I do too... and my desktop is clean.. I use the quick launch bar for all of my programs when using windows. So, they would all just appear as icons anyway.
Been doing that for years. However with Vista I find that all I need to do is start typing the program name. (Eg. WORD) and it will start giving me a listing.
One thing you can do is create shortcuts, and put them in the system32 folder (preferrably one word names)
That way, you can go to start -> run, type the name of the shortcut, and run your program that way.
and it doesn't use up resources to search the disk like in vista.
Though most of the time, I just throw my shortcuts in a 'shortcuts' folder on the desktop
I'm not on my PC right now, but my programs include: