My anecdotal evidence from a surgeon in the family is that the medical dictation is still very bad. His practice of 4 doctors spent a bunch of money on Dragon, fought with it for a month, and then went back to old-fashioned human dictation.
from what I remember, you might be right that Dragon is not that great, PowerScribe is the one I remember being more popular -- I was doing RIS (Radiology Information System) work at the time about a year ago.
