Hi Nate,
I'm bumping your post back up because somebody must have experience with Windows 7 voice recognition. Personally, I use Dragon medical because time is money, but frankly time is aggravation and I don't need any more of it these days. Having a preloaded medical library is a wonderful thing. The $1,000+ you'll spend is like a shot. It hurts for a little while at the beginning but is quickly forgotten. The pain of training new medical words will hurt for months and months.
My 2 cents.
Dave
FP