Our office has been using Sage (Medware, now Sage) since 1996. It is simple, and has never been a source of the frustrations I read about from other PM programs. It doesn't have a lot of "management" bells and whistles -- but how much of that is appropriate to a small practice anyway? You can do billing, scheduling, and manage accounts receivable very competently.
Backup is easy, and the rare crash is easily recoverable. Networking in a small office environment is flawless.
We started using AC on a regular basis about 6 months ago after dabbling at it for well over a year. I like it very well, except the PM part is useless.
Running Sage and AC separately really isn't much of a problem -- EXCEPT! -- Add Quest. Now we have to have patient insurance information for the "bridge" to Quest to work very well. They have spent a lot of time and money trying to get us integrated, and the HL7 files seem to work just fine even without insurance info in the AC database, they come into the AC accounts without a hitch. But we can't order directly from AC, because we haven't been adding or updating insurance information in AC -- just in Sage. Adding that much more overhead to the receptionist's duties seems a little too much at this stage -- maybe later on, or maybe there is some kind of interface that will allow the two to merge. There is something advertised to work, but it seems pretty expensive, and I'm not willing to bite at this point.
