Jim,
I'm the cheap black sheep here, and I love Win 8.1 Pro. I am not a fan boy for Microsoft. Yes, you can boot to the desktop.
My hospital had a difficult time connecting me into their clinical databank, but they figured it out after 1-2 hours. Primarily since they had not dealt with Win8 before. Check with your hospital IT if that's an issue for you. It has something to do with the new version of internet explorer possibly not being supported on their systems yet I believe.
Win8.1Pro is Win7Pro with a normal desktop you need, plus a Metro interface for touchscreens you will not need.
Win8.1Pro is Win7Pro with better security.
Win8.1Pro is Win7Pro at half the price.
Win8.1Pro is Win7Pro without the start button. You can add it with free add-ons (start8 or classicshell), that we don't use.
Win8.1Pro is Win7Pro but faster. I'm biased
Win8.1Pro is Win7Pro with a different way to turn it off or restart it, in the right instead of left lower corner.
Win8.1Pro is Win7Pro but with a probably cheaper upgrade path to Win9Pro in about a year.
Win7Pro with AC was the worst experience with computers in my career.
I bought 5 new HP Win8 "down"graded to Win7 machines for my exam rooms 1 year ago. It was hell with AC only. AC kept crashing when I came in the room to log in on almost every patient. Nobody here had any issues and guardian support at AC had never heard of it. When Win8.1 came out last October, I bought new machines for the exam rooms, upgraded everything to Win8.1Pro, and haven't had an ounce of trouble with the machines, or with AC, or with my staff about Win 8.1Pro.
I suggest that you watch some youtube videos on Win8 navigation and searching, because it is different and smart doctor types don't like to feel stupid. To boot to desktop you right click on the taskbar in the desktop, go to the navigation tab, and check the two top check boxes in the Start section, and go to work. I haven't seen any employee trying to explore Metro land, even though I told them that they were welcome to explore. If they do and get lost, just push the Windows key and the D key together and they will go back to the safety of the desktop.
I suggest that you buy a Win8.1Pro box and play with it for a while before you decide. You can always downgrade it.
I gave a 2 page letter to the staff about working in Win8.1, how to open and close it, how to get back to the desktop if they get lost in touchscreen metro land, listings for youtube videos, and I haven't had any complaints. They figure it out quickly and it becomes routine.
