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Dr. Tamara Lynn Augustin, MD

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Specializes in: Internal Medicine (Adult Medicine) and Hospital Medicine (Hospitalist)

Wayne State University School of Medicine (2007)

Professional interests include: bleeding disorders, venous disease, thyroid problems, and more.

102 Irving Street Nw
Washington, DC 20010

(202) 877-1000

Dr. Tamara Lynn Augustin, MD is an internist in Washington, DC specializing in internal medicine (adult medicine) and hospital medicine (hospitalist). She graduated from Wayne State University School of Medicine in 2007 and has 19 years of experience. Dr. Tamara Lynn Augustin, MD is affiliated with MedStar Health.

Office Locations

102 Irving Street Nw
Washington, DC 20010

(202) 877-1000

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110 Irving Street Nw
Washington, DC 20010

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3800 Reservoir Road Nw
Washington, DC 20007

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Some issues Dr. Tamara Lynn Augustin, MD can help you with:

Gastrointestinal Problems (Digestive Disorders)

The gastrointestinal system, or GI tract, is the name given to a collection of organs that work together to digest food. These organs fit together in a long tube, running from the mouth to the anus, and include the esophagus, stomach, and intestines, among others. With so many parts working together, complicated by today's busy lifestyles and diets, digestive problems are common. As many as 1 in 3 Americans have a digestive or GI disorder. There are a huge variety of digestive problems, but the most common are IBS, constipation, GERD, hemorrhoids, and ulcers.

IBS, or irritable bowel syndrome, happens when the muscles surrounding the colon contract too easily or frequently. The result is abdominal pain, cramps, diarrhea or constipation, gas and bloating. IBS attacks can often be brought on by specific triggers, so a key part of treatment is learning which foods trigger IBS attacks and avoiding them. Treatment also includes exercise, avoiding stress, and medications if needed.

Constipation, or large, hard, or infrequent stools, happens to everyone at some point. It can be caused by a disruption in routine or food, or by eating a diet without many fresh fruits and vegetables. Although it is uncomfortable, constipation is common and usually not serious, but it can sometimes become chronic. Adding fiber to the diet, exercising, and taking medications may help.

GERD, or gastroesophageal reflux disease, is a severe form of chronic heartburn where stomach acid spills back up into the esophagus. Left untreated, the acid may even eat away at the esophagus and cause serious damage. Treatment includes changing the diet to avoid trigger foods, losing weight if needed, medications, or even surgery.

Hemorrhoids are blood vessels around the rectum that become irritated, swollen or torn while straining during a bowel movement. They are most often caused by constipation, but can also be caused by pregnancy, diarrhea, or simply a genetic predisposition towards hemorrhoids. Treatment involves first treating any constipation issues, then keeping the area clean and soothed until it has healed. If these measures are ineffective, surgery is sometimes used.

Peptic ulcers are sores or spots of inflammation in the lining of the stomach or close to the stomach in the small intestine. Usually this area is coated with a protective lining that shields the tissue from the strong stomach acid, but a break in the lining can let acid in, causing the sores. It used to be thought that stress caused ulcers, but now it is known that is not the case. Most often, they are caused by an infection by H. pylori bacteria, but ulcers can also be caused by alcohol abuse or overuse of aspirin, ibuprofen, naproxen, or other NSAIDS. The symptoms of an ulcer are pain, hunger, nausea, and fatigue.

Gastrointestinal problems, perhaps more than any other area, are markedly affected by lifestyle. Many disorders can be prevented or treated at least in part by eating a healthy diet high in fiber, exercising regularly, drinking enough water, and limiting alcohol intake. Still, the frequency of digestive disorders means that even the healthiest person can be affected by them. Anyone who notices blood in their stool, experiences abdominal pain, unexplained weight loss, or any significant change in bowel movements should see a doctor.

Heart Problems

The heart is one of the most important organs in the body. This smooth muscle expands and contracts rhythmically an entire lifetime, pumping blood to the lungs and then to every other cell in the body. When heart problems occur, it becomes difficult for the body to get the nutrients and oxygen it needs via the blood. So while there are a variety of illnesses and disorders that affect the heart, most of them cause weakness, exhaustion and shortness of breath. The most common heart conditions include heart disease, angina, arrhythmia, and valve disorders.

Heart disease is the leading cause of death in the United States for both men and women. This includes coronary artery disease, heart attacks, congestive heart failure, and congenital heart disease. Some conditions, such as genetics, cannot be controlled. But there are many other things one can do to lower their risk for heart disease. Controlling high blood pressure and cholesterol levels, reducing or stopping smoking, exercising more and losing weight if needed, and eating a diet low in sodium can all protect the heart.

Angina is a squeezing type of chest pain that happens when the muscles around the heart don't get enough oxygen. It can be regular or infrequent. Usually, angina is caused by coronary heart disease. However, not all chest pain is angina. Chest pain can also be caused by a lung infection or panic attack, for example, so it is important to have any sudden pain checked.

Arrhythmia is the word for when the heart beats too fast, too slow, or irregularly with skipped beats. It can feel frightening, and depending on the type it can be dangerous, but in most cases arrhythmia is not serious and can be treated. It is very common, especially in older adults.

