Hi Gene,
There are many more things to consider including how your office is set up if there is downage of the Internet vs AC crash. We have little issue and, in fact, when our Dell exploded (not quite that dramatic, but some wires were burned to a crisp. We were out of most, but Dell got there soon enough to watch me fix it.
With centralized management you have WAY more control over your users using Group Policy. Someone screwing around with AC folder, stop that immediately no mater who it is. Centralize logging. Etc. As one IT tech told me, he won't work on P2P, because it is too difficult.
One area I think you are failing to posit are replication backups and failover. Certainly VMs can be set to operate in the clouds and you can have failover or replication with immediate change to the good server.
I don't think you can add certain software to the cloud. Say you wanted to change to Medware as a scheduler/billing softare; I am not sure you can do that.
Plus there is always the small issue of DNS, DNS, DNS and even DNS.
You can have the best of both worlds, but it would require some upfront research. I would suggest two things since you seem to be prone to #7 above.
You should acquire as much information on the cloud services, but as to your other decision, at least look at an IT company who could recommend setups, help with an ala-cart support (sp?) and ask them if they could set up a server/cheaper server for replication. Let them take over backups. They may even have in house setups at their business which would essentially be the cloud as to getting back up and running. You shouldn't look at it as an all-or-nothing issue with a server problem.
My recommendation would have a list of scenarios and questions, problems you had in the past with being down and the cloud. But, I would go to their shop to ask the questions. If they immediately come to yours, they may charge or get into bashing your current setup, lol. Of course, they will slightly be biased toward an in-house solution just as AC may be biased toward the cloud. The failover and replication backups using VMs would be ideal. Of course, if you went that route, it would be easiest if at least an IT company set that up and/or you could call them with help in those situations.
CAVEAT: In the distant past, discussions such as these deteriorated into a C/S vs P2P setup. Certainly, P2P is enough to run AC. I believe we got into that too much. We didn't get into both work. What are the advantages to an office that uses C/S. I was about as much to blame for perpetuating this "discussion" and I tried as much as I could to develop flame wars, which only turned out to be "embers." (A slight political statement).
So, we shouldn't get onto that. It should be should you stay in house and, if so, use a C/S setup vs a P2P and what would be most efficient and reliable vs using the cloud. There are many other situations here that would push you one way or the other, but I don't have enough room, and I do not have Bert A. MVP, MCITP credentials and Sandeep-qualified behind my name.
In the end, I wouldn't make any decision without talking to local experts. I would also be right up front with you are looking at various IT vendors looking for advice and possible implementation without resorting to el cheapo, but also wanting to compare. This will keep their prices down some. As an FYI: I lease from a doctor who uses client/server. The score right now is Bert:190 hours plus untangling ethernet cables and reading manuals and on my back connecting and troubleshooting vs Gary's 0 given he has IT. OK, he had one issue. But, I fixed it. But, he never, ever touches it. IT support from a local vendor does all that remotely. But, again, they are still on Win 7. I also do a lot of projects and add software, etc., which helps me tremendously and also goes out of its way to break everything.
HTH.
