Adolescent Medicine

The Adolescent Medicine Service provides primary care enrollment of adolescents in the National Capital Region and welcome consultations on all Military Health System adolescent beneficiaries from primary care providers, or other health care professions. The mission of the Adolescent Medicine Service is to provide the highest quality care available for adolescents using the nationally recognized guidelines for health maintenance and specialty care The Adolescent Medicine Service also trains the primary care providers of the future to better assess and meet the multiple growth, development and psychosocial needs of teenagers.

General Information
Patient services provided:
Inpatient and outpatient evaluation of problems including:

• School, sports and college physical exams
• Patient and parent education on both the routine and special issues of adolescence
• Acute care illnesses and injuries other than obviously broken bones
• Routine care of acne, allergies and asthma
• Routine adolescent gynecology and evaluation of menstrual pain, irregularity, or excessive bleeding
• School problems
• Nutrition and disordered eating (too much, too little)
• Psychosocial issues of depression or behavior problems
• Primary care for persons with chronic illnesses.
• Sexuality related concerns
• Adolescent-specific tobacco use cessation
• Adolescent Sports Medicine

Allergy and Immunology

Allergy and Immunology provides comprehensive diagnosis and management of allergy-immunology related conditions for patients of all ages. To be seen by an allergist, a consult (referral) from your Primary Care Manager is required. Services include:

• Allergy skin testing for foods, environment, and bee and fire ant stings
• Immunotherapy (allergy shots)
• Pulmonary function testing
• Bronchodilator and nebulization treatments
• Food, drug, and exercise challenges
• Intravenous immune globulin administration

Ambulatory Procedure Unit

The Ambulatory Procedure Unit (APU) handles preoperative screenings, medication infusions, and second-stage postoperative recovery. APU staff obtains laboratory specimens, performs electrocardiograms, screens patients for anesthesia assessments, and provides pre- and post-operative patient education. On the day of surgery, the APU provides hospital access to those patients scheduled for ambulatory procedures. The APU offers an onsite pharmacy so patients can pick up medications after their surgery. APU can also provide overnight observation to patients who require airway and pain management after surgery.

Ambulatory Surgery Center

Rapid advances in surgical technology and pain management have opened the door to Ambulatory Surgery Centers (ASC). Recovery is usually shorter and closely supervised by skilled post-operative medical staff. Our ASC supports seven surgical specialties incorporating both surgical and ambulatory procedure visits. Recoveries occur in the Post Anesthesia Care Unit (PACU) or in Phase II recovery of the short stay unit. Patients arrive on the day of surgery. Hospital admission is not required.

Anesthesia

Uppermost in the minds of most patients facing a hospital procedure is a safe and comfortable experience. NNMC’s highly qualified anesthesia specialists provide anesthesia services and critical care management to patients undergoing surgical and obstetric procedures. This involves using general or regional anesthesia, along with careful patient monitoring both during the procedure and in the post-procedure period. Pain management, a specialty within anesthesia, provides evaluation and treatment of pain conditions. A comprehensive approach is taken to the management of acute, chronic, and cancer pain.

Armed Forces Center for Child Protection

The mission of the Armed Forces Center for Child Protection (AFCCP) is to provide objective child treatment expertise when and where it is needed throughout the Defense Department. Services include forensic interviews and medical examinations of children suspected to have been abused, medical and legal case review, guidance, expert testimony and child treatment education. The AFCCP trains multi-disciplinary professionals who may come in contact with child abuse cases. Trainees include health care providers, mental health professionals, family advocacy personnel, criminal investigators, military attorneys, dentists, chaplains, teachers, and professional daycare providers.

Armed Services Blood Bank Center

The Armed Services Blood Bank Center is a tri-service blood donor center that collects, tests, manufactures and distributes blood products (red blood cells, fresh frozen plasma, cryoprecipitate and platelets). In addition to supplying local Military Treatment Facilities (NNMC, WRAMC, Malcolm Grow); we also supply the Armed Services Whole Blood Processing Laboratories (ASWBPLs); which are central repositories for both liquid blood and frozen reserves to support military contingency requirements. The Armed Services Blood Bank Center is licensed by the Food and Drug Administration (FDA) and is accredited by the American Association of Blood Banks (AABB) and the College of American Pathologists (CAP).

