As with any new software experience, I believe the operators training effort is very important. I regret that all dictionaries are not available to Mac users as well as other goodies the PC group gets. Powerbook for about a month now. I do heavy duty medical dictation, long letters, lots of technical phrases, etc. I've also spent time creating lots of macros.
Saving seems to take a long time also.
So far, I am soldiering on, and creating more and more macros. Like others, I also wish I could dictate straight onto Word.