Why should I be upset with proprietary software?

It can't be improved without trying to keep customers happy, most of whom are asking for options that break the functionality to suit their inability to conceive of the proper software use in their procedures. The end of this "functionality creep" is a less useful product.

Commercial groups are not prepared to employ/second doctors to develop the reporting functions - there is little idea of the medical dynamic that drives reporting in very random directions.

Software requirements for the OIS are often gathered in 1-5 days - really, it took me 5 years to learn to think this way with a base medical degree, and somehow a kid with an IT degree is going to understand this in one week? Yah, right!