Chapter 47
On her way home, Choi Yuri stopped near the entrance to the alley.
Seohwa Women's Hospital was no longer hidden behind construction fencing.
So today is opening day.
She had been rushing to work that morning and had not paid attention.
Now the barriers were finally gone, revealing the sign.
Black letters on a white background.
[Graduated from Hanguk University College of Medicine]
[Training at Johns Hopkins Hospital]
A banner announced that Director Seo Pilju himself would personally see patients every Wednesday.
Wednesday special hours were from 8:00 a.m. to 6:00 p.m.
General appointments on Monday, Tuesday, Thursday, Friday, Saturday, and Sunday ran from 7:30 a.m. to 6:30 p.m.
Choi Yuri stared at it in disbelief.
"They're obviously targeting us."
Hyundai OB-GYN Clinic closed only on Wednesdays.
Every other day, it operated from 8:00 a.m. to 6:00 p.m.
Seohwa opened thirty minutes earlier and closed thirty minutes later.
Even now, when Yuri was leaving work, the other hospital was still open.
Let me take a look.
Yuri carefully peered inside.
The waiting room was visible through the glass doors.
Rows of chairs.
It was definitely larger than Hyundai OB-GYN Clinic.
There were already quite a few people inside.
Then the glass door opened.
One woman entered.
Yuri recognized her.
She had come to Hyundai OB-GYN without an appointment the previous week, but because everything had been fully booked, Yuri had scheduled her for the week after next.
Another woman entered.
A patient who had canceled her Thursday appointment this week.
That's Na Yuran. She called and said something came up.
Then another.
And another.
Yuri began counting.
Five or six people entered in less than ten minutes.
Every face looked familiar.
Through the glass, she could see them registering at the front desk.
Kim Eunjeong too.
Seong Juhui too.
They're all people who already had appointments at our clinic next week.
Choi Yuri stopped walking.
She should have gone home, showered, and rested.
Instead, she was so angry that her fingers trembled.
She took out her phone.
A text message could only hold forty characters, so she had to send two.
[Director, I'm in front of Seohwa Women's Hospital right now. There are quite a lot of people.]
[I even saw patients who were coming to us go inside there.]
Last time, the director had said it would be fine.
But once she saw the operating hours and the Wednesday schedule, surely even Director Im would understand.
It was not her imagination.
This hospital was clearly targeting Hyundai OB-GYN.
Since we expanded and hired two more doctors, Director Im has been eating nothing but one roll of kimbap for lunch.
What if the clinic failed?
Everyone here was so kind.
It was such a good place to work.
It needed to succeed for a long, long time.
Yuri clenched and opened her fist, then started typing another message on her flip phone.
[Director, should we extend our clinic hours too?]
One week passed.
Gain took out a calculator and notebook.
It was time to organize the expenses.
She could have used Excel, but she wanted to write everything down by hand and use it to plan the clinic's next stage.
Now that we've added so many employees, labor costs have increased dramatically. I need to do an interim review.
First came the monthly fixed expenses.
Rent: 2.1 million won.
Pyo Jinwoo's salary: 9 million won.
Saetbyeol's salary: 8 million won.
The nurses' salaries.
Employer contributions to national insurance programs.
Medication costs.
Disposable supplies.
Fixed monthly expenses easily exceeded 25 million won.
Next came the expected monthly revenue.
Gain multiplied the number of outpatient patients by the average consultation fee.
I expected to run at a loss for the first three months.
Seeing the actual number still made her uneasy.
Skipping lunch and eating one roll of kimbap would not solve this.
Gain stared at the calculator display for a long time.
If it's true that patients are moving to Seohwa, this number will be even worse next month.
She had heard Seohwa was attracting patients.
Every newly opened business drew customers at first.
So Gain had not been especially worried.
But her employees were becoming anxious.
Choi Yuri wants us to extend operating hours.
Lee Seyoung even offered to delay her maternity leave and work overtime.
Jo Eunjae had decided she would disinfect the clinic even more thoroughly than Seohwa.
She started arriving thirty minutes early and cleaned the floors more thoroughly than the cleaning lady.
Everyone cared about this place in their own way.
The deficit is still within the range I expected.
For now, it was manageable.
But once deliveries began, things changed.
Prenatal and postpartum checkups had government-set reimbursement rates.
The fees were fixed.
And the more deliveries a hospital handled, the more likely it was to lose money.
Delivery table.
Two fetal monitors.
Neonatal resuscitation table.
Incubator.
Suction equipment.
Warmer.
Defibrillator.
Even buying everything used required a significant initial investment.
Labor costs were an even bigger problem.
Natural labor could not be scheduled.
Someone had to be available at night.
At dawn.
On holidays.
Night-shift and holiday pay had to be added.
The on-call anesthesiologist was also expensive.
Dawn calls required extra compensation.
Based on Somang City's population and last year's birth numbers, natural deliveries alone can't avoid running at a loss.
Six months ago, the last delivery hospital in the city had closed because it could no longer absorb the losses.
Women in Somang City now had to drive at least thirty minutes to give birth.
But Gain desperately wanted to offer deliveries.
