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I am not sure where it stops, if its based on reputation alone, or based on # of GPs or staff. If it is based on how large your hospital is and staff, then its just a cycle of hiring more to take care of the neverending amount of people coming in until there's too many people because its limitless scaling.
And to your point, since space is limited, the scaling will always be a problem if it is limitless.
I don't see how space is an issue when space is always limited on every map no matter what. It just makes more sense to limit patients to the space you're given, rather than give more space which there's a absolute maximum for.
You cant satisfy demand because you dont have the space.
Maybe it scales up a bit fast, you dont seem to be penalized enough for deaths, when you get lots of people and they are dying left right and centre the ques keep growing rather than people deciding a erip to your hospital is a suicide mission they would rather not do.