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.
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.
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Metformin for weight loss: who it helps and who it doesn’t
An inexpensive diabetes medication that sometimes helps with weight. When it makes sense, and what to expect.
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.
GLP-1 side effects: what to expect when starting Wegovy, Ozempic, Mounjaro, or Zepbound
Nausea, fatigue, constipation, and more. A family physician explains what GLP-1 side effects are real, what helps, and what to ask before you start.
Weight loss medication insurance coverage: what is covered in 2025
What insurance covers for Wegovy, Zepbound, Ozempic and more. Medicare, Medicaid, private plans, prior auth, and out-of-pocket costs explained plainly.
Immigration Medical Exams
What happens at the I-693 exam, from a Civil Surgeon who has done thousands of them.
What to expect at your immigration medical exam
Step by step, from what to bring to when you will get your sealed I-693 envelope.
What is a Civil Surgeon? Finding a USCIS-designated Civil Surgeon near Washington, DC
A USCIS-designated Civil Surgeon in University Park, MD explains the I-693 exam, required vaccines, and what to expect.
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 do not need.
Aesthetics & Skincare
Honest notes on treatments Dr. Gougian uses herself.
Botox vs. Jeuveau: an honest comparison
Two very similar treatments, a small price difference, and how to decide between them.
Skin tag removal vs dermatologist: when to see a family doctor
Most skin tags do not need a specialist. When your family doctor can remove them, what it costs, and when a dermatologist referral makes sense.
How to Start Tretinoin Without Wrecking Your Skin
Go slow and moisturize. Expect a rough week or two. A doctor's guide to the most studied skincare ingredient there is.
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.
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.
About the Blog
Questions a Post Can’t Answer?
Bring them to a visit. Same doctor every time, and enough time to actually talk.