As hospitals struggle to cope with the influx of new arrivals from overseas, the medical community has been struggling to meet the demand.

As of Wednesday, the U.S. Centers for Medicare & Medicaid Services said there were more than 1.2 million medical patients on the waiting list for emergency room care in California.

In many cases, doctors have been forced to take on extra patient loads, with some doctors working overtime to accommodate the new patients, including a nurse who had to bring in 10 new patients a day.

The new arrivals are often the result of new rules enacted last year that require doctors to treat patients with chronic conditions, such as obesity, diabetes, cancer and chronic heart disease.

California has been the most successful state to enact these rules, said Dr. Jeffrey D. Gartenberg, a Stanford University geriatric physician who is chairman of the medical directorates of the American College of Emergency Physicians and the American Medical Association.

The rules have been well received by patients, who have shown an acceptance of a new lifestyle and increased use of care, Gartenburg said.

But the rules have also created a logistical challenge for hospitals, which have to coordinate and manage hundreds of patient visits a day, he said.

Many hospitals, especially in the East Bay, have been operating under the assumption that they would continue to operate under the old rules until they are met, Gartsenberg said.

California is not the only state struggling to maintain access to care.

A recent report from the Kaiser Family Foundation found that California’s emergency room population has declined more than 40% in the past decade.

And the number of physicians in the state has declined by over a third, the report said.

But Gartberg said that while hospitals can be hit hard by the new influx, they are not the most difficult to manage.

He said the vast majority of the people who are not coming to the emergency room are not emergency room patients, and most patients who get treated there are already being seen at other hospitals, such in the San Francisco Bay area.

The vast majority are Medicare patients, he added.