I agree more with trubolotta than the contents of the article. I do not see why there needs to be separate table for one-time meds vs. recurring meds. In fact Pet_Medication could contain a bit column to indicate it is recurring. The overhead of one bit is much less than an entire table along with the foreign keys to maintain it. Possibly another tinyint column to indicate recurring frequency (e.g. 1= daily, 2-weekly, 3=monthly...)

A properly designed structure with proper indexes will perform amazingly fast, especially in this environment. Unless they are a verterinary clinic with 50 doctors seeing 30 patients each a day, six days/week and you have 20 years of medical history with each patient having an average of 2 medications per visit.

Even then, you have to realize that a large percentage of patients may not even require medication. But even so, this is very doable with good response time in SQL Server.

I have designed HR systems that join up to 20 tables in certain queries with sub-second response time reading the data.