>"It's similar to how Salesforce.com started with small businesses and eventually broke into enterprise sales from the bottom up."

No it's not.

Missteps with something like Salesforce might cost people jobs.

When a hospital makes a misstep, people might die as a result.

A hospital's operations are no more a scaled up version of a small group practice, than its physical plant is a scaled up version of a bungalow.