Adolescent Medicine
The Adolescent Medicine Clinic provides primary and specialty care in preventive health services, health promotion, illness and injury diagnosis and treatment, adolescent gynecology, sports physicals and psychosocial support for teens and young adults ages 12 to 23 years.

Allergy and Immunology
Allergy and Immunology provides comprehensive diagnosis and management of allergy-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

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 postoperative 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 (APU). 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 during the procedure and post-operation pain control.

Armed Forces Center for Child Protection
The mission of the Armed Forces Center for ChildProtection (AFCCP) is to provide objective child treatment expertise when and where it is needed throughout theDefense 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 day care providers.

Armed Services Blood Bank Center
The Armed Services Blood Bank Center is a tri-service operation that collects, manufactures and distributes blood products (red blood cells, fresh frozen plasma, cryoprecipitate and platelet products). In addition to supplying localMedical Treatment Facilities (NNMC, WRAMC, Malcolm Grow) blood products are shipped in support of military operations throughout the world. 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

NNMC also offers a Perinatal Loss Support Group that provides support to families who are grieving the loss of a baby through miscarriage, stillbirth or newborn death.

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
• 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 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 stereo tactic biopsy. As such, the BIC uses new daylight processing machines that speed the completion of mammograms, meaning technicians no longer need to use a darkroom to develop X-rays.

Cardiothoracic Surgery
Board-certified cardiothoracic surgeons perform state-of-the-art adult cardiac surgical procedures, including coronary artery bypass grafting, valve repair and replacement, surgery to correct atrial fibrillation and arrhythmia, 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.

Cardiology
Our 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
• Cardiac Catheterization
• Cardiac Electrophysiology Studies
• Cardiothoracic Surgery
• Cardiac Intensive Care
• Medical-Surgical Intensive Care
• Cardiac Rehabilitation

Child and Adolescent Behavioral HealthDepartment
This department offers outpatient therapy for children, adolescents and their families. NNMC provides the only adolescent inpatient unit and Residential Treatment Program in the entire military, serving adolescents between ages 12 and 18 who have at least one of the following conditions:

• Preoccupation with suicide
• Uncontrollable aggressive behavior
• Acute psychotic symptoms

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 ClinicalNutrition Department works collaboratively with NNMC Health Promotion nutrition staff to address group and individual diet counseling for weight management, hypertension and cardiac related diet needs. Appoints for outpatient medical nutrition therapy services require a provider consult. Questions concerning Clinical Nutrition services call (301) 295-4065.

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 areferral.

Colon Health Initiative
Colorectal Cancer is the second leading cause of cancer related deaths in this country. Most colorectal cancer develops from polyps that grow in the colon over time. If polyps are detected and removed, the risk of developing colorectal cancer is greatly reduced.

At NNMC, eligible patients can be screened in two ways:

• Virtual Colonoscopy, a new procedure, is a CT Scan of the abdomen and is done in the Radiology Department. A small rectal tube is inserted into the rectum and the colon is distended with air. The images obtained are downloaded into a computer system and the radiologist can look inside the colon to detect polyps. This procedure can also look at the other abdominal organs and can possibly detect other abnormalities. It is estimated that approximately 20 percent of patients will have a polyp. If polyps are detected, you may have an Optical Colonoscopy the same day or make an appointment at your convenience. The procedure itself takes approximately 30 minutes. The results take an additional hour if you wish to wait.

• Optical Colonoscopy is also available and done with an endoscope that is inserted in the rectum and examines the large intestine. If polyps are found, they can be removed at that time. Sedation is given through an IV and someone must be with you to drive you home after the procedure. The length of time is approximately three hours.

You can self-refer to the Colon Health Initiative by calling (301) 319-8284 to speak with a nurse who will answer your questions to determine if you meet the screening criteria. You can also come by the radiology desk and ask to speak to a Virtual Colonoscopy nurse or drop off the completed questionnaire at the front desk of the gastroenterology clinic.

Dentistry (General)
General Dentistry offers appointments for annual T-2examinations and cleanings at the same visit. You may also make an appointment for your annual T-2 examination without a cleaning. Patients who wish to be examined for a chief complaint may also make an appointment. Walk-inexaminations are still possible and every effort will be made to see you in a timely manner. Patients in need of immediate attention will be seen on a walk-in basis as quickly aspossible.

