* Driving demands are often excessive and inefficient, with large geographic coverage areas that are not always well clustered, making productivity feel unnecessarily difficult to maintain
* Limited flexibility in case assignments, even when routes are clearly inefficient or impact daily workload significantly
* Little to no meaningful internal promotion pathway, with leadership roles rarely filled from within the clinical staff
* Compensation growth is minimal, with raises not consistently reflecting workload, experience, or performance
* Starting PTO accrual is very low compared to industry standards
* No 401(k) employer match, which is a notable drawback for long-term retention and benefits competitiveness
* Management approach can feel rigid, with limited willingness to adjust quotas or operational expectations despite clinician feedback and field realities