Behavioral Health Care

Adult Behavioral Health focuses on interventions that result in functional improvement in patients’ lives. Services include emergencies, urgent care and “walk-ins.”

Individual and Family Treatment

• Assessment of psychiatric emergencies, urgent care and routine evaluations
• Psychological testing on site or by consultation
• Neuropsychological testing and evaluation
• Individual, group and family psychotherapy
• Medication treatment for substance abuse and mental disorders
• Patient and family education

Support for Active Duty Personnel

• Fitness-for-Duty evaluations
• Temporary Disability Retired List (TDRL) and Medical Board Evaluations
• Other military specific evaluations, including suitability for military service, submarine screening, etc.
• Family and couples therapy
• Group psychotherapy and workshops such as depression, anxiety, anger and stress management

Breast Care Center

In collaboration with the National Cancer Institute and the Uniformed Services University of the Health Sciences, the National Capital Area Breast Care Center at NNMC is a Center of Excellence in breast cancer research. The center focuses on incorporating superior methods of early detection comprehensive treatment and long-term surveillance of breast cancer. Our multidisciplinary staff is dedicated to providing you and your family with a network of skilled professional support groups, social workers and information services to ensure the best possible physical and psychological rehabilitation. The Breast Care Center also provides:

• Detection and follow-up screening
• Genetics testing for Patients determined to have a high risk for breast cancer
• High-risk assessment classes
• Pre- and post-operative care
• Case management
• Educational resources
• Physical Therapy

The Breast Imaging Center (BIC), formerly known as Mammography, allows self-referrals for annual mammography screening. Same-day imaging services are often provided for Breast Care Center patients. Like the Breast Care Center, a goal of the BIC is to provide state-of-the-art patient care using advanced technology and today’s latest digital equipment, breast ultrasound and stereotactic biopsy. Currently the BIC uses both digital imaging and film imaging equipment. Breast MRI services are also offered to patients who meet the guidelines recommended by the American Cancer Society.

Cardiology

Cardiology Services offer comprehensive and specialized procedures in both inpatient and outpatient settings, including assessments, diagnoses, treatment plans and evaluations. Interventional cardiologists treat blockages in the heart and peripheral blood vessels when surgery is not necessary. They perform state-of-the-art interventions, such as cardiac catheterization (used for diagnosing heart conditions, including coronary artery disease and defective heart valves); balloon angioplasty (dilation of narrowed vessels); implantation of stents (mesh used to support the dilated vessel from within); stents coated with drugs or plastic sheets; directional atherectomy and rotablation (using drills and cutting devices to open complex and calcified lesions) and catheter based repair of atrial septal defects (holes in the heart). Cardiac electrophysiologists provided catheter based treatment of cardiac arrhythmias and implantation of pacing and defibrillation (shocking) devices to regulate cardiac rhythms.

The Cardiology service line offers both inpatient and outpatient services. All patients receive assessment, diagnosis, planning, intervention and evaluation of their individual needs. Each clinic offers standard and specialized procedures within its own service. Patients receiving outpatient procedures are seen by appointment or by referral. Services offered include:

• Non-Invasive Testing-Treadmill Stress Testing, Tilt Testing, Dobutamine stress testing, Thallium and adenosine stress testing.
• Cardiac Catheterization, stent placement, angioplasty, Electrophysiology studies, ablation for atrial Fibrillation, pacemaker and defibrillator implantation.
• Cardiothoracic Surgery- NO we giveCardiac Clearances for Cardiothoracic surgery, CT surgery is its separate service, patients see CT surgery after they see us, then postop we see the CT surgery patients and eval for cardiac rehab.
• Cardiac Intensive Care
• Medical-Surgical Intensive Care
• Cardiac Rehabilitation
• Echocardiography, Trans Thoracic Echo with / without bubble study, Trans Esophogeal Echo with / without bubble study.
• Anticoagulation Management

Cardiothoracic Surgery

Board-certified cardiothoracic surgeons perform state-of-the-art adult cardiac surgical procedures, including coronary artery bypass grafting, valve repair and replacement aortic aneurysm repair, and adult congenital cardiac defect repair. Surgeons also perform a full range of thoracic surgical procedures, including minimally invasive, which include surgery for lung cancer, esophageal cancer, mediastinal tumors, benign diseases of the lung and esophagus, correction of chest wall deformities, and sympathectomy for hyperhydrosis.

