That's because lots of those get started by some doctor in their "spare time" and end up getting used, passed around, hacked on, etc. Doctors may be smart people, but they aren't software engineers.
That being the case, it's been my experience, that once an application gets in place and is being used it is almost impossible to transfer an organization on to something else.
Reminds me of the old joke:
Q: What's the difference betwwen a doctor and stock broker?
A: The stock broker knows he's not a doctor.
"That's because lots of those get started by some doctor in their "spare time" and end up getting used, passed around, hacked on, etc. Doctors may be smart people, but they aren't software engineers."
Run into that from time to time as well. Most Docs have no problem taking out a mortgage for their setup.