Why a Physician?
Shenary J. Cotter, MD • November 5, 2019
Medical Education — Gainesville, FL — Gainesville Direct Primary Care Physicians LLC

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 medical school, after the first year of residency, and after the 3rd year of residency. Additionally, every 3 years, a Board Certified Family Medicine Physician must complete more testing, and once every 10 years every physician must RE-TEST .....pass a comprehensive Family Medicine Board Certification Examination that takes a full day to complete, and includes information from the entire scope of the field of Family Medicine.

Frequent questions that I get when patients are looking for a potential physician is "do you do more than just prescribe medications/push pills? Do you look at the whole individual and at the causes of problems? Do you have a holistic approach to taking care of patients?"

These questions make me sad. I have no idea where the idea took hold that Family Medicine physicians DON'T look at the "whole" patient when evaluating for health or causes of illness. When did I become a "pill pusher" in the minds of the general public?

One of the sources, I believe, has come from what we call "industry healthcare." Industry healthcare is the medical setting that has physicians seeing 25 - 30 patients a day, barely spending 15 minutes per patient, constantly running late, and being unavailable to see patients when they need to be seen. This unnecessarily pushes patients into urgent care or emergency department settings when these should have been handled in the office of their very own physician. 

Physicians need to apologize for participating in this. Most all of us didn't mean to cooperate in this for greed. We thought we were trying to help more people. I apologize.

Dr. Tyndall-Smith and I don't participate in that any more. 

Other reasons patients sense physicians are "pill and problem based" include receiving that message, incorrectly, from some others who wish to practice in the heatlhcare setting but in a field other than medicine: this can include nursing, chiropractic, chinese medicine, accupuncture, and naturopathy and homeopathy. In an effort to explain why a patient should NOT choose a physician and choose them instead, some members of these fields will focus on what they believe physicians aren't. The idea that anyone has to denigrate physician care in order to promote their own care is unfortunate: each of these areas has definite unique positive things to bring to patient care without insulting or belittle medical doctors and our sacrificial and extensive education and training, the high standards we are held to, the legal standard we answer to, and our dedication to helping patients. 

Also problematic for the patient is understanding what type of "doctor" they are seeing - because it has become more commonplace for healthcare practitioners from fields other than medicine to refer to themselves as physicians and "doctors" without ensuring that patients understand exactly what type of doctor they are. There is a difference between having earned a doctorate degree, and being a "doctor" in a healthcare setting. 

At Gainesville Direct Primary Care Physicians, we are very transparent about who we are and what our qualifications are. We clearly and accurately represent ourselves, our education, our Board certification, and our titles. Our patients will only receive care from a physician. We have the time in our direct primary care setting to spend time with patients to take care of them in a truly holistic fashion, combining the best of science has to offer with our ability to connect with and relate to our patients.

As physicians, we are held to a standard of providing evidence-based care. This means that we cannot simply claim that what we are doing works by giving anecdotal (story-like) evidence, or personal opinion, or quoting "evidence" from a single study that may or may not actually have studied what it claims to have studied. We have to prove that what we are doing works before we actually do it, with high quality studies that have been corroborated with additional studies and data, and agreed upon by a consensus. 

If you are asking yourself, "Why a physician?" Come visit us for a free visit. You'll see EXACTLY why a physician. 

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

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

What's a Board, and what does it certify?

By 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 c

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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