My satellite clinic is about an hour away. I drive there with my nursing staff each month.

We load up ECG equipment, pacemaker programming machines, and a few other doctoring items in my truck.

I provide services to an area that has no permanent resident doing what I do.

Then, I return home.

Today is one of those days. I arrive back to my main office. It’s after 5pm and officially closed for the evening. I hurry to help my remaining staff return numerous phone calls to patients who had left messages while I was away. I hope to finish up at the office soon. Then, I intend to check on a patient at the hospital before making it home for dinner with my family.

I peer down at a piece of paper on my desk, given to me by one of my staff. It’s a printed email message. Sent by the Centers for Medicare and Medicaid Services (CMS).

The message is arguably from the most descriptive email address on the planet—and I’m not making this up—it’s from DONOTREPLY@CMS.GOV.


It’s rather fitting.

Because they definitely don’t want you to reply. That would be easy for me. Too efficient, perhaps. No, they don’t want a reply. They just want me to DO what they say.

I’m being required to verify something or another, so that someone or another, can work with CMS on my behalf. Submitting patient health data.

You really have no idea how many American resources are being devoted to the submission of your healthcare data. I could give you the financial figure. You wouldn’t believe it. But, I’ll tell you anyway.

U.S. physician practices are spending $15.4 billion per year just reporting quality metrics. It’s really gross theft from any myriad of endeavors that would be more helpful to our society.

My time-consuming task today relates to four of the silliest letters in healthcare: PQRS.

PQRS relates to healthcare “quality” reporting. They will tell you that it is going away. But, it’s really just getting replaced with more alphabet soup: MACRA, MIPS, APM, and so forth. I try to keep up with all these things, but even I’m starting to lose track.

Oddly, the email message from DONOTREPLY still references this outdated PQRS term. Almost as if the left hand doesn’t even recall what letters the right hand is supposed to be holding anymore. But, don’t try to logically figure this out. DONOTREPLY operates outside of logic.

DONOTREPLY instructs me to access online CMS’s Enterprise Portal to verify myself. I try my government-issued User ID. (I won’t even tell you the story of how long it took me to obtain it.) But, my ID doesn’t work today. I’m now going to have to call somebody.

“We are experiencing higher than expected call volumes…” the automated message repeats as I navigate through a menu of choices pushing button after button. I wait and I wait.

Finally, I speak with Sue. Her computer is running slow, she says. But, she will help me with re-activating my User ID. Sue just needs to re-login to her computer. She tells me that her own password resets every five minutes—again, this is no joke—so she is having to get another one issued herself. Just to help me.

Sue finally gets my User ID straightened out. Now, on to my password. I must create a new one. I try five different ones—using asterisks, dollar signs, slashes, and so forth—but the system won’t accept any of them.

Sue tells me this is a common problem. The system is very sophisticated, she says. So sophisticated, in fact, that ultimately Sue has to give me an example password for me to use! The one she gives me meets specifications. Security at its best. Yet, somehow, I now feel less secure.

I enter my User ID and new password. But, my login still doesn’t work.

Evidently, I need another code now. It’s called an “MFA.” I’m almost certain the last letter of this acronym stands for just another Annoyance. (Feel free to make up your own terms for the first two letters.)

To get the MFA code, I have to register for it on a different webpage. This requires reseting the password I just created! Unbelievable.

So, I reset my password AGAIN. I wait another 10 minutes for the CMS server to send me a confirming email. Then, I have to come up with more answers to my own security questions.

“What is your favorite childhood toy?”

I make something up that I probably won’t recall tomorrow. Done.

“What is an important date in your life?”

I type one in. The system doesn’t accept it. I try three more times. I get locked out. I then have to reset my password for a third time! I  wait for another confirmation email. The saga drags on and on.

Finally, I make it into the system. I navigate through five more pages to finally find what needs verifying. I get all the way to the end and see the “Confirm” button. I try to click on it. The button is greyed out. It isn’t even an active button that I can click on!

Sue tells me this type of thing has actually been happening a lot. She says it usually means that I didn’t really need to verify anything in the first place. DONOTREPLY just sent an email message to everyone—even those who needed to do nothing. It was their mistake.

Sue gives me a ticket number so that I can reference this mistake if DONOTREPLY ever tells me in the future I failed to verify. I’ve got a sinking feeling DONOTREPLY already possesses no recollection of this ticket number whatsoever.

I have many logins and passwords. Yahoo. Google. My bank. My office. The hospital. Credit cards. Utility company, and so forth. Dozens upon dozens of login systems. Without a doubt, the system developed and used by CMS is the very worst one. Not even close. Whatever we’ve spent building this operation for data submission is just outrageous to think about.

It’s boondoggling at its finest. I even looked up that word just now to make sure I used it correctly. Waste money or time on unnecessary or questionable projects. Precisely. This defines what I continue to see with our government’s attempt at healthcare.

And, yet, we parade along with its ideas. Many vote to support even more management from it.

I don’t care where you sit—on the left or the right. Frankly, I don’t associate myself with either seat at this time, because the entire bus is driving us to unreasonable places. It’s becoming harder to identify the logic inside the ride anymore.

If I told you tomorrow that McDonalds would be in charge of your healthcare, I suspect you might just be a little skeptical. You may wonder what was going on. You probably would look into it a bit. Spend some time reviewing whether this was indeed the best manager for your health.

Yet, where is that equivalent skepticism when our government assumes full control? A central authority, far removed from any local chef, deciding upon a limited menu, for who’s interest?

DONOTREPLY can spend our resources. It can definitely coerce. But, it can’t create. It can’t create a good login system. It can’t create a good data submission concept. It can’t create what’s best for your health.

DONOTREPLY will continue to be about boondoggling. It wants me to be one part of it. And you, the other.