Last year I built a fairly high-powered server (And wired the network, built all the client machines and swore the air blue over the @%$^£^& software he runs his practice on) for a dentist dedicated to running a fancy database with which he runs his practice.

Got a very unusual support call this afternoon. "Can you come and fix the server, it's making a noise like Kenny's drill" Told them to shut it down at close of play today. Have to be there at 7am hoping that it is a failed fan and not a failed drive.

That could be bad.

Very bad.

Last time the former server died I ended up on the reception desk as the patients arrived. In between reboots and database rollbacks and rebuilds I was the receptionist. No paper records - they're all in the temporarily (Well 10 hours later I got it working) inaccessible database. Don't ask me how much I dislike the dental practice management software I've been exposed to as it'd get me kicked out of any civilised company. Or Windows Server 2003R2 - won't work on anything more recent.

So patients come in. No records so have to ask them.

"Which dentist are you in to see?" There are 3 possibilities


"Is it a man or a woman?" One of the three is female.


Rats! The woman is new so:

"Does the dentist have hair?" The boss shaves his head.


OK, another one for Kenny.

"Are you in for a checkup or treatment?"


FFS! who are these people? There is no way at all I'm submitting to a stranger for any sort of medical treatment when I don't know exactly why I am there, or what I am there for. Now we don't normally have to pay for healthcare here, but this is a purely private practice so everyone there is paying quite a lot of money to be there at all. And they had no clue as to why they were there!


That time, I finally got the server up and running just as the last patient left, ten very lucrative hours later.

But I really, really hope it is a fan and not the boot drive this time.

Remind me to image the boot drive and database this time. Easy then to roll forward from the hourly backups. I hope!

Sadly I can't take the drive image home with me on one of the many spare drives sitting around as that would break about 3,000 data protection laws.

Two weeks of data recovery, not to mention rebuilding a server on the spot is really, really not my idea of a good time. Sleeping and playing with the dog are a lot more fun even if the hourly rate is a bit worse.

So here's hoping it is just a fan with shot bearings. Am taking a bunch of fans in the hope that they are the problem.

You should install that noisy Sun server you have for the client. 1) It makes so much noise he'll never notice a problem again. 2)It won't run Windows, so he can use a decent database. ;)

If I could write practice management software, I'd not be doing what I do. This stuff is smart and includes the 3D stuff from the frighteningly expensive whole head imaging device (Which would buy my home and then some). I optimised the box for I/O running Windows Server 2003R2. The software is certified on XP and this config of Windows Server. The lease on the software would buy my car roughly every hour.

I'm allergic to databases - never had to work with them (And don't want to start now - my CS courses ended in 1980) while being fully aware that every business application is a database in fancy dress.

I'm not a database guy. Hardware I can handle - software if a reboot won't fix it, ask someone else. If there were a Linux/Solaris/GNU based practice management setup that could handle the X-Ray machines and their imagery I'd install it last month. Kodak sell the practice management software, the imaging devices and everything in between. With undocumented protocols. You buy their stuff or it doesn't work. Annually

Besides the only place in the practice with enough spare space for the Sun server would be the reception area. The patients might not like it.

Then there is the fun stuff about integration with both NHS and HMO proprietary protocols which are not documented anywhere till you give them a lot of money. Actually we don't have HMO's in the UK - we call them insurance companies.

If I had the skills to build that sort of thing, my income would be rather more than it is. By a factor of 100.

And I'd hate myself.

Now that I looked into it a little bit, there is an astonishing list of open source practice management software.

Most of it is probably junk, but then again I know absolutely nothing about how to manage a practice.

It's really astonishing how much non-computer people are willing to pay for substandard SW, just because it all seems like a magical box, just because it's slightly customized to their purpose. Most of this SW is pretty simple, too; they're essentially DB frontends that at most move a few docs around, essentially a straight replacement for file clerks.

Does the kodak stuff even use sql svr? Or some hokey scheme they invented themselves?

The medical industry is characterized by out of control spending. Even if a better, cheaper solution exists, they often don't look twice at it because they think everything has to be expensive.

Well it uses Microsoft's version of SQL server. Not a recommendation in my book.

What you are really paying for is the official NHS and insurance company payment schedules and the ability to submit them online. The patient record and appointment stuff is straightforward but nicely done. The user end is OK, the back end is actively hostile to anyone who has to configure it. This is by design.

The documentation is lacking. Almost completely. You are supposed to hire one of their consultants at scary $ per hour to install, configure and maintain it.

That's for sure. A dentist's chair costs around $50,000 before you bolt on all the essential drills and stuff. To set up a surgery here, you are spending around $150,000 on hardware. Then there are the compressors, sterilisers and so on.

My father was MD of the company that made the world's first MRI scanner. GE and Philips wanted the market so added a zero to the selling price of the large electromagnets required.

The parts cost around $300,000 back then (80's).The selling price was around $800,000 which was fine till they installed one in Zurich. It really wasn't the best idea to install a device that detects very, very faint RF signals right under the power switching gear for Zurich's underground railway. Building a Faraday cage to put it in killed the company - much to the delight of Philips and GE.