Dermatology
Board-certified dermatologists, dermatopathologists and residents provide comprehensive health care to patients of all ages with skin-related conditions, including skin cancer diagnosis and treatment, dermatopathology and ultraviolet phototherapy. Dermatology also performs MOHS Surgery, a unique surgical procedure for excising skin cancers, which has the highest cure rate for non-melanoma skin cancers. NNMC’s MOHS surgeons are fellowship trained and members of the American College of MOHS Micrographic Surgery and Cutaneous 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 of high risk diabetic patients. The Diabetes Care Center includes diabetes education, a foot care clinic and a diabetes support group. Referrals are required from Primary Care Managers or other providers.

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 and treatment
• Social Worker assessment and intervention

Early interventionist team partners with family members to develop an individualized family service plan, 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 Early Intervention Program at Quantico Marine Corps Base and Naval Surface Warfare Center Dahlgren, as well as NNMC.

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 health care or special education needs.

Gastroenterology
The Gastroenterology Clinic provides comprehensive care to adult patients requiring diagnostic and therapeutic treatment for gastrointestinal conditions. Your primary care doctor can treat most common GI ailments. In cases of recurring or more serious problems, however, you may be referred to a gastroenterologist. GI provides colorectal screenings, flexible sigmoidoscopies and colonoscopies for the following disorders:

• Gastro-esophageal Reflux Disease (GERD)
• Bowel diseases such as Inflammatory Bowel Disease (IBD)
• Chronic abdominal pain or constipation
• Colorectal and other gastro-intestinal cancers
• Food intolerances
• Gallstones
• Liver diseases
• Ulcers

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
• Pediatrics
• Vascular trauma and critical care
• Oncology
• Advanced Laparoscopy

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 Promotions and Physical FitnessAssessment (PFA)
The Health Promotion Department provides resources to assist all beneficiaries in maintaining optimal health and physical fitness. Programs offered to active duty, family members, retirees, reservists, DoD civilians, and contractors include: individual and classroom-based counseling for nutrition, fitness, tobacco cessation, weight management, hypertension reduction, cholesterol management, and stress and anger management. The department also includes the Physical Fitness Assessment and Fitness Enhancement Program (FEP) for active duty members.

Health Readiness Department
The Health Readiness Department oversees the Individual Medical Readiness (IMR) program designed to ensure service members assigned to National Naval Medical Center have completed annual medical readiness requirements during their birth month to maximize operational readiness. IMR consists of six essential components: dental readiness, immunization status, readiness laboratory studies, individual medical equipment, deployment-limiting conditions, and an annual Periodic Health Assessment (PHA). The goal of NNMC and its Branch Health Clinics is to maintain a minimum of 85 percent medical readiness for deployment. In addition to IMR, Health Readiness also provides medical screenings for overseas suitability, reenlistment, physical examination and deployment health.

Hearing Conservation
Hearing Conservation services address auditory readiness, audiometric fitness-for-duty and prevention of job-related hearing loss. Audiometric screening services and diagnostic audiology are provided for employees exposed to hazardous noise levels. Additional services include employee education, hearing conservation program management and oversight, audiometric technician training and certification, and professional mentoring. This department also fits and issues hearing protective devices.

Hematology and Oncology Services
NNMC’s Hematology and Oncology Clinic, in conjunction with the National Cancer Institute (NCI), offers standard and research protocol treatment to active duty, retired and civilian patients. By working with the NCI, NNMC is able to offer more than the traditional options for treatment. They also have an onsite chemotherapy satellite pharmacy and a specialized onsite laboratory.

HIV Program
The Navy Central HIV Program is the central coordinating office for all HIV testing. A contract laboratory performs all testing off-site.

Immunization Clinic
Immunization Clinic provides customer-focused, walk-in complete immunization service to pediatric and adult beneficiaries in the National Capital Area. The clinic is open Monday thru Friday from 8:30 a.m. to 4 p.m.

Industrial Hygiene
The Industrial Hygiene Program evaluates biological, chemical and physical hazards in the work place and provides consultation on matters of work place health. Industrial Hygiene ensures that staff providing care to patients work in a healthy environment.

Infection Prevention & Control Services
Infection Prevention & Control Service provides direction and oversight for the prevention and control of health care-associated infections among patients, visitors and staff.

Inpatient Medicine
Inpatient Medicine provides around-the-clock, high quality nursing care to Internal Medicine patients with complex medical problems. Advanced technologies are used to aid in healing wounds. The medical team also uses pro-active pain management plans to ensure patient comfort. Patients and families are assisted with discharge planning for post-hospitalization care ranging from home health care service or equipment to assist rehabilitation services.

