Category: Uncategorized

I chose to start my own practice to allow me to have flexibility for both myself and my patients. As patients, I expect you to keep your appointments, arrive early or on time, and bring your medications and other relevant medical information to your appointment. In return, I schedule longer appointments and do my best to be flexible to your needs, including occasionally scheduling appointments for patients outside of my regular business hours.

Normal Business Hours are Mondays-Thursdays from 7:30AM-3:00PM. I will be available for after-hours calls until 6PM, including on the weekends and days off, unless otherwise noted on the calendar on my website (www.maryammahmoodianmd.com) or on my voicemail greeting. If my office is closed because of bad weather, it will also be posted on my website as well as on my voicemail greeting.

After hours, or when I am gone, if you need something that cannot wait until the next business day, you will either need to go to one of the Urgent Care centers or to the emergency room. Please note that medications may not be refilled except during my regular business hours. It is your responsibility to contact the pharmacy at least a few days before you run out of your medicine. I do not admit or care for patients in the hospital, but I do my best to follow along in your inpatient care.

I generally refer most patients who need vaccines to one of the local pharmacies or to the health department. I work closely with Labcorp, and this is where I send most of my patients who need blood work done.

I do preventative medicine, including women’s health exams and pediatric checkups. I manage both acute and chronic medical problems such as diabetes and hypertension. The only chronic condition that I am not comfortable managing is chronic pain, but I am happy to refer any patient with this to an orthopedist, pain specialist, or any other specialist they may need to see to alleviate their pain. I also do not perform disability assessments, do DOT physicals, or see patients for a Workmen’s Compensation case.

I do perform immigration physicals which cost $150 for individuals over the age of 15. The price includes the physical, labs (if these are done at Labcorp) and paperwork. The charge for the TB test and vaccines is separate and will come from wherever you have these done. The $150 will be required to be paid up front. For children under the age of 15, I charge $80 per immigration physical.

For individuals with insurance, I expect you to bring in your insurance cards and for copays to be paid at the time of your appointment. For individuals without insurance, I charge $150 for a new patient and $75 for follow up appointments, and this must be paid at the time of the appointment. This fee does not include any potential labs or further testing.

Minors under the age of 19 must be accompanied by a parent or legal guardian.

I do have an Arabic interpreter who is usually able to come in as needed. For other languages or if she is not available, I try to always have an interpreter present. As of right now, I accept most types of insurance including: Anthem, Optima, Aetna, Cigna, Virginia Premier, and Virginia Medicaid. I am still in the process of getting credentialed with Medicare, so as of right now, I am unable to accept patients with Medicare.

Spring is finally here!   The temperature is warming up, the grass is growing, and the flowers are blooming. It’s such a great time of year… unless you’re one of those unfortunate individuals who suffers from seasonal allergies. Then, you know, it’s just a matter of time before they flare-up again. There’s just nothing else that can make a nice walk in the park turn into misery when the itchy eyes, runny nose and sneezing starts kicking in. The next thing you know, you’re congested and feeling miserable, and you just want to go home.

Here are some tips to beat those allergy symptoms or at least help you feel better, so you can spend some time outside enjoying the nicer weather.

First of all, pay attention to the pollen counts. These are usually available on the weather channel or during the local news. They can also be found on a weather website. On days when the pollen count is higher, try to avoid being outside. Exercise inside instead.

It’s ok to enjoy time outdoors, but try to do it in the mornings or evenings. Unfortunately, it is probably better to spend your time on a paved trail or in a park as opposed to hiking in the woods where you would be exposed to more pollen. Also, if possible, avoid running or biking on the city streets because of the higher amount of pollution. And be sure to wear a mask when you are working outside, whether it’s in your flower garden or cutting your grass.

Take over-the-counter allergy medicine such as Loratadine or Zyrtec. Benadryl also works well, but it can make you feel drowsy. These tablets help with the itchy, watery eyes and the sneezing and runny nose.

Use saline or steroid nasal sprays (like Flonase), to help with congestion. Sudafed can help when your ears feel plugged, but, like Benadryl, it also causes drowsiness. Also, you shouldn’t take it if you have high blood pressure. It doesn’t require a prescription, but you can’t just buy it over the counter. You have to buy it directly from the pharmacist. Also, you shouldn’t drive or operate heavy machinery after taking either Benadryl or Sudafed.

None of us like to take pills or use medicine. However, if you know that your allergies are worse during the spring and fall, it’s often beneficial to take the allergy tablets or use the nasal spray daily until either summer kicks in or it starts to freeze. Some insurances will cover the medicines, and some of them are $4 with a prescription, so you might schedule an appointment with your provider before you buy one. Otherwise, they tend to be a bit expensive.