Heart valve problems can happen in any one of the the heart's four valves that keep blood flowing where it needs to go. Babies can be born with problems in their heart valves, or valves can be damaged by infections. The valves can stiffen and become less mobile, or they can stop closing properly and 'leak' when the heart beats. Valve problems can usually be repaired surgically.

Kidney Stones

Kidney stones are hard deposits that form in the kidneys, made up of minerals that are normally present in urine. They can vary in size, from as small as a grain of sand to as large as a nickel, occasionally even larger. Sometimes they lodge in the kidney, and sometimes they break free and make their way out through the urinary tract, which can be extremely painful.

Kidney stones can be smooth or jagged and are yellow to brown in color. They are mostly comprised of the minerals calcium, oxalate, and phosphorus. Examining the stones to see what they are made of can show what caused the stone to be formed in the first place. For example, a stone made of mostly calcium, which is the most common type, can happen any time the urine becomes too concentrated due to dehydration or a blockage in the kidney. A uric acid stone forms when acid levels in the urine get too high, usually due to excessive consumption of animal protein such as meat and fish. A struvite stone is a sign of certain infections, and a cystine stone can be due to a genetic disorder that raises the risk of kidney stones.

The most common symptom of kidney stones is pain, either in the back or lower abdomen, or severe pain when urinating. There may also be blood in the urine. Treatment for kidney stones depends on how large the stone is. Very small stones can pass out of the body on their own, and they do not require treatment other than drinking adequate water and taking pain killers. Larger stones need to be broken apart and removed. The main treatment options are:

Shock wave lithotripsy, which uses sound wave vibrations to break apart the stone
Percutaneous nephrolithotomy, or the use of a very tiny tool (like a wire inserted through the back) to break apart and remove the stone
Ureteroscopy, a thin tube inserted through the urethra and bladder to the stone, where tiny tools can grasp the stone and remove

People who have had one kidney stone are at risk of developing another. To reduce this risk, patients are given instructions specific to the type of stone they developed. Generally the instructions will include drinking more water to dilute the urine, but it may also involve lowering sodium intake or eating less meat.

Noteworthy Medicare Patient Procedures Performed by Dr. Tamara Lynn Augustin, MD in 2024

Click on any procedure below to see further details on volume and pricing among Medicare patients.

Top 25%

By Volume:

inpatient hospital care

In 2012, Dr. Tamara Lynn Augustin, MD performed more inpatient hospital care (for patient admitted to hospital) procedures for Medicare patients than 75% of providers in related specialties within District of Columbia.

Medicare Procedure and Patient Information

2012 Medicare Procedure Volume

The top procedures that Dr. Tamara Lynn Augustin, MD treated as an internist in Washington, DC during 2012 were hospital care and inpatient care.

Volume of procedures performed by Dr. Tamara Lynn Augustin, MD for Medicare patients.

hospital care	199
inpatient care	199

Medicare Procedure and Patient Information

2013 Medicare Procedure Volume

The top procedures that Dr. Tamara Lynn Augustin, MD treated as an internist in Washington, DC during 2013 were hospital care and inpatient care.

Volume of procedures performed by Dr. Tamara Lynn Augustin, MD for Medicare patients.

hospital care	931
inpatient care	931

2013 Medicare Patient Data

Information about Medicare patients treated by Dr. Tamara Lynn Augustin, MD.

**Gender**
Male	86
Female	152

**Ethnicity**
Non-Hispanic White	207
Black	13
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	0
From 75 to 84	73
85 and over	115
Less than 65	0

Conditions of Medicare patients treated by Dr. Tamara Lynn Augustin, MD in 2013

Hypertension	75
High Cholesterol	71
Stroke	13
Ischemic Heart Disease	47
Depression	31
Chronic Kidney Disease	39
Asthma	14
Osteoperosis	12
Atrial Fibrilation	28
Heart Failure	36
Chronic Obstructive Pulmonary Disease	25
Diabetes	31
Dementia	36
Cancer	21

Medicare Procedure and Patient Information

2014 Medicare Procedure Volume

The top procedures that Dr. Tamara Lynn Augustin, MD treated as an internist in Washington, DC during 2014 were hospital care and inpatient care.

Volume of procedures performed by Dr. Tamara Lynn Augustin, MD for Medicare patients.

hospital care	702
inpatient care	702

2014 Medicare Patient Data

Information about Medicare patients treated by Dr. Tamara Lynn Augustin, MD.

**Gender**
Male	92
Female	157

**Ethnicity**
Non-Hispanic White	214
Black	0
Hispanic	14
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	47
From 75 to 84	65
85 and over	117
Less than 65	20

Conditions of Medicare patients treated by Dr. Tamara Lynn Augustin, MD in 2014

Hypertension	75
High Cholesterol	67
Stroke	16
Ischemic Heart Disease	54
Depression	42
Chronic Kidney Disease	51
Asthma	14
Osteoperosis	15
Atrial Fibrilation	32
Heart Failure	38
Chronic Obstructive Pulmonary Disease	34
Diabetes	33
Dementia	31
Cancer	18

Medicare Procedure and Patient Information

2015 Medicare Procedure Volume

The top procedures that Dr. Tamara Lynