The latest earnings report from three-time Stock Advisor pick Quality Systems (NASDAQ:QSII) looks like a guy with a hair transplant who's just been in a bar fight: The top line was great, but by the time everything else took its shot, earnings looked pretty roughed up.

Revenue from the health-care software systems provider rose 31% over the year-ago quarter. Some of that was due to the recent acquisition of HSI, but even excluding the addition, intrinsic growth was still up a healthy 22% year over year.

Gross margins slipped 325 basis points, but some of that decline had to do with lower-margin products that Quality Systems inherited from its acquisition. Management thinks it'll be able to increase margins in the future by lowering labor costs, but for now, the bottom-line growth is dragging.

Earnings were also hurt because of the long-running feud between board members.  Management prevailed at the shareholder meeting in September, but the disdain doesn't seem to have subsided: President and CEO Steve Plochocki referred to Ahmed Hussein as a "dissident shareholder" during the conference call. The proxy fight ended up costing the company $0.03 per share in earnings this quarter. It's too bad that companies with salacious boardroom fights -- like Quality Systems, Biogen Idec (NASDAQ:BIIB), and Vaalco Energy (NYSE:EGY) -- can't sell pay-per-view rights to make up some of the costs.

Then there are some mysterious legal costs that cost the company $0.02 per share. Management was rather coy about the issue -- not something Fools like to see -- but it did say the issues were in the past.

After all of that, earnings per share finished up just 6%, but if you add back in the proxy and legal costs, which hopefully were one-time issues, EPS rose by a more reasonable 20%.

On one hand, this company is selling products and services that are considerably cheaper than a robot from Intuitive Surgical (NASDAQ:ISRG), but they're also a little more dispensable than patient supplies such as drug-eluting stents from Abbott Labs (NYSE:ABT). Doctors' offices and hospitals may be recession-resistant, but they're far from recession-proof, and spending on systems from Quality Systems may be the first thing that gets put on hold.

On the other hand, health-care costs are on the rise, and that could help Quality Systems, because its main selling point is that moving toward electronic records saves costs. With the government actively interested in helping lower costs, Quality Systems will probably see increasing sales even in the midst of a recession.