Layoffs are coming at Novant Health Inc. in Winston-Salem. A memo to employees from Novant COO Jeff Lindsay revealed the health system plans to eliminate 48 jobs in the next few days.

One of the eliminated positions will be from Medical Park Hospital with the remainder coming at Forsyth Medical Center. The Business Journal of the Greater Triad Area published Lindsay’s memo.

“Medical centers and hospitals, both nationally and locally, are making very difficult decisions to ensure the continued financial health of their organizations,” Lindsay’s memo said.

The reason for the cuts, according to Lindsay, is that high unemployment has left many patients without health insurance and most are postponing care until absolutely necessary.

“That said, Novant Health is financially secure,” Lindsay wrote. “We’re a successful organization by almost every health care industry benchmark. But based on recent trends we must be proactive, right now, and make tough decisions to ensure we have the resources to continue to deliver high-quality care to the communities we serve.”

According to the Business Journal, Novant was the Triad’s fourth-largest employer last year with nearly 9,000 total employees.