Where I work, security is fairly high on the list of priorities.  With that being said, even here things could be more secure.  Sure, I have a separate dedicated "admin"...

I'm presuming when it fails, you're trying to run it as a scheduled Agent job?  If so, you need one of two things on the server itself, either:
1.  MS...

An problem solved.
Searching yesterday I'd come across a post from someone with a sort of similar issue, which was resolved by switching from the OLEDB provider to the ADO.NET...

Finally getting some time to breath a bit.
Checked my work phone before I left this morning, one of my production SQL was non-responsive.  E-mailed one of the guys who...

Fill factor is also important when it comes to inserts.  Using your PatientID as an example, if your application numbers patients by 10s (so 10, 20, 30...) and "child accounts"...

Time for something completely unrelated to SQL, although if anyone is in Atlanta, GA next year the weekend before Labor Day, we could always arrange to meet up for a...