospitals to make this hospital, and it's too large."

Kery said there's one important test any plan must meet to get his support: "It must provide good if not better patient care than now exists. If that could be done in such a way as to save money, we need to look at it."