Now may not be a great time to change your software......YET. As I'm sure you're aware, there are/will be government incentives for offices to go completely electronic in the very near future. As a result, a lot of vendors are making a lot of claims and promises that may or may not be true.
There is a certification that these vendors must have/meet in order to qualify for the financial incentives offered from the government, so "buyer beware" and please do your homework.
As you know, I would like to remain anonynmous on this site, therefore I won't name the specific software our practice is utilizing since it's a very unique software and it's not presently being used by too many podiatric practices.
Additionally, our practice is relatively unique with well over a dozen doctors and over twice that many locations. Therefore, our computer needs may differ significantly from yours and your needs may differ from the doctor down the street.
I believe that it is important for most practices to have software programs that integrate billing with their records, but I also believe that many small practices are "oversold" products that they may not need.
The major things to keep in mind if you are a relatively small practice, is the history of the company, whether or not they are podiatry specific and the cost of yearly support and/or updates.
I would DEFINITELY ask for a list of references. In my experience with these companies, the list of unhappy clients is usually longer than the list of happy clients. A great resource to ask about a particular software program once you've found one, is Dr. Barry Block's website/email "PM News" which is a daily email listserv you can subscribe to for free. If you post your question on that site, it's read daily by thousands of DPM's.
For our office, I created templates for the most common ailments we treat, including follow up visits, new patient visits, etc. However, unlike some templates, information for each patient is unique and must be added so each note doesn't look like a "cookie cutter". The only problem is that you must be a decent typist, and some of my partners are almost computer illiterate and still want to dictate or handwrite, so there's a slight lack of consistency in our practice.
I'm presently working with our software company with a TRUE EMR system which is a point and click menu which covers EVERYTHING but still has space to allow you to type any additional information.
So, the bottom line is that true custom made software will probably be cost prohibitive. You would probably benefit the most from a podiatric specific all inclusive podiatric program that allows for customization. But also follow my advice about the companies history, support fees, renewal fees, update fees, whether they have CHCI (or whatever the letters are) certification, etc.
And when you find a few companies, go on PM news and ask for other's advice or experience with that company and I guarantee you'll get some responses.