"This stuff isn't hard if you know your way around a computer" This is true. What's hard is finding recent grads willing to suck it up and work with 40 year old technology. If you want to submit claims to Medicare directly, you have to do it via ZMODEM on a direct dial 56k line. ATZ...ATDT PHONENUMBER...I do it every day. As for development. Do you know a lot of MUMPS programmers? Do you know a lot of programmers who know what MUMPS even is? This is what 90% of the currently used EMRs use as a backend/DB. VistA, EPIC, Centricity, Meditech...all of these vendor packages use M, and there have always been jobs for people with MUMPS skills. At least there has for the 15 years I've been doing it. With the influx of Government monay, the need will only increase. But try finding classroom instruction in MUMPS - it doesn't exist. You sound really confident though, so you are probably right.