The baby makers.

• Author: Bailey, David
• Position: Center for Reproductive Medicine

THE BABY MAKERS Making test-tube babies is the easy part. Making money's the problem for this Charlotte infertility clinic. They nicknamed her The Debboe, and she was the first -- but not the worst -- of the office managers that Dr. George Gaunt Jr. and Barbara Fields would hire.

In the summer of 1983, a salesman came to Gaunt and Fields to demonstrate how they just couldn't do without a self-correcting typewriter for their new office, the Center for Reproductive Medicine -- a Charlotte clinic designed to help infertile couples have babies.

"We had the secretary interview at the same time that the typewriter salesman was there to see if she could type or not," Fields recalls. "The salesman says, `Type your name into the typewriter'...and she typed D-e-b-b-o-e. And he said, `Oh, we've made an error. That's good. Let me show you how to correct it.' And he corrected it and said, `OK, type your name again,' and she mistypes it."

Thinking that she had been intimidated by the new memory typewriter, they went ahead and hired her. "[She had a] wonderful personality," Fields says. "Patients just loved her. ...She'd been an office manager for 10 years in a doctor's office, right?"

After a few months, they sent The Debboe, as they began calling her, to a beginning typing class at the local community college. But the real surprise came several months later.

"We just assumed patients were receiving bills, and it took us at least three or four months to realize nobody was sending out any bills," Fields says.

What brought that realization about was when Gaunt asked the secretary to order something for the lab, and she told him she couldn't because they didn't have any money. "We had a [$25,000] line of credit with the bank to cover us, and I assumed we still had it, and the secretary said one day, `We've spent it out,'" Gaunt, 46, recalls.

"We're working our guts out taking care of patients," Fields, 44, says. "There ought to be money up front in the business office to pay the bills, but things came to a screeching halt when there were no more resources. ...

"For the first time, we really realized we were running a business, and it never dawned on us that we would be running a business."

So began the business education of a Yale medical-school graduate with a Ph.D. in biochemistry from Rockefeller University and a no-nonsense nurse, teacher and family-planning practitioner. Their problem, in retrospect, was a simple one. Like some others who have gone into medicine thinking more about meeting mankind's needs than balancing a budget, they didn't know how to manage their money.

"You don't learn it in medical school," Fields says, "and you don't learn in nursing school about asking people for money. Administration always did that, right?"

"There's always that feeling that you really ought not to be charging people anyway," says Gaunt.

The couple, partners in both marriage and business, have a long waiting list of people seeking their services. The in-house lab they set up when they opened has grown and prospered, performing tests for hospitals and doctors in six states. In their small, almost homey clinic furnished with early American-style furniture, they've been able to produce six test-tube babies -- removing the egg from the mother and fertilizing it under controlled lab conditions before replanting it. In fact, their in vitro fertilization success rate is better than that of some top university medical centers.

Despite these successes and the handsome fees Fields and Gaunt charge for making babies, the center has never generated more than a small profit, they say. They pay themselves a good salary, though they won't say how much. Their operation just about breaks even each year, they say, and money problems have been a constant side effect of the center's phenomenal growth -- 200 percent in each of the first two years.

And money troubles did not go away after annual growth leveled off at 25 percent. Even now, Fields and Gaunt are still trying to figure out how to make the business turn a decent profit, although over the years they have learned a lot. But they've learned the hard way, mistake after mistake after mistake.

Charlotte native George Gaunt spent his time at Chapel Hill getting a bachelor's degree in chemistry and zoology. In 1968, he went on to graduate school at the University of Michigan, where he got interested in a newly discovered substance called lysosome. Lysosome helps cells use proteins and carbohydrates by breaking them down into usable forms.

The man who first detected and identified lysosome was at Rockefeller University in New York City, where applicants must have a letter of recommendation from the president of their school and a stellar academic record to get in. Gaunt boldly presented the lysosome scientist with some novel research he wanted to conduct and was accepted. In 1973, he earned a Ph.D. in biochemistry with an emphasis in reproductive biology.

Gaunt's mentor at Rockefeller ended up winning the Nobel Prize for his lysosome work, but Gaunt had another goal -- medicine. "What I always wanted to do is apply basic...