This isn’t really health-related, but it is still relevant to our growing city.

As we watch the news and see more and more pictures and stories about the refugee crisis in Europe, many of us feel helpless, because we just have no way we can help them. However, here in Harrisonburg, we have our own large number of refugees who have been resettled in the last several years. While they may not have made the national and international news, they have still come here from terrible situations in their home countries. They usually have suffered not only fighting in their own countries. Many have also suffered in refugee camps they were forced to flee to and wait in while undergoing the scrutinizing process prior to being resettled in the west. Even the immigrants who live here, documented or undocumented, came here because of poor living and economic situations in their home countries.

I used to live and work in Lincoln, Nebraska, a town that is like a larger version of Harrisonburg. There was a very large population of refugees and immigrants as well as the University of Nebraska with its own large population of international students. Many of you may have read the book by the best-selling writer, Mary Pipher, titled The Middle of Everywhere, about the refugee and immigrant community in Lincoln.

It doesn’t take much to help these individuals. We don’t have to spend hours a week volunteering just to make them feel more welcome and at home. There are lots of little things we can do instead.

Things like speaking English slowly, but not loudly, to them. Other little things that can make a big difference are not tapping your foot or sighing loudly when you’re in a line behind them at the grocery store. They may not understand English well, but they aren’t deaf. Gently helping them count out their money as they struggle to figure out which bills they need to use. Slowly pointing things out to them if they seem confused, trying to always be on time, and using every mistake as a learning experience.

We in the health care industry forget that these individuals are coming from places where they can just walk in anytime to see the doctor. Instead of lecturing them about how a one day old rash or cough is not necessarily a reason they need to be seen right away, we can use that time to gently find out why they felt that they needed to see someone right away. Keep in mind that in their own countries, a rash or a cough could have indicated a serious illness. And just by learning about these fears, it can make us all better providers.

The most important thing we can all do is to treat them like human beings. It’s so easy to grumble about why they don’t learn English. But any of us who have traveled to non-English speaking countries know how difficult it is to get around when few people speak your language. We know how difficult it is to calculate how many pesos or dinars we have and which bill is which when the numbers are written differently. Taking a taxi or asking for directions can be a huge challenge. Even if we stay there for several weeks or months, we might return only speaking a few words in the language of the country we were in. And why is that? Because naturally, we gravitate toward people who can speak English and understand us. It’s not that easy to learn a foreign language.

Most refugees and immigrants are grateful that they were given the opportunity to have a better life in a country where they don’t have to feel afraid every time a police car passes them on the road or when their child comes home with a mild cough. They want to give back to this country by working hard and by studying/learning English. Many of them use the money they earn to send to their families back home which indirectly helps those economies. We are fortunate to live in such a diverse community where we can learn about each other and learn to work together.

Winter is a hard time of year and an especially common time of year for SAD or depression.  The days are shorter; often it is dark going into work and then almost dark after as well.  The weather is colder, which makes it more difficult to push yourself to even do the simpler things like grocery and other shopping.  Normally, it seems like much more fun to shop outside when there are sales or at the farmer’s markets as opposed to being inside a place like a bigger department store or the mall, except in winters.

Being outside on sunny days, whether it’s exercising or even just sitting on the porch, makes you have much more energy.  It also makes you feel stronger and less depressed and overall happier.  Oddly enough, SAD is actually pretty common, even though you may not feel like it is.

It’s strange how, when we lived in the cold upper Midwest (South Dakota, Nebraska, and Iowa), I felt like my SAD was under better control.  That might have been just having gotten used to living in that area for so long and being adjusted to the long winters.  In eastern SD, once it started snowing around November, it seemed like it just stayed cold during the days and nights.  Because of this, every time it snowed, it would just pile up and up and up, until the end of March or even early April.

It’s also strange how we refer to certain areas of different states.  In Virginia, it’s northern, central and southern.  It’s the Shenandoah Valley, the mountains, and the beach.  In SD, it’s east river (east of the Missouri River) and west river.

An important treatment for SAD is bright lights.  Keeping any room that you are in (except the bedroom) brighter can make you feel better.  Sometimes, it’s beneficial to see a counselor for a few months.  It can also be easier to take an antidepressant during the winter.  A supplement such as St. John’s Wort is supposed to help, although studies have shown that it doesn’t work as well as a prescription antidepressant.  There is nothing wrong with taking such a prescription for the 4-6 months that the days are shorter and the weather is cold/ snowy.