International Travel Clinic
International Travel Clinic is available on a self-referral basis for patients who will be traveling overseas. This clinic sees travelers in family groups and reviews their itinerary to make recommendations for immunizations, malaria, diarrhea and other disease prevention. It’s advisable to make appointments at least four weeks prior to travel since some immunizations and anti-malarials require weeks for administration. Patients are required to bring outpatient medical records and immunization records to all appointments.

Internal Medicine Clinic
The National Naval Medical Center’s Internal Medicine health care providers are skilled professionals who diagnose and treat adult patients with a wide variety of health conditions from simple to highly complex. Internal Medicine is comprised of two clinics:

• Internal Medicine Blue Clinic (located near the Emergency Room and Immunizations)

• Internal Medicine Gold Clinic (formerly the Family Health Center).

The clinics are staffed by physicians specializing in internal medicine, geriatrics, family and operational medicine as well as Nurse Practitioners, Physician Assistants, a Behavioral Health Specialist, Independent Duty Corpsmen, Registered Nurses, Licensed Practical Nurses, and Hospital Corpsmen. Our treatment team ensures that patients receive the highest quality medical care.

Services of the Internal Medicine Clinics include:

• Comprehensive primary care
• Preventive health care and health maintenance
• Patient and family education
• Physical, cognitive and functional assessment and care of geriatric patients
• Diabetes care, education and case management
• Behavioral Health
• Refractory hypertension
• Consultative services and discharge planning
• Minor procedures
• Walk-in sick call for active duty only (Gold Clinic sick call available Monday thru Friday from 7 to 9 a.m.)

Laboratory Anatomic and Clinical Pathology
Board-certified and resident pathologists perform a wide variety of tests on blood and other body fluids collected in the operating rooms, wards and clinics to determine if cancer or other abnormalities are present. The laboratory reports regular culture results as well as run specialized tuberculosis, viral and immunological tests. In support of NNMC’s cervical cancer screening program (pap smears), cytopathology uses liquid pap tests (ThinPrep) for patients seen at NNMC and other clinics that use laboratory services here. NNMC’s laboratory examines bone marrow for the presence of leukemia and other diseases. The laboratory staff also participate in a pathology training program and has pathologists board certified in multiple subspecialties.

Laser Vision Center
A new era in corrective eye surgery - photorefractive keratectomy (PRK) surgical procedures and Intralase LASIK - is helping vision-impaired patients see clearly without the hassles of glasses or contact lenses. For PRK, a doctor sculpts the surface of the cornea with an Ultraviolet (cold) laser to change the surface curvature of the cornea, resulting in a correction of the refractive error. For Intralase LASIK, a fematosecond laser creates a surgical flap on the front of the cornea. Then, the underlying surface of the cornea is sculpted with an Ultraviolet (cold) laser in order to change the surface curvature of the cornea, resulting in a correction of the refractive error. Priority is given to Sailors and Marines who work in extreme physical environments that preclude the safe use of eye glasses or contact lenses. An evaluation for eligibility may be requested by all active duty Navy and Marine Corps personnel. Eligibility will be determined by an ophthalmologist or optometrist. An eligible member’s unit commander must endorse the request and determine the level of priority. Once a command-endorsed request is received, the NNMC Laser Vision Center staff will review requests for final determination of clinical appropriateness and priority.

Medical & Reproductive Genetics
NNMC is one of the first military medical facilities to offer genetic counseling services to families with a known history of genetic disorders or newly suspected genetic conditions, including pre-conception counseling, prenatal counseling and diagnostic testing. Genetics professionals interpret family and medical histories to assess the chance of disease occurrence or recurrence. Education is provided to families regarding inheritance of a particular condition, testing options and resources to enable individuals to make informed decisions regarding reproductive or management choices.

Mother & Infant Care Center and Couplet Care (MICC)
NNMC’s MICC delivers more than 2,000 babies each year and is one of the largest birthing centers in the Defense Department medical system. The MICC embodies the most modern concepts in childbirth philosophy, technology and design. ‘‘Family-Centered Care” is integrated with advanced medical technology to ensure a safe, comfortable and individualized birth experience. Labor, delivery and recovery all take place in specially designed birthing rooms with warm, home-like environments, featuring private bathrooms, birthing beds, televisions, pullout sofas and telephones. Operating rooms with the latest medical equipment are conveniently located for Cesarean deliveries. After delivery, your family will stay in a special Couplet Care room, where a specially trained nurse cares for mother and baby.