She could not keep operating at a loss forever.
Fortunately, or unfortunately, the technique she had learned recently could help make up for it.
No wonder so many doctors had attended the intrauterine insemination training course.
Intrauterine insemination was a non-covered treatment.
The hospital could set its own price.
If I charge three or four hundred thousand won per cycle, that will give us more room.
It did not even require much equipment.
A semen collection room.
Centrifuge.
Microscope.
A semen incubator.
Procedure fees.
Ovulation-inducing medications.
Follicle ultrasounds.
All of it was outside standard insurance coverage.
To monitor follicle growth, patients needed an ultrasound every two days.
Four or five scans per cycle.
If each scan cost twenty thousand won, that alone generated revenue.
There were many other potential charges too.
Ovulation injections.
Semen analysis.
Luteal-phase support.
Gain underlined the numbers.
If oral medication alone was used, a cycle cost around three hundred thousand won.
Once injectable medications and procedure fees were added, the cost easily exceeded eight hundred thousand won.
For older women or those with poor ovarian response, higher doses and additional tests could push the cost past 1.2 million won.
And intrauterine insemination rarely worked on the first attempt.
The procedure placed prepared sperm deeper into the uterus so they had an easier time reaching the egg.
Even then, many sperm still failed to reach their destination.
Most couples tried three or four cycles on average.
"..."
Gain's pen stopped.
Three cycles meant at least 1.2 million won.
At the higher end, 3.6 million won.
Because the treatment was not covered by standard reimbursement, the Health Insurance Review and Assessment Service would not reduce the fee.
Gain could charge almost anything she wanted.
If she wished, she could make plenty of money from it.
But she did not want to overcharge desperate couples.
She only wanted fair payment for the treatment she actually provided.
Gain drew a line through the figures.
Then I just need to turn three or four attempts into one.
Most inserted sperm never reached the far end of the fallopian tube.
Gain thought of one drop of divine power.
She could not create sperm that did not exist.
But if healthy sperm already had the strength to swim, perhaps she could give them a small push so they would not lose their way.
That seemed possible.
After lunch, the staff naturally gathered in the waiting room.
Lee Seyoung spoke first.
"New patients for this Thursday are only half what we had last week."
She frowned.
"I think they went to see the director at Seohwa on Wednesday."
Bae Sora, a nurse who had started the previous week, cautiously glanced at Seyoung.
The look practically asked, Is this place really going to be okay?
Lee Seyoung subtly nodded where the others could not see.
Bae Sora had extensive delivery-room experience and was Seyoung's junior from school.
Oh Dayoung, the neonatal intensive-care nurse Hong Inyoung had recruited, was not nearly as cautious.
She crossed her arms.
"That hospital looks like it opened here specifically to steal our patients."
"Surely not."
Lee Seyoung laughed.
"They were probably already planning to open around here and it just happened to overlap."
Choi Yuri sighed.
"Some people who were coming to us are going there instead."
She lowered her voice.
"Actually, quite a few patients canceled our appointments and went there."
The newly hired nurses did not look reassured.
Bae Sora fidgeted with the edge of her nail.
Oh Dayoung stared at the floor with folded arms.
Then the examination-room door opened.
Gain stepped out.
"I have something to tell everyone."
Everyone looked at her.
A moment later, Kim Saetbyeol and Pyo Jinwoo also came out of their rooms.
"Starting next week, our clinic will begin handling deliveries."
Pyo Jinwoo smiled with satisfaction.
"Excellent. I'll take the first on-call shift."
"It took time to secure on-call anesthesiologists."
Gain continued,
"They'll be available starting Tuesday."
"From then on, we'll take both vaginal deliveries and cesarean sections."
Lee Seyoung's eyes widened.
"Really?"
"Yes."
Gain nodded.
Finding anesthesiologists who could come whenever called had not been easy.
Relying on only one was risky.
Fortunately, one of Gain's seniors working as an anesthesiology fellow at Hanguk University Hospital agreed to take calls on his days off.
That senior then introduced another friend.
Gain had secured two anesthesiologists.
"We're currently the only hospital in Somang City offering deliveries."
She looked around the room.
"The hospital everyone's worried about doesn't handle deliveries. They focus on gynecologic conditions."
"If women come to us during early and mid-pregnancy, many of them will naturally stay here through delivery."
The employees looked slightly reassured.
Bae Sora and Oh Dayoung exchanged smiles.
Both had years of specialized experience, one in a delivery room and the other in a neonatal intensive-care unit.
Yet since joining Hyundai OB-GYN, they had mostly been assisting with ordinary outpatient care.
"So that's why Seyoung unni asked me to come here."
"I knew we were going to start deliveries soon."
Bae Sora smiled.
"I'll start preparing the delivery-room manual right away."
"Good."
"I'll do the nursery manual too."
Oh Dayoung spoke next.
"The incubator cable is the wrong standard, so we need to reorder that as well."
Gain nodded.
"Make a list of everything you need and give it to me."
Her gaze moved to Choi Yuri.
"Don't worry too much. That hospital and ours are going to end up seeing different patient groups."
"Yes, Doctor."
Yuri answered energetically.
