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It's a generational thing as well.

My wife is just out of residency running her own medical practice. She went with the latest-and-greatest electronic medical record system that's all either web of iPad based, with all her records stored in the cloud and fully integrated with similarly advanced billing software. It's pretty good, and does most of what we need well. It's definitely head-and-shoulders above any other software out there that's specific to her specialty.

Right now she's considering buying another practice, and during the pre-purchase process the ~65 year old doc was talking about how fantastic their medical record/billing software suite is. Does everything they could ever want it to do, everyone in the office loves it, etc..

So, I ask for a demo, and he loads up a Filemaker database running off the server in the back room. Looks like it was designed in 1996, offers zero web-connectivity, and they're 100% happy with it.

That practice would never consider "upgrading" to the software we use. We'd never consider the software they use. There's a generational gap in medicine and dentistry, just like everything else. The more young docs come out of medical school, the higher their expectations will be for things like GUI, UX/UI and mobile connectivity.

Depending on how you mean generational - if the implication is that younger generations won't be susceptable to this, then I disagree. If instead you mean that it's generational in terms of software generations and the systems we first learn to use - with that, I definitely agree.

For your wife, in ten or twenty years that all-touch cloud-based system will be as the Filemaker system is for the 65 year old doc, when the next generation of latest and greatest comes around.

It's not about the abilities of the technology, IMO, but about people's resistance to change for the sake of change. If what they have works well for them, there is very little impetus to accept change, particularly when technology is not their actual business.

Except that with a cloud-based product, she won't have a choice. She'll wake up a morning and the product will be different, she'll have to accept it.

Just like all the changes in gmail are not welcome by everyone, but you can't just choose to stick with the 2004 version.

Or, maybe, she'll get an email saying "we're sorry but we'll shut down the service, the company is closing". Or "we're glad to announce we're acquired by our competitor, see how you account will be migrated."

YES! I think the generational aspect of it is more that the older practitioners have been burned more by the new-fangled thing, and what's most important to them is a system they can trust.

There is a finite number of times that a small business owner can say the words, "I'm sorry, I can't schedule your appointment right now because our system is down" before never saying that again becomes their number one software-related concern.

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