It’s important to take care of yourself physically and mentally during the winters.  Joining a gym, exercising at home, or working with a personal trainer is an excellent way to help you feel stronger and more energetic.  Going to a warm coffee shop or restaurant, the theater, and concerts can as well.

Who among us hasn’t gotten a common cold, with all of the miserable symptoms that go along with it? Symptoms like a sore throat, chills, muscle aches, coughing, sneezing, runny nose… and the list just goes on and on.

Unfortunately, there’s still no medication that is going to help you get through a cold any quicker. And, contrary to what we might think, rather than going to see your doctor, the actual best thing to do is to stay at home, drink warm liquids and take symptomatic treatment. Going to the doctor can actually expose you to more infections and also expose others to your virus. Viruses are one of those things that you do not want to share.

So here are a few tips to help you get through that misery.

First of all, get the flu shot. While it doesn’t protect you from getting a cold and doesn’t cover all strands of the flu (there’s just too many of them), it does cover what strands are predicted to be the most prevalent that season. The flu is a virus and cannot be treated with antibiotics, but if you do get it, it will make you feel even more miserable than the common cold. And you cannot get the flu from the flu shot. Let me repeat that. You cannot get the flu from the flu shot.

If at all possible, do everything you can to stay home from work or school. Rather, it’s better, again, to not expose others or potentially expose yourself. If you have a regular medical provider who you see, they might even be willing to give you a note for a day or two off work without seeing you (which is yet another reason to have a regular primary care provider). And it really is better to just wait out the infection rather than running to the doctor. Especially for the common cold, you do not want to go to the ER. Why would you want to expose yourself to every illness that exists in an emergency room? And why would you expose your own virus to someone else in the ER who might be very sick and at a higher risk from getting very ill if they do catch your virus?

Use symptomatic treatment to help you feel better. For a sore throat and chills, drink warm liquids and take Tylenol as needed. Tylenol will also help with the muscle aches. For the cough and chest congestion, Vicks Vaporub can help. For a runny nose you can take an allergy medicine like Benadryl or Loratadine. For a stuffy nose, use a saline nose spray. However, remember that all medicines have side effects, and some of these medicines might make you feel drowsy, so read the instructions carefully or call your doctor’s office before you take anything.

To try to keep yourself from getting a cold, wash your hands regularly. Quit smoking and stay away from secondhand smoke. Exercise regularly, drink 6+ cups of water every day, and try to always get at least 6-8 hours of good sleep to keep yourself healthy.

And remember that colds are caused by viruses and cannot be treated with antibiotics, so don’t pester your medical provider about giving you a prescription for one. However, colds may turn into a bacterial infection especially in young children and adults with risk factors (smoking, chronic illnesses, etc). So if you do stay sick for over a week, at that point it is a good idea to see your provider.

Who among us hasn’t gotten a common cold, with all of the miserable symptoms that go along with it? Symptoms like a sore throat, chills, muscle aches, coughing, sneezing, runny nose… and the list just goes on and on. Too many times, we run to the doctor right away. We delude ourselves into thinking that since our last cold, he or she might have discovered some new magic cure that will help us get over it right away.

Well, unfortunately, there’s still no medication that is going to help you get through a cold any quicker. And, contrary to what we might think, rather than going to see your doctor, the actual best thing to do is to stay at home, drink warm liquids and take symptomatic treatment. Going to the doctor can actually expose you to more pathogens and also expose others to your virus. Viruses are one of those things that you do not want to share.

So here are a few tips to help you get through that misery.

First of all, get the flu shot. While it doesn’t protect you from getting a cold and doesn’t cover all strands of the flu (there’s just too many of them), it does cover what strands are predicted to be the most prevalent that season. While the flu is a virus and cannot be treated with antibiotics, if you do get it, it will make you feel even more miserable than the common cold. And you cannot get the flu from the flu shot. Let me repeat that. You cannot get the flu from the flu shot.

If at all possible, do everything you can to stay home from work or school. Rather, it’s better to again not expose others or potentially expose yourself. If you have a regular medical provider who you see, they might even be willing to give you an excuse note without seeing you (which is yet another reason to have a regular primary care provider). And it really is better to just wait out the infection rather than running to the doctor. Especially for the common cold, you do not want to go to the ER. Why would you want to expose yourself to every illness that exists in an emergency room? And why would you expose your own virus to someone else in the ER who might be very sick and at a higher risk from getting very ill if they do catch your virus?

