Can't speak for the medical school but my guess is familiarity. Can't remember what the Mac landscape was like at that point but it probably wasn't vetted enoug

Can't speak for the medical school but my guess is familiarity. Can't remember what the Mac landscape was like at that point but it probably wasn't vetted enough for HIPAA. And windows 7 wasn't that shitty at the time. And even so, let's say they didn't use Windows — I'd still expect the same rigor for any operating system update.