MICC also offers:

• 24-hour visitation
• Priority-parking passes for new and expectant mothers
• Lactation (breast-feeding) consulting and education sessions
• Room service and ‘‘Special Delivery” meals for new moms

Neonatal Intensive Care Unit (NICU)
NNMC's Level III Neonatal Intensive Care Unit (NICU) provides the highest level of care for newborns at risk from the National Capital Area, as well as those transported from local hospitals and overseas locations. Some of the conditions that may cause a newborn to be referred to the NICU are premature birth, low birth weight, infection, respiratory problems or birth defects. Staffed by physicians in neonatal medicine, including three board-certified neonatal specialists who apply the most advanced medical technologies available, the NICU offers around-the-clock intensive care for over 400 high-risk critically ill newborns each year.

Nephrology
Nephrology Service is a specialty clinic, evaluating and treating a full range of genitourinary system and kidney disorders. The clinic assumes primary responsibility for coordination and administration of medical care for adult patients (18 years of age and older). Expert and compassionate staff members provide initial evaluation and assist the patient to attain the optimal state of wellness by understanding and participating in care.

Neurology
Physicians with extensive expertise and experience in neurology use advanced diagnostic procedures and facilities to diagnose and treat adults with disorders of the nervous system (brain, spinal cord and peripheral nerves). Health care professionals in Neurology perform surgical and non-surgical solutions for a broad range of neurological disorders, including epilepsy, headaches, multiple sclerosis, strokes, sleep disorders, tumors and cerebrovascular conditions. Evaluation, treatment and follow-up often involve a close collaboration with other health care specialists.

Neurosurgery
The dedicated neurosurgeons at NNMC bring extensive expertise to the evaluation and treatment of nervous system disorders requiring surgery. We offer state-of-the-art neuro-endovascular treatment for intracranial aneurysms, arteriovenous malformations and stroke with specific emphasis on carotid artery disease. Neurosurgeons also focus on intracranial stenosis and emergent revascularization procedures. Additionally, we have the most experienced nationally known military neurovascular surgeon on staff, trained in interventional neuroradiology, cerebrovascular surgery and neurocritical care. Neurosurgery at NNMC has a distinguished history of significant and successful surgical accomplishments that utilize a team approach to solutions. Physicians’ specialties may include neurologists, oncologists, speech pathologists, physical medicine, rehab specialists and psychiatrists. Areas of expertise include, but are not limited to:

• Cerebrovascular and stroke
• Tumors: brain, pituitary, acoustic and skull base tumors
• Spinal disorders
• Radiosurgery
• Epilepsy

Nutrition Management
Nutrition Management provides meals for inpatients, clinical nutrition care to inpatients and outpatients, and health education. Nutrition Management also offers individual nutrition counseling, therapeutic diets and classes for diabetes, and cholesterol and weight management. Counseling is available to those eligible for military medical care.

Obstetrics & Gynecology
NNMC is the Tri-Service Referral Hospital for obstetrics, high-risk pregnancies, and deliveries for the National Capital Region and national and international commands. Specialists in obstetrics and gynecology diagnose and treat both acute (short-term) and chronic (long-term) conditions. Prenatal (before birth) care is highly personalized to the individual patient’s needs and includes a comprehensive childbirth and parenting education program. NNMC’s obstetrics professionals use the newest technology and equipment, such as 4-dimensional ultrasound and video teleconferencing. Gynecologic surgeons have expertise in both traditional gynecologic surgery and minimally invasive procedures such as laparoscopy, endometrial ablation and hysteroscopic tubal occlusion. Other services provided by the Obstetrics & Gynecology clinic include:

• Maternal-fetal medicine consultation
• Contraceptive counseling
• Hormone Replacement Therapy
• Colposcopy

Occupational Health Clinic
The Occupational Health Clinic offers medical care to civilian staff for work related illness or injury and ensures health in the work environment by providing the following services:

• Pre-placement evaluations
• Medical surveillance and certification examinations
• Worksite visits
• Return-to-work evaluations
• Workers Comp⁄FECA program consultation

Occupational Safety
The Occupational Safety Program provides safety inspections for all NNMC workplace areas, thereby ensuring a safe workplace for employees, patients and visitors. Other safety programs include respiratory protection, mishap reporting and investigations, safety training, hazard abatement and ergonomics.

Occupational Therapy
Occupational Therapy (OT) professionals provide outpatient and inpatient services to individuals with orthopedic, neurological and physical disabilities. Occupational Therapy’s goals focus on increasing one’s level of independence with self-care, work and leisure skills through purposeful activity. Customized treatment plans can include therapeutic exercise, education on injury prevention and ergonomics, provision of some adaptive equipment and recommendations for home safety.

