Ive been using VOX for about 6 months now and I love it. Yes it is somewhat quirky and limited in variability but overall its a great program. I fly both airliners and small planes in both IFR and VFR modes with VOX and have had more often than not no problems at all. Update 6.20 seems to really have fixed some of the problems people often experience. As for the procedures Ive never flown outside FSX so Im not up on real world procedures. I know you can skip the radio check if you want, the start up thing sounds like a small issue to not use a program. The default ATC is way more limited than VOX.