What's a Board, and what does it certify?
Shenary J. Cotter, MD • August 8, 2019

Gainesville Direct Primary Care Physicians proudly promotes the Board Certification status of myself and my partner, Althea Tyndall-Smith MD. But what does this mean, and why should you care?

For physicians, Board Certification is a designation that requires three steps. The first two steps take a minimum of 11 years, and include a four year bachelor degree, four years of medical school, and a residency (apprenticeship training) of at least 3 years. The last step is an ongoing process that can be revoked in any 3 year period during which the ongoing criteria are not continuously met. 

Additionally, physicians may complete a Fellowship in a specialty area beyond initial residency. For example, a Family Medicine physician who completed that 3 year post-medical school residency can do an additional 2 years and obtain the opportunity to sit for a Board Certification examination in Integrative Medicine, or Palliative Care, or Obesity Medicine. There are many others, as well. 

The American Board of Medical Specialties (ABMS) oversees these certifications. There is a failure rate for the Board Examinations. For Family Medicine physicians, the examination requires weeks to months of additional study preparation, must be repeated a minimum of every 10 years and includes 360 questions that must be answered in 4 separate blocks of 100 minutes each. 

Other types of healthcare professionals may also be "Board Certified." What is important to know is that there is not one "Board" that certifies different healthcare professionals with the same requirements. For example, advanced practice registered nurses (APRNs) may take an examination after two years (this varies) of post-bachelor degree education that board certifies them in Family Practice. The board that certifies them as such is a nursing board. An APRN who passes this examination in the area of Family Practice Nursing may self-descsribe as "Board Certified in Family Practice." 

Other healthcare professionals who may be board certified include chiropractors, holistic healthcare practitioners, naturopathic doctors, and accupuncture practitioners. Each of these professionals will have certified under an entirely separate board than the ABMS.

Gainesville Direct Primary Care Physicians support and encourage our patients to explore all healthcare forms that have been shown by evidence to not be harmful and to help for the condition that it claims to help. We enjoy working with many different types of heatlhcare professionals and actively seek non-medication modalities to improve our patients' health, through what we offer as well as through our allied healthcare professionals. We recognize that there is everything to be gained by encouraging our patients to take responsibility for their health by exploring the breadth of what healthcare has to offer today. We also encourage our patients to understand exactly who is caring for them, and the qualifications. 

ABMS

Family Medicine Holistic Covid Consideration

By Shenary J. Cotter, MD • November 15, 2020
Wow! What a title! It packs a LOT into a few words. When a family physician, a primary care physician, has to consider how to advise a patient, this is going to include what is called "shared decision making." And never has this been more relevant than during the current times. As we head into Thanksgiving and Christmas, with the Heartland of our nation facing unprecedented sickness and deaths from COVID 19, we ALL must make difficult decisions about personal safety, but also that safety of t

Primary Care PTSD

By Shenary J. Cotter, MD • February 9, 2020
This is a confession. It's not pretty. But it happened and reminded me of my commitment to justice in medicine. My partner, Althea Tyndall-Smith MD, and I left employed positions as Family Medicine physicians in order to practice medicine in a manner that honored ourselves as physicians, as wives and mothers, and that honored our patients just as much. We stepped off "the treadmill" of frantic running from room to room, documenting enough "bullets" on our EHR notes to make sure and capture al

Coronavirus: Should You Be Concerned?

By Shenary J. Cotter, MD • January 29, 2020
Coronavirus, named by the CDC 2019-NCoV, has arrived in the United States. Reports of severe illness, hospitalization, and death have prompted many questions about the risk to ourselves and our families here in Gainesville, Florida. When faced with questions regarding communicable diseases, the best source of information that I have found is the Center for Disease Control website: CDC.gov. It is CRUCIAL that objective, scientific sources be sought instead of second or third (or fourth or fift

Screening: Looking for Something Wrong when Nothing Is Wrong

By Shenary J. Cotter, MD • January 22, 2020
The most common reason that people come to the physician is that something is wrong. Often, it is due to symptoms that have either not responded to normal over-the-counter medications and "tincture of time," or it is due to the patient being concerned that it is more serious than the troublesome but largely benign viral illness or rash. One of the most IMPORTANT reasons to establish with, and come in to see, your physician is for health screening. A screening test or evaluation is something th

Why a Physician?

By Shenary J. Cotter, MD • November 5, 2019
Gainesville Direct Primary Care Physicians currently offers patients a choice between Althea Tyndall-Smith, MD, and Shenary Cotter, MD. Both physicians graduated from accredited schools of medicine, and completed three year residencies in Family Medicine. In addition to completing residency, multiple arduous and comprehensive tests were successfully completed in order to get into medical school, pass from the second year to the third year of medical school, pass each clinical rotation during m

Open Enrollment - Time to Make a Change to Direct Primary Care!

By Shenary J. Cotter, MD • September 4, 2019
Fall is the Season of Pumpkin Spice, Gator Games, and .....open enrollment. This is a GREAT TIME to decrease your commercial insurance plan coverage (which will make your plan less expensive), and add a membership with Gainesville Direct Primary Care Physicians. The money saved by doing this, even with the added membership, most often results in a net savings for the member or family. Let's look at this more closely! First, what exactly is "open enrollment," and why does it exist? Health Insu

Direct Primary Care.....and automobiles? huh?

By Shenary J. Cotter, MD • August 14, 2019
OK, hang with me here. We are going to start with an analogy. Imagine that every issue related to your car was subject to the question, "does my auto policy cover that?" Yes, collisions and accidents, absolutely. But what about cleaning the fuel injector? Periodic oil changes? Replacing the tires as they normally wear out, with age and use? What about cleaning the carpet, or repairing upholstery tears? Periodic "check ups" and "diagnostics?" If your auto policy "covered" these things, what

Feeling Healthy?

By Shenary J. Cotter, MD • August 7, 2019
It is a fantastic feeling - that vibrant sense of wellbeing when we are making all the right choices and effort, and we are seeing, and feeling the results. But "healthy" is more than what we are feeling. A rough night sleep, a car that won't start, a difficult interaction with someone at work - these are all experiences than result in feelings that try to lie to us. The lie says that we are failing, that we can't succeed, that trying is too hard, and that our efforts can't matter. The TRUTH
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