Using the hospital as the doctor's office is not uncommon in America. When you're low on cash and don't have insurance, visiting the emergency room is a viable option.
And may be less of an option now that more people are insured.
Research out of the University of California-San Francisco notes in California since the passage of the Affordable Care Act (Obamacare). There are some caveats to the information, which lead author Shannon McConville explains in her visit.