I had to work with an internal recruiter for the entire process, including receiving my offer. I felt I had an argument for a higher salary, but my message was poorly conveyed to the practice leader, so they declined my counter. I was able to contact him directly to make my case, and he agreed. However I still had to go through the recruiter. She was slow to answer emails and schedule calls. So each step of the back and forth would take 1-2 weeks. We ended up hitting a deadline for filling the position without finishing the process. All of this could have been avoided if I just worked directly with someone who actually works for the practice rather than a recruiter.