Ramp up time can vary greatly from person to person, but the general consensus is that it takes a few months of hard work to establish that rolodex of of physicians to work with.
A lot of time is spent on the phones and can be frustrating towards the beginning. However, with practice and extra hours, come great rewards.
The technology could be more reliable. Occasionally crashes. Also utilizing other methods of acquiring a list of candidates perhaps through LinkedIn would benefit out arsenal greatly.