Oncology
NNMC partners with the National Cancer Institute (NCI) to offer state-of-the-art clinical research trials for cancer treatment. As a patient, you will have access to research protocol and standard treatment options. By working with the NCI, NNMC is able to offer more than the traditional options for treatment. Chemotherapy and oncology certified nursing staff meet the national standards in oncology and show commitment to patient care. Education of patients and their caregivers in all topics related to treatment and quality of life is a major nursing priority.

Operating Rooms
NNMC’s Main and Ambulatory Operating Rooms provide comprehensive inpatient and outpatient care for the following surgical specialties:

• Cardiothoracic Surgery
• Dentistry
• General Surgery
• Gynecology
• Neurosurgery
• Ophthalmology
• Oral-Maxillofacial
• Orthopedics
• Pediatric Dentistry
• Plastic Surgery
• Reproductive Endocrinology and Infertility
• Podiatry
• Urology
• Vascular Surgery

Highly skilled surgeons perform state-of-the-art surgical procedures such as total knee and hip joint replacements, cardiac bypass and heart valve replacements, and neurosurgical procedures.

The Ambulatory Operating Room is a comfortable, convenient environment for patients having surgical procedures that do not exceed two hours. It is a fully equipped, state-of-the-art facility where doctors can perform conscious-sedative surgeries. Rapid advances in surgical technology and pain management have opened the door to ambulatory surgery where hospital admission is not required.

Ophthalmology (Eye Clinic)
Ophthalmology provides a full spectrum of clinical ophthalmology services to all categories of military health care beneficiaries, including comprehensive eye examinations and treatment, utilizing laser treatment or surgery when indicated. Disorders treated include cataracts, glaucoma, corneal disease, eyelid abnormalities, eye infections or inflammation, retinal disorders, ocular injuries and ocular changes from diabetes.

Optometry Department
NNMC’s Optometry Department offers treatments ranging from comprehensive eye examinations and contact lens care to the prevention, remedy, and control of eye problems, diseases and injuries to the eye. Services are provided to patients of all ages from 6 years old and up. Optometry does not perform new contact lens fitting; only renewals of present contact lenses if they are fit properly. Optometry does fit medically necessary contact lenses. Medical records and current eyeglasses or contact lenses are required for all appointments. Active duty and retired military members are eligible for military-issue glasses through our Optical Shop. Referrals are not required.

Orthopaedic Surgery
Orthopaedic Surgery is a completely integrated service between NNMC and WRAMC. At both hospitals, board-certified orthopaedic specialists work as one team to address the full spectrum of musculoskeletal concerns, from pain management and sports medicine to total joint replacement. Sports medicine specialists treat injuries with the latest in minimally invasive and arthroscopic surgical techniques and non-surgical techniques, as well as with aggressive, proactive rehabilitation. Specialists in hand, upper extremity and micro vascular surgery treat common and complex conditions including traumatic, degenerative, congenital, and repetitive use injuries. Adult-reconstructive surgeons perform joint reconstruction and joint replacement surgery, utilizing state-of-the-art implants and the most up-to-date surgical techniques. Foot and ankle surgeons and podiatrists address all concerns of the lower extremity. Nationally recognized specialists in trauma orthopaedics provide care to our wounded warriors and to beneficiaries with community-based traumatic injuries including hip fractures, wrist and ankle fractures. The orthopaedic service also provides specialized care in spine surgery, musculoskeletal tumor surgery and pediatric orthopaedic surgery and participates in cutting-edge research in the advancement of all areas of orthopaedic surgery.

Oral and Maxillofacial Surgery
Oral and Maxillofacial Surgery diagnoses and treats patients with diseases, injuries and defects of the hard and soft tissues of the mouth, teeth, jaws and face. They also correct problematic wisdom teeth, facial pain, facial trauma, sleep apnea and misaligned jaws. Reconstructive and dental implant surgeries are offered as well as treatment for tumors, cysts and other defects of the jaws and face. Emergency care for non-active duty patients is limited to humanitarian relief of acute pain, trauma and infections. The Tricare Dependent Dental Plan, administrated by United Concordia, and the Retiree Dental Plan, administrated by Delta Dental, is available to meet the dental needs of non-active duty family members and retirees. The only Orofacial Pain Center in the Defense Department is also located at National Naval Medical Center. It diagnoses and manages pain symptoms of the mouth, jaw, face, head and neck.

