Only way to advance is getting into management, and even then, it depends on who you know and how much they like you. Management also doesn't care how hard you work, they value Press Ganey scores over employee happiness. They will write you up a dozen times for being 1 minute late, but never notice hard work or even work anniversaries. If a patient says anything that's remotely negative about you or resembles a complaint, you have to go through training and make an "action plan" so you can align your behavior with their values. All of it is a joke. Management pushes a completely different set of values than what actually happens in their clinic. STAY AWAY!