Its probably pretty common. Its unlikely that anyone at the clinic has any idea how the billing system works; the accounting department is just staffed with acc

Its probably pretty common. Its unlikely that anyone at the clinic has any idea how the billing system works; the accounting department is just staffed with accountants and has no engineers. The doctors and nurses and receptionists know even less about it. Fixing the problem might be even more trivial than mirroring the whole database, but there's no way for anyone at the clinic to know that.