Block does average returns pretty well, but not complex. Better than most small tax shops, they do train their preparers, and they don't cheat. Fine for a couple W-2's, and itemized, simple schedule C or E, but that is not what I do very often. Usually have to account for several activities (S-corps, partnerships, trusts, rental activities, etc) before the 1040 can be completed.
The limit on medical itemized deductions really stinks. The folks who benefit from that most are asset long seniors living in high priced nursing homes.