Otolaryngology Surgery (ENT)
This department's wide range of medical and surgical specialists work together to treat patients of all ages who have problems of the ear, nose, throat, related head and neck structures, and hearing loss. Otolaryngology surgery, commonly known as ENT (ear, nose and throat), provides comprehensive, compassionate care; whether your newborn baby needs a hearing test, you are experiencing dizziness, or you have an infection or allergy.

Pediatric Medicine
Specialists in pediatric medicine provide both primary and specialty care services for children (birth through age 12). Pediatrics offers a broad range of services including endocrinology (gland and hormone function), respiratory care, child neurology, cardiology (heart function), high-risk infant care, and lactation (breast feeding) consultation. You can also use the Pediatric Medicine Clinic for well baby and child check-ups, school or sports physicals, acute care issues or follow-up care.

Pediatrics Neurodevelopmental Division
The Neuro-Developmental Pediatric Division sees children of all ages and provides pediatric neuro-developmental assessments and treatment. Services include:

• Neuro-developmental pediatric services by developmental pediatricians
• Neuro-psychological, physical therapy and occupational therapy diagnostic assessments and treatment
• Evaluation and psychological behavior management services for children with such diagnoses as ADHD and Pervasive Developmental Disorders (PDD)
• Social worker interventions as needed

Pharmacy
Pharmacy services are one of the most popular benefits to our beneficiaries. In addition to obtaining your medications from the NNMC Pharmacy, your pharmacy benefit now includes the TRICARE Mail-Order Pharmacy (TMOP) and the TRICARE Retail Pharmacy network (TRRx). Since 2003, NNMC’s pharmacy has used an automated, robotic system for filling refill prescriptions. This technology guides pharmacy staff at each step in the prescription filling process, minimizing the potential for human error. It uses bar code technology to reduce wait times and ensure medication-dispensing accuracy. The pharmacy processes approximately 60,000 prescriptions each month. Due to the volume of pharmacy visitors each day, please familiarize your self with the established procedures and routines. Simple measures such as using the automated call-in refill service, taking the appropriate ticket at the pharmacy and having your identification available will help keep operations moving as quickly and efficiently as possible.

NNMC Main Pharmacy
The Main Pharmacy is located in Bldg. 9 on the second floor. Hours of operation are from 7:30 a.m. to 8:30 p.m. (Monday thru Friday) and Saturdays from 8 a.m. to noon. Peak business hours are on weekdays from 11 a.m. to 2 p.m. and 4 p.m. to 5:30 p.m., with the busiest days being Monday, Tuesday and the day after a three-day weekend. It is in your best interest to plan your visits around these times to reduce your wait.

NNMC Satellite Pharmacy (Drive-Through Refill Service)
NNMC offers a drive-through pharmacy refill service for patients to receive their refills without leaving their car. The average waiting time at the Pharmacy Refill Satellite is two to three minutes. Refills must be called in 3 days prior to pick-up at (800) 377-1723 or online at www.bethesda.med.navy.mil⁄refill. Hours of operation are from 8 a.m. to 6 p.m. Monday thru Friday and Saturdays from 8 a.m. to noon.

Physical Medicine & Rehabilitation
Physical Medicine and Rehabilitation (PM&R) offers a non-surgical approach to pain, injury and disease for neuro-musculoskeletal (involving the muscles and skeleton) disorders. Services include the evaluation and management of:

• Back and neck injuries or pain (Musculo-skeletal Medicine)
• Nerve and muscle disorders (Electrodiagnostic Medicine)
• Functional limitations due to injury or disease (General Rehabilitation)

Our physiatrist (specialist in Physical Medicine and Rehabilitation) is expert in musculoskeletal anatomy, biomechanics and exercise physiology, and evaluating symptoms and identifying their underlying causes.

Physical Therapy
Physical Therapy serves patients who have physical impairments, functional limitations, disabilities or changes in physical function and health status resulting from injury, disease or other causes. Physical therapy specialists administer treatment, develop rehabilitative programs and offer education for neurological, musculoskeletal disorders and post-surgical complications.

Podiatry
With training in the latest surgical techniques, doctors in the Podiatry Clinic address foot and ankle pathologies for patients of all ages. Podiatrists are also trained in clinical treatments, and possess the skills and knowledge necessary to handle all levels of the diagnosis and treatment of the lower extremities.

Post Anesthesia Care Unit
The fundamental purpose of the Post Anesthesia Care Unit (PACU) is to provide direct and continuous patient observation during emergence from anesthesia in the immediate post-operative period. The goal is to prevent or promptly recognize and treat post-operative complications. Nurses in this critical care unit are skilled in providing advanced life support measures.

