No pay rises
Managers are hardly ever in the clinic and do not routinely provide feedback on your performance, making it difficult to figure out what you should keep working on.
You'll have clients call you on the phone complaining about their cancelation/freeze/transfer forms not having been processed for the last two months. Then, they'll ask you when your general manager works next; and sure, you can give them information on *when* your manager is meant to be in the clinic or can give them a call back, but they hardly ever are.