Brian,
Last I checked Open Office was free:
http://www.cdearth.com/openoffice-office-suite.htm And Star Office was $69.00
http://www.staroffice.com/I also find it hard to believe that a physician's office would not have Word. Now granted to have it in every room would cost money unless you were smart enough to hold onto Office2000 which is free (and highly illegal -- back to the EULAs again).
Wouldn't you think that WordPad is better than the letter writer. As George continues to say, the best code is free code. The best programs are free programs. Why build a letter writer when Microsoft, Open Office and Star have already done it?
There is really no need to bundle anything with Open Office when it is free.