Ken, it is a lot of work ... it's my husband's hobby, LOL all I do is feed them every morning! We had tanks with fresh water fish for a few years back in the early 1970's but he's been into the marine fish for many years now. I know it's a lot of upkeep, he's always having to check this or that with the filters, pumps and all the paraphernalia/mechanical equipment beneath the tank. Marine aquarium systems have become very popular and there are lots of aquarium shops around Florida. I remember my husband telling me that one of the shop owners he's conversed with over the years would go over to the inlet and fill buckets of salt water for the tanks at his shop which would sure be a lot easier than all the mixing and checking salinity etc. that has to be done when doing water changes every so often. We sold our boat a year ago so my husband said he may get our nephew to take him out some time and he'll fill his 5 gal buckets with salt water to have on hand for our aquarium. I know there used to be companies who would go to businesses and maintain marine aquariums.
I bet your patients did love the aquarium in your reception area! It's is very relaxing and calming to watch fish and sea creatures. There's an oral surgeon in Daytona that I went to a few years ago and he had a very large and beautiful marine aquarium system set up in his reception area. I don't know what size the tank was but it was huge and ran down the entire center of the reception area. His son was into the salt water aquariums so he took care of the maintenance for his dad. There are a few restaurants here in Florida that have marine set ups and I used to love flying Southwest Airlines out of Orlando because their concourse had salt water tanks that were nice to look at.