Child and Adolescent Behavioral Health Department

This department offers outpatient therapy for children, adolescents and their families.

Chiropractic Department

The Chiropractic Department addresses problems that are neuro-musculoskeletal in nature (dealing with nerves, muscles and bones). This clinic focuses on neck, mid-back, and low-back pain. Treatments consist of adjustments (manipulation of joints or soft tissue), physio-therapeutics (use of ultrasound, electrical stimulation, heat and ice), counseling on ergonomics and education in exercise. Treatment from chiropractics requires a referral from your primary care manager or, in the case of pregnancy and those under 18, a referral from Obstetrics or Pediatric and Adolescent Medicine.

Clinical Nutrition

The Clinical Nutrition Department works closely with the interdisciplinary health care team to provide nutrition services and Medical Nutrition Therapy (MNT). The Clinical Nutrition Department staff works cooperatively with Combined Food Operations staff to assure conformance to diet prescriptions during the patients’ stay at NNMC. In the outpatient setting, Clinical Dietitian staff provides nutrition counseling to individuals and groups with diabetes, complicated obstetrics, complex gastrointestinal problems, oncology and other complex dietary therapy needs. The Clinical Nutrition Department works with NNMC Health Promotion nutrition staff to address group and individual diet counseling for weight management, hypertension and cardiac related diet needs. Appointments for outpatient medical nutrition therapy services require a provider consult.

Cochlear Implants

NNMC is offering the services of a cochlear implant program for patients who meet a specific criterion. This device is the result of groundbreaking research through the application of sophisticated technology and allows deaf patients to perceive sound. Please make an appointment at NNMC’s Otolaryngology Department for a referral.

Cosmetic Surgery

Our mission priority is reconstructive surgery for trauma and cancer patients. Most reconstructive procedures are Tricare-covered benefits and patients are entitled to appointments within 30 days. Cosmetic surgery, on the other hand, is not a Tricare-covered benefit and will only be performed as resources allow. Examples of cosmetic surgery include liposuction, breast augmentation, breast lifting, face lifting, abdominoplasty, and blepharoplasty. If these procedures are offered, patients must pay the federally-mandated surgical fees before surgery. The cosmetic surgery billing policy applies to all patients, active duty or otherwise. Also, initial cosmetic surgery appointments often require patients to wait beyond the usual 30 day window. If you are interested in cosmetic surgery, your doctor may submit a consult request. The outcome of that request will be determined largely on the department’s space availability.

Dental Readiness Clinic

The Dental Readiness Clinic offers appointments for annual dental examinations and cleanings at the same visit. You may also make an appointment for your annual dental examination without a cleaning. Walk-in examinations are still possible, and every effort will be made to see patients in a timely manner, however appointments are highly encouraged in order to minimize wait-time in the clinic. Patients who wish to be examined for a chief complaint (sick call) are also highly encouraged to make an appointment. Patients in need of immediate attention will be seen on a walk-in basis as quickly as possible. The Dental Readiness Clinic offers a full range of general dentistry services including cleanings, fillings, crowns and bite guards. Services that cannot be completed in the clinic will be referred to the appropriate specialist as required.

Dermatology

Dermatology residents and board-certified dermatologists and dermatopathologists provide comprehensive healthcare to patients of all ages with skin-, hair-, and nail-related conditions, including skin cancer diagnosis and treatment. Additional services include laser therapy for medical conditions, ultraviolet phototherapy, and Mohs micrographic skin cancer surgery. To be seen by a dermatologist, a referral from your Tricare Primary Care Manager is required. Inpatient care is provided on a consultative basis.

Diabetes Care Center

Our goal is to improve the health and quality of life for all of our patients with diabetes by providing comprehensive services. The Diabetes Care Center provides diabetes education, case management, podiatry services, nutrition consultations, and a diabetes support group. Referrals are required from the Primary Care Managers for the podiatry services only.

