Policies in the handbook often felt confusing or unfair in practice, and enforcement seemed inconsistent. I had concerns about privacy practices and raised them internally because I did not feel comfortable with how sensitive information was handled. Leadership decisions appeared to favor friends or relatives of management, which affected morale and trust. Equipment and software were frequently outdated or in need of repair, which made it harder to do the job well. To my knowledge there was not consistent on site medical leadership, which contributed to uncertainty around clinical decisions. Benefits were minimal during my tenure and I did not receive clear information about improvements. Communication from the top was reactive rather than proactive, so issues lingered.