A reoccurring complaint was that CiviCRM didn't work properly, and after questioning, we found out that people struggled with keeping their system and procedures up to date. We encounter these types of problems more with open source software implementations.
On the system level: because Civi is FOSS user often just got the software installed by an administrator and started working with it. This is good, a quick-start and learn, but not without risks. Often, the organisation applying for Civi didn't calculated in maintenance cost and or appointed a person responsible to keep the system fresh.
On procedure level: because the cost of running an open source CRM system is relatively low, the decision of implementation is quickly done and not guided by an expert on the process level. How do you keep your data input clean? How do you divide your different constituents in user types? How do you prevent duplicates and generate full record?
At Enabl.ist we can help you not only with system and procedural levels but also with hosting.
The benefit of open source with the comfort of a service