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Please move this discussion to Products for a more prompt response.
I have gone from a ESP like MailChimp and VerticalResponse to a MAP and yes, during the implementation I was still utilizing the ESP until I had Marketo fully implemented. Once I did, I was eager to get started using it for email sends, so we ended our subscription with our ESP. That is the only case I can think of for not sending emails from Marketo immediately. I have not heard of any Marketo instance not utilizing email sends, it's a core functionality that surpasses what as ESP can accomplish.