The practitioner software I saw was built in dBASE III or dBASE III+.

I know a chiropractor and physical therapist who've done exactly that. It boggles the mind.

It doesn't boggle the mind at all. People want results and income, not elegant software. The more it does the more it gets in the way. Better crap software written by a domain expert than great software written by what a programmer thinks a practice needs.

Oh, no, I get that, believe me. It's millions of lines of code in Access--from the technical side it boggles the mind.

The business case is quite clear. :)