Preventive Medicine & Environmental Health Services
Preventive Medicine and Environmental Health services ensure the health and safety of the NNMC community by protecting staff, patients and visitors from environmental and health threats through communicable disease, food, water and facility sanitation surveillance. Others services include: food safety inspections, smallpox vaccination program, tuberculosis control program and environmental health consultation.

Pulmonary Medicine
Pulmonary Medicine provides state-of-the-art diagnosis and treatment services to adult patients with diseases of the chest, lung and respiratory systems such as:

• Asthma
• Chronic Obstructive Pulmonary Diseases such as chronic bronchitis and emphysema
• Cystic fibrosis
• Occupational lung disease
• Tuberculosis
• Pneumonia
• Pulmonary hypertension

Radiology
Radiology offers a full spectrum of diagnostic and therapeutic radiological services, including radiographic examinations, Magnetic Resonance Imaging (MRI), computerized axial tomography studies, ultrasound studies and mammography studies. This department also interprets films and fluoroscopic screen images for staff medical officers, and provides education for NNMC staff. Radiology provides services in the following areas, while ensuring radiation safety for patients, staff and the environment:

• Diagnostic Radiology
• Nuclear Medicine
• Physics and Radiology Safety
• Radiation Therapy
• Interventional Radiology
• Breast MRI

NNMC has the Defense Department’s first Positron Emission Tomography (PET) scanner, which allows patients suffering from diseases like cancer, dementia, epileptic seizures and coronary artery disease, a chance to receive more accurate diagnosis and improved care, with less need for invasive biopsies and surgeries.

Rheumatology
Rheumatology diagnoses and treats certain autoimmune diseases and musculoskeletal pain disorders, including arthritis and osteoporosis. These diseases are usually marked by inflammation and degeneration of connective tissue structures of the body, especially the joints. Rheumatology also provides follow-up, monitoring, education and counseling.

Social Work Division, Clinical CareManagement Department
Social Work is a consultation service to multidisciplinary teams in the primary and specialty clinics and inpatient units. Social workers help patients and families to cope with chronic, acute or terminal illness; to handle problems that may interfere with recovery or rehabilitation; to plan for patients' needs after discharge; and to connect with agency and community resources. They provide the following servicesto patients and families whose lives are impacted by medical issues:

• Medical crisis counseling for new diagnoses and exacerbations of illness.
• Bereavement services for end of life issues and other losses
• Psychosocial support
• Discharge planning
• Admission prevention
• Resource Management
  • Help in obtaining durable medical equipment
  • Referrals to home health services and hospice
  • Placements in nursing homes and rehabilitation facilities

Speech Language Pathology
Speech Language Pathology provides a broad spectrum of diagnostic and treatment services such as pre- and post-operative assessments, language and cognitive-linguistic assessments, communication therapy, swallowing and feeding therapy; as well as continuity of care for patients through their schools, other hospitals, community speech pathology clinics, rehabilitation centers and nursing homes.

Sterile Processing
Sterile Processing provides receipt, decontamination, sterilization, and redistribution of surgical instrumentation for NNMC and tenant commands, including the Uniformed Services University of the Health Sciences, the U.S. Capitol, and the White House. Skilled professionals monitor, receive and transport regulated medical waste to secured storage awaiting pick-up by a designated authority. SterileProcessing is also the collecting point for outpatient disposal of used syringes and needles.

Substance Abuse Department
The Substance Abuse Department administers and coordinates the Substance Abuse and Rehabilitation Program (SARP) that provides continuing counseling for patients diagnosed with substance-related disorders who have successfully completed a treatment program. They also serve patients identified with substance abuse problems, drug or alcohol dependence, or other behavioral conditions requiring a structured and closely supervised environment. A full range of individual, group and family therapy services are provided in all program areas. Also provided are administrative assistance, drug and alcohol information, preventive education and referral assistance as part of an on-going outreach program.

Surgical Inpatient
This department provides warm, personal care combined with modern, state-of-the-art facilities for patients’ comfort, safety and successful surgical outcomes. Services include:

• Bedside care before and after operations
• Advanced wound care
• Patient education
• Discharge planning

Transfusion Services
Transfusion Services provides and manufactures blood components based upon the unique needs of our patients in Obstetrics & Gynecology; Hematology & Oncology; General; Orthopedic; Cardio-Thoracic Surgery; Internal Medicine Clinics; Neonatology and Neurosurgery. NNMC’s blood bank transfuses 4,200 blood products annually and is staffed around the clock, including weekends and holidays.

