As the economy spirals downward, fewer patients are choosing to undergo elective surgeries that are lucrative for hospitals and help subsidize the care uninsured patients receive in emergency rooms, The New York Times reported Friday.

At the same time, with job losses escalating around the country, more and more uninsured patients are showing up in emergency rooms, the Times said.

In a tough economy, "they wait," said Dr. Ted Epperly, president of the American Academy of Family Physicians, referring to patients putting off knee-replacement surgeries or tummy-tucks, who can get by without the procedures.

"It's safe to say hospitals are no longer recession-proof," David Rock, a healthcare consultant in New York told the Times.

In Gainesville, Fla., Shands HealthCare will close a 367-bed hospital due to a lack of patients and economic downturns. "We cannot carry it anymore, said Timothy Goldfarb, the eight-hospital system's chief executive officer.