The neighborhoods around Cleveland Clinic changed drastically in the 1970s, and as many acres of land became available, the Clinic purchased the properties and banked them for future expansion. Cleveland Clinic was a unique entity among local hospitals. In 1978, it was seeing 2,500 patients a day and had one of the busiest surgical practices in the United States, yet only a small percentage of these patients were local. At the same time, the Clinic provided a substantial economic benefit to the region. There were 6,000 people working directly for Cleveland Clinic in 1978, making it the sixth largest employer in the city.