My thoughts:

We have to be realistic about our expectations at the price we pay. AC needs 60 doctors a year ($1000/Dr.) to pay for one *ENTRY* level programmers salary (~60K). Putting these sorts of pressures on them will lead to a poor and unfinished product. We've all seen it before. A company tries taking too much on its plate and ends up failing. We've seen some of the repercussions with them trying to implement all the MU stuff, ePrescribe, etc. Do you really think Practice fusion only makes $1000 dollars a doctor with the ads? Those sort of target groups are what advertisers dream of. I personally wouldn't be surprised if it were 5-10 times that. Google is making billions with a shotgun approach.

You might be wondering how big companies like Microsoft and Adobe do it, but they already have an established market. I'd imagine we'll see rapid development on par with those companies once AC gets big enough. That's assuming small practices are still around in a few years. The ones around me are disappearing very quickly.