One Physician’s Journey from Burnout to Rebirth

By Michael McGrady


After 18 years of practicing medicine in a broken system, Shenary J. Cotter, a board-certified physician in Gainesville, Florida, was about to hang up her white coat.


Bureaucratic micromanagement had worn her down far enough.


“Gradually, my scope of practice was eroded by industry health care,” Cotter said. “You know, the treadmill administrators and bureaucrats making money off of physicians and patients.”


Burnout had drained her desire to continue to work as a doctor, Cotter says.


“I was ready to quit,” Cotter said. “I was so burned out and despondent, and I just no longer wanted to be a part of health care.”


At the last minute, Cotter’s discovery of direct primary care (DPC)—a direct-pay membership model that avoids insurance and typically costs patients $50 to $150 per month—changed her mind.


Growing Frustrations

Cotter had been practicing as a family physician with a major academic medical network in north-central Florida. One of her frustrations was government oversight that proved “meaningless and irrelevant” to the quality of the health care she provided. Others were the institutional deterioration of the patient-physician relationship, unaffordability, and lack of price transparency.


In other words, she had the same complaints that most patients do.


Accidentally Reborn?

Cotter characterizes her transition to the DPC model as a happy accident.


One night in 2017, while surfing the internet, Cotter came across the Docs 4 Patient Care Foundation’s (D4PCF) website ( just weeks before the organization hosted its annual “Direct Primary Care: Nuts and Bolts to 2.0” conference in Orlando. After she received a scholarship to attend the conference just two hours from her home in Gainesville, she decided to see what DPC was all about.


What Cotter learned there transformed her from a burned-out doctor into a happy on, Cotter says.


“I feel like I had primary care PTSD,” Cotter said. “I don’t have any of that anymore. I’m happy. I’m relaxed. I’m in charge of my schedule.”


After Cotter attended the 2018 D4PCF conference, Cotter was hooked on DPC. Leaving her career in academic medicine, Cotter partnered with Dr. Althea Tyndall-Smith to create Gainesville Direct Primary Care Physicians, where Cotter regularly treats 140 patients, as of this writing. The practice is growing, and financial forecasts are positive, Cotter says.


From Burnout to Rebirth

Thanks to her innovative direct-pay model and renewed ambition, Cotter says she is happy and feels as if she’s making a difference for her patients.


“I enjoy practicing medicine now,” Cotter said. “It’s exciting. It’s fun. My office is only a few minutes from my house, so I don’t have a big commute. I’m just happy. I’m a happy mother. I’m a happy wife.”


Servings as a DPC physician has restored enjoyment and excitement to her career, Cotter says. But it also allows her to practice medicine in accordance with her conscience.


“In my entire [previous] career, I couldn’t be myself,” Cotter said.  “I love God, and I just love making people know how much God loves them. In my prior position, I wasn’t free to talk about it. I wasn’t free to do it. I wasn’t free to pray for my patients.”


Now Cotter is free to interact with her patients how she and they think is best.


“This is who I am,” Cotter said. “I have patients who share my beliefs, and I have patients who don’t share my beliefs. Everybody understands. I accept you just the way you are. I get to be me and they get to be them.”

Physicians like Cotter will gather on November 14–16 at the 2019 DPC conference hosted by the Docs 4 Patient Care Foundation at the Rosen Centre Hotel in Orlando, Florida. Registering for the 2019 conference may be the first step to your reborn career.

Michael McGrady ( is a free-market health care journalist. McGrady’s work has been published in The Wall Street Journal, Washington Examiner, Newsday, The Hill, Patient Daily, The Heartland Institute’s Health Care News, and others internationally.

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