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Some centers need complete updates, replacement, better treatment of staff.

It is normal to have 70-hour work weeks for months at a time. Hourly staff compensation is poor, so managers often have to step in to perform several other people's duties, as positions are vacated or remain open for long periods of time. McDonald's feel to the business model: give the cheapest prices and try to get the most people in. Care suffers and it creates a poor work/life balance as staff struggles to meet excessive efficiency goals. Directors of Operation are reactionary, rather than working with the clinics proactively. No sense of team between clinics and middle/upper management.