Use symptomatic treatment to help you feel better. For a sore throat and chills, drink warm liquids and take Tylenol as needed. Tylenol or Ibuprofen will also help with the muscle aches. For the cough and chest congestion, there’s just nothing that works better than Vicks Vaporub. For a runny nose take an allergy medicine like Benadryl or Loratadine. For a stuffy nose, use a saline nose spray.

To try to keep yourself from getting a cold, wash your hands regularly. Quit smoking and stay away from secondhand smoke. Exercise regularly, drink 6+ cups of water every day, and try to always get at least 6-8 hours of good sleep to keep yourself healthy.

And remember that colds are caused by viruses and cannot be treated with antibiotics, so don’t pester your medical provider about giving you a prescription for one. However, colds may turn into a bacterial infection especially in young children and adults with risk factors (smoking, chronic illnesses, etc). So if you do stay sick for over a week, at that point it is a good idea to see your provider.

For immigration physicals, the cost is $150 for adults and $75 for children under the age of 15. This must be paid up front, at the time that you come in for your appointment. I do not bill insurances for these physicals, because they are generally not covered. It is best if you bring a copy of the I-693 form with you to your appointment, with your section completed. You will also need to bring a photo ID such as a passport (from any country) or a driver’s license. Since I don’t do labs or vaccines in my office, unfortunately, these will need to be done at a different location. The following are a list of requirements.

For adults 15 and over:
RPR (blood test for syphilis)
TB skin test which is done and then must be read within 48-72 hours; if the TB test is positive a chest x-ray is required and the report must be included in the packet.
Vaccines- Tdap is required; flu vaccine is required during flu season (the end of September- the end of March); proof of an MMR (or an updated vaccine or blood titers done); pneumonia vaccine for individuals 65 and older

For children under 15:
TB skin test which is done and must be read within 48-72 hours; a chest x-ray if the TB test is positive and again the report must be included in the packet.
All vaccines must be up to date for their age and proof of these is required. This includes the flu vaccine during flu season (the end of September- the end of March). If you don’t have a copy of the vaccines, you can either get one from his/her physician’s office or from the school.

The best way to do the physicals is to do the tests and vaccines before your appointment. If you have insurance, you can get these done at your local physician’s office, and they may be covered by your insurance. If you don’t have insurance (or even if you do), you can get these done at your local health department. By doing these ahead of time, you can bring the results to the physical, and then the papers can be completed while you’re in the office. If you choose to wait until your appointment, unfortunately you will need to return to the clinic to pick up the papers after your lab results come back, your vaccines are done, your TB test has been read and your chest x-ray is completed if this is needed. The papers must be kept in a sealed envelope and be sent in that way with your application. I will give you a copy and keep one for myself, just in case there is a problem. Fortunately, I have never had one returned to me, knock on wood!

If you have any questions about this, feel free to call me at any time or you can ask me when you call to schedule your appointment.

All primary care practices are unique in different ways, so what makes this practice different?

My practice is modeled after the practice of my own family physician. It’s very similar to the solo family practices that used to be, if they had the benefit of electronic medical records. It is designed to keep overhead low, be able to allot more time for patient appointments, and practice medicine at a comfortable pace. While I currently don’t have other staff, that may change in the future.

The reason I decided to open my own practice is because I wanted to have flexibility for both myself and my patients. While I do have set office hours, once patients have been seen enough to establish a doctor-patient relationship, I will try to do my best to work with your schedules. I don’t mind occasionally coming in before or after hours, or on a holiday or Saturday if that’s the only time you have available. I don’t do labwork in my office, but Labcorp is right around the corner. I also don’t do vaccines, but instead send my patients to the health department to get those done. I see both pediatric patients and adults, and I am also a civil surgeon with USCIS which allows me to do immigration physicals. Although I only practice outpatient medicine, if one of my patients gets admitted to the hospital, they will get excellent care from the hospitalists and I will do my best to follow along during your stay.

I will almost always be available by phone or through my patient portal after hours. I have a calendar on my website that indicates when I will be gone or any changes in my hours. Anytime I am gone, I will still have access to my electronic records and will still take calls, unless otherwise noted. If I don’t answer the phone, it is usually because I’m either with a patient or temporarily busy. However, if you leave a message, I will always return your call as soon as possible. After hours, if you need to be seen urgently, you will need to go to one of the urgent care centers or to the emergency room. If it’s something that can wait until the next day, I will do my best to get you scheduled to see me that day. Of course, even during the day, if you have a medical emergency, you will need to go to the ER.

Currently, I accept the following insurances: Cigna, Virginia Medicaid, United HealthCare, and Anthem. I anticipate accepting other insurances, including Optima and Medicare, in the future. Please contact me if you have any further questions.