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"You don't get blood pressures done, sugar measurements in diabetics, temperatures taken, turning of patients, just basic care," said Dr. Kate Grimwade, one of five government doctors on staff on this day.
Few of them have doctors on staff, and most are owned by for-profit companies.
Doctors on staff have been told to abide by the guidelines or face the consequences.
In February, the hospital's board of directors limited the heart program to doctors on staff, prohibiting Drs. Chandna, Gaalla and Parikh from treating patients there.
This, Fernandopulle explained, would force doctors on staff to focus on service, in order to retain their patients and the fees they would bring.
Although dozens of needle exchange programs, rehab centers and pain specialists in at least 16 states distribute it, the prescription requirement severely limits its availability to those organizations that can afford to have doctors on staff.
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While all of the hospitals had at least one medical doctor on staff, two hospitals had only one doctor and three had only two doctors.
All accredited sleep centers are required to have one certified sleep doctor on staff.
There is electricity now, and the ceiling has been patched, but there is still no doctor on staff.
Dr. Barkley also suggests calling a nearby medical school or university psychiatry program and asking whether there is a doctor on staff who specializes in adult A.D.H.D.
Mr. Hawkins said that the factory was air-conditioned, that it paid overtime and that it had a nurse and a doctor on staff.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com