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As Donald Trump returns to the White House promising to obliterate business as usual in Washington, the city's lobbyists are preparing for a seismic shift in how — and where — they do business.

Three years ago, when Mark Goff and Phillip Engel had their first viewing of Château Avensac in the south of France, only one thing prevented the California couple from putting in an offer: Was it old enough?

When Josef Woodman's shoulder gave out in 2012 — strained from chopping firewood on his farm outside Chapel Hill, North Carolina — he said he was quoted between $2,400 and $3,200 for an MRI at Duke University Hospital.