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If you frequently move between computers and have to disconnect your nuance PowerMic or  Philip speechmike regularly to use Dragon Medical on another computer, you may run into an issue where Dragon Medical has selected the wrong audio device. Dragon won't work until you select the correct microphone.

The easiest way to avoid this is to ensure that the microphone is plugged in before launching Dragon.

But if you get stuck you can simply refer to this video below  and this will solve the problem within about 30 seconds.