Sorry you had such a horrible experience with TotalMD. We don't use the cloud version so I didn't have the problems you had. I'm surprised they can't make change to the could version more frequently. I thought that frequent updates would be one of the benefits of any could PM.
The sever version is not pain free though. There were hiccups that I had to contact support for. I was also very vigilant in following up with the support team via email. So the things that I needed to change got done in the end, sometimes after many weeks.