Educational and Developmental Intervention Services (EDIS)

EDIS serves families whose eligible children have developmental and educational needs, from birth to 35 months of age. Pediatric specialists address the cognitive, communication, social, emotional and adaptive developmental delays and medical conditions that have a high probability of delay.
Specialists provide:

• Neuro-developmental assessment of high-risk children
• Special education assessment and direct services
• Assessment and physical therapy
• Assessment and occupational therapy
• Speech & Language assessment andtreatment
• Social Worker assessment and intervention

EDIS partners with family members to develop an Individualized Family Service Plan (IFSP), implementing the plan in accordance with the child’s specific needs. Together with families, EDIS strives to foster and optimize the development of children with special needs. EDIS personnel staff the EDIS Program at Quantico Marine Corps Base and Naval Surface Warfare Center, Dahlgren. NNMC personnel provide consultative support to the EDIS Programs.

Emergency Medicine Department

NNMC’s Emergency Medicine (EM) Department offers world-class emergency care 24 hours a day, 365 days a year. The Emergency Medicine staff is composed of Navy and civilian physicians, nurses, and technicians – including NNMC-trained Navy residents, interns, and board-certified Emergency Medicine specialists affiliated with George Washington University. As members of a military treatment facility, NNMC’s Emergency Medicine staff is also trained in disaster preparedness and mass casualty response.

Endocrinology

Endocrinology is the science of the hormones produced by the various endocrine glands of the body, such as the thyroid, adrenal and pituitary glands. The Endocrinology Clinic provides comprehensive care to adults who are referred from their primary care provider because they require diagnosis and management of hormonal disorders. Some conditions include hypothyroidism, hyperthyroidism, thyroid nodules and thyroid cancer, hypercholesterolemia, diabetes mellitus, hypogonadism and adrenal insuffiency. The endocrinologist also specializes in metabolic bone disorders like osteoporosis.
Services include:

• Advanced metabolic testing
• Bone densitometry scans to evaluate for osteoporosis
• Fine needle biopsy of thyroid nodules
• Continuous glucose monitoring for complicated cases of diabetes
• Evaluation and management of severe nutritional disorders

Exceptional Family Member Program

The Exceptional Family Member program is a mandatory program designed to identify family members with long-term healthcare or special education needs.

Gastroenterology

Gastroenterology provides a wide range of comprehensive care to adult patients requiring diagnostic and therapeutic treatment for gastrointestinal conditions. The staff of gastroenterologists, radiologists and registered nurses offers colorectal screenings via optical and virtual colonoscopies, upper endoscopy, advanced interventional endoscopic therapies, endoscopic ultrasound and pH and esophageal motility studies to evaluate the following disorders:

• Colorectal and other gastrointestinal cancers
• Gastro-esophageal Reflux Disease(GERD)
• Bowel diseases such as Inflammatory Bowel Disease (IBD)
• Chronic abdominal pain or constipation
• Food intolerances
• Liver diseases
• Peptic ulcer disease
• Pancreatico-biliary disorders

You can self-refer to the Gastroenterology Department by calling 301-319-8284 or come to the department in person at building 9, first floor.

General Surgery

General Surgery evaluates and treats a broad range of disorders requiring surgery. Our staff surgeons are board certified – many in more than one specialty. NNMC provides the following general surgery sub-specialties:

• Colorectal Surgery
• Pediatric Surgery
• Trauma and critical care
• Surgical Oncology
• Advanced Laparoscopy and minimally invasive surgery

Geriatric Medicine

Geriatrics is the branch of medicine focusing on health promotion, disease and disability prevention, and treatment options in later life. Geriatricians diagnose, treat and manage diseases and conditions common to many older adults. They give particular attention to conditions of special concern, including falls, imbalance, incontinence, pre-operative assessment and post-operative management, cerebrovascular disease, dementia, memory loss, sensory impairment and other cognitive and mood changes that may occur with aging.

Health Promotion and Physical Fitness Assessment (PFA)

The Health Promotion Department/ Wellness Clinic offers services to assist individuals in achieving optimal health and fitness. Programs are offered for active duty, active duty family members, retirees, and DoD civilians. These include classes for tobacco cessation, weight management, hypertension reduction, cholesterol control, and stress management. Registered dietitians also offer individual nutrition counseling. The department also provides the Ship Shape program, Physical Fitness Assessment and Fitness Enhancement Program (FEP) for active duty members.