Urology
Urologic Surgery provides specialized medical and surgical care for problems of the urinary tract. Specialists evaluate and manage conditions of the male genitourinary tract and the female urinary tract including male infertility, impotence and prostate disease utilizing minimally invasive techniques such as laparoscopy and robotic surgery; sterilization and vasectomy; urinary disorders such as cancers, incontinence, urinary tract stones and infections. The staff is committed to preventive prostate health care, achieved through prostate biopsies, studies with other medical institutions and keeping a keen focus on future, state-of-the-art medical treatments. A prostate cancer support group is also available and is open to all who have been diagnosed with prostate cancer and their family members. In addition, this department has a specialist in Pediatric Urology to investigate problems such as birth defects of the urogenital system and to provide care for children with bedwetting problems and urinary tract infections.

Patient Rights and Responsibilities
At National Naval Medical Center, we demonstrate our support and commitment to Patients Rights through the day-to-day processes and standards by which our staff interacts with patients. These interactions reflect a fundamental respect for our patients' dignity and are guided by the staff's awareness of the ethical issues surrounding patient care. For a detailed explanation of your rights and responsibilities, ask for a Patients Rights brochure the next time you visit NNMC. (El libro de derechos de paciente esisponible tambien en espanol.)

Your Rights:

1. To Receive Quality Care
2. To Receive Explanations of Care
3. To Receive Pain Management
4. To Participate in Your Care
5. To Provide Informed Consent
6. To Refuse Treatment
7. To Arrange for an Advance Directive
8. To Know the Identity of Health Care Staff
9. To Receive Respectful Treatment
10. To Be Provided Privacy, Security and Safety
11. To Express Your Feelings
12. To Refuse Participation in Research
13. To Receive Visitors and Communications
14. To Understand Rules and Regulations
15. To Voice Your Concerns

Your Responsibilities:

1. To Provide Information About Your Health
2. To Provide Information About Advance Directives
3. To Follow NNMC Rules and Regulations
4. To Be Respectful and Considerate of Others
5. To Comply with Recommended Medical Care
6. To Arrive on Time for Appointments
7. To Return Medical Records

You Can Help by Donating Platelets!
Help save a life by giving your gift of life. Please support our nation’s dedicated military family by donating platelets. You will be helping patients undergoing an organ transplant or who have been diagnosed with cancer, leukemia or a blood disorder such as aplastic anemia.

How will platelets help?
During chemotherapy and radiation, many times both cancer and healthy cells are destroyed. Blood and platelet transfusions prevent hemorrhaging in these patients or help them to fight infection. Several donors may be necessary to support one patient!

What is the process?
The process of platelet donation is called Aphaeresis. An Aphaeresis donation allows collection of platelets, plasma and white blood cells. Blood is drawn from the donor’s arm and sent through sterile tubing into a centrifuge in a cell-separator machine. During this two hour process, platelets are separated and the other blood cells are returned to the donor.

Why is the need so urgent now?
Recent military obligations and vaccinations have significantly depleted our platelet donor pool. Since platelets are good for only 5 days, we urgently need a pool of reliable and repeat platelet donors to replenish and maintain our supply.

Who will benefit from my plateletdonation?
Platelets collected will be used in military hospitals in the National Capital Area for sick active duty members of all branches, their families and retirees.

Who can donate?
Eligible donors have to be healthy individuals who weigh a minimum of 110 pounds. Other factors may be considered for eligibility.

If you are interested in donating platelets, pleasecall the blood bank for more information at(301) 295-1737.

When to Use theEmergency Room
You need emergency medical treatment when you have a sudden, unexpected medical condition or the worsening of a condition that poses a threat to life, limb, or sight. If you believe an injury or illness is life threatening or if you experience any of the following symptoms, call 9-1-1 or immediately go to the nearest emergency department:

• Bleeding that won’t stop
• Vomiting or coughing blood, or passing black stools
• Severe pain in the chest, upper abdomen or down the arm
• Heart stops beating or pulse is very faint
• Difficulty breathing (or the presence of blue lips, face or nail beds)
• Severe headache (with nausea, vomiting, fever or dizziness)
• Consciousness is altered or affected
• Injuries from trauma (such as from a fall or automobile accident)
• Suicidal or homicidal feelings
• Extensive burns, especially where skin is white or charred
• Eye injuries (or acids or other strong solutions in the eye)
• Seizure or convulsion that does not stop
• Insect sting when the patient is known to have allergic reactions
• Suspected poisoning, numbness or paralysis in a part of the body