Thier wages. They pay $15/hr., which is the same you can make at McDonald's or Wal-Mart, and you will not have homework or such a heavy workload. No PTO, paid holiday, no paid vacation, and deficient health insurance. Non-stop, back-to-back phone calls. Your brain does not have time to adjust from one language specialization to another in between phone calls. During one phone call, you may be interpreting for a pharmacy, and the next phone call will be a totally different industry.