A colleague of mine recently spent $40,000 on an office phone system. When we opened 4 years ago, we spent $3000 on ebay and I though it was a lot.
But phones can do more now .. and I think that an idea system would look something like this.
If you agree, please consider adding to the "bounty" so we can all create an excellent phone system for medical offices that doesn't cost $40,000. And of course if you have suggestions or additions .. please modify the description .. as it's on a wiki over there at voip-info.org.