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Because you can optimize the storage of each table; furthermore, you will avoid self-joins.
answer is C, the problem here is the self-join (avoid self-join if possible) on a Denormalized table. So the solution is to Normalize
Normalizing the database into separate Patients and Visits tables, along with creating other necessary tables, is the best solution for handling the increased data size while ensuring efficient query performance and maintainability. This approach addresses the root problem instead of applying temporary fixes.