Small and midsize hospitals have usually been in a difficult situation, compared to large institutions, in terms of operation. However, their financial status has become worse recently, industry sources said. Even successful hospitals had a setback due to the workforce shortage, which led to rising labor costs, they said.

As large hospitals take away not only patients but doctors and nurses, smaller hospitals suffer from the double whammy of the staff shortage and high employment cost. Small and midsize hospitals cannot help but raise salaries for doctors and nurses to keep them from leaving for large hospitals.

Tertiary general hospitals have expanded the nursing and care integration service. University hospitals, including Ewha University Seoul Hospital and the Catholic University of Korea Eunpyeong St. Mary's Hospital, have grown in size to absorb the nursing workforce. Consequently, small and midsize hospitals suffered a shortage of nurses.

A general hospital had to raise nurses’ wages by more than 30 percent in the past three years, and another general hospital, 11 percent. A third general hospital with 500 sickbeds suffered an exodus of nurses who used to work at the operation rooms. The hospital had to close four out of nine operation rooms.

Hospitals struggle to hire not only nurses but physicians. As the law capped the maximum work hours of trainee doctors at 80, tertiary general hospitals hired more hospitalists, and this had a significant impact on smaller hospitals.

“The number of patients who visited small and midsize hospitals decreased due to the concentration of patients in large hospitals, said Chung Young-ho, president of the Korea Small and Medium Hospital Association. “Above all, however, the labor costs went up.”

In the past, hospitals lacked only nurses. Still, now they find it difficult to hire physicians and pharmacists, he added.

“As smaller hospitals find it hard to get medical staff, they are competitively raising wages. If a hospital provides a high salary for one person, it has to raise all the other existing employees’ salaries,” Chung said.

The shortage of medical staff is affecting not only smaller hospitals but large ones. Some said the government’s broadening of the health insurance coverage aggravated the situation, saying a rapid increase in CT and MRI tests drove up salaries of radiologists.

Radiologists’ salaries soared by over 100 million won ($86,195), but many hospitals still find it challenging to hire a radiologist. Some large hospitals even discussed sharing their medical staff to have them take a turn in night shifts.

Lee Eun-sook, president of the National Cancer Center, said she heard that a tertiary hospital offered a salary of 100 million won higher to hire a radiologist from the NCC. A radiology-related company was even trying to attract radiologists, offering a high wage for part-time work.

“There is no way we can respond to this. It is a serious problem,” she said.