Love Dragon 10 Medical. Really didn't like Dragon 9 and actually completely abandoned Dragon until earlier this year. Is it worth the cost difference? Of course not but the medical portion is nice. It's not perfect and has trouble with my southern accent at times but I've learned to enunciate quite well. I use the Dictaphone PowerMic and it has definitely been a HUGE difference.
My next step is to develop "Voice Fields" when I get some extra time.