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Health & wellness blog

Notes From the Practice.

We write about the topics our patients ask about most: navigating the immigration medical exam, understanding your weight loss medication options, and taking care of your skin and your health between visits. Written by the physician who will actually treat you, not aggregated from the internet.

Weight Loss & GLP-1 Medications

Plain explanations of the medications you have heard about, and what they cost without a subscription.

Wegovy vs. Zepbound vs. Ozempic vs. Mounjaro: what is actually different

Two molecules, four labels. How the GLP-1 medications compare on results, side effects, and insurance coverage.

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Weight loss without a subscription: what you are actually paying for

How telehealth memberships price weight loss, and what a visit with a physician costs instead.

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Immigration Medical Exams

What happens at the I-693 exam, from a Civil Surgeon who has done thousands of them.

I-693 vaccines: what is required, and what immunity testing can replace

The USCIS vaccine list explained, and how a blood test can spare you shots you don’t need.

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Aesthetics & Skincare

Honest notes on treatments Dr. Gougian uses herself.

How to start tretinoin without wrecking your skin

Go slow, moisturize, and expect a rough week or two. A doctor’s guide to the most studied skincare ingredient there is.

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Family Medicine & Preventive Care

The everyday questions between visits.

The vaccines adults actually need

Tdap, shingles, pneumonia, flu, COVID: what is recommended at each age, and what is optional.

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What a metabolic health assessment can tell you

Blood sugar, cholesterol, liver, blood pressure, and waist size, read together instead of one at a time.

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About the Blog

The things our patients ask about most: GLP-1 medications and weight loss, the immigration medical exam process, skincare and aesthetic treatments, and everyday family medicine such as vaccines and metabolic health.

When there is something worth saying, typically once or twice a month. Older posts are updated when guidance changes, so what you read here reflects current practice.

Yes. Start with the post on what to expect at your exam, then visit the full immigration medical exam page for pricing, requirements, and scheduling. Immigration medical exam

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