HockeyRef,
I believe in the democracy of the market. Those who are sufficiently tech savy to be able to run a medical practice, computer systems are few and far between. Even so they should still have the ability to own and manage their software/data in their own environment.
Then there are those who do not want the hassle of purchasing, managing and maintaining servers and/or software. They should also have that option.
Instead of focusing on the "unscrupulousness" of the vendor, the consumer should be offered a choice which they will make depending on THEIR needs.
The market should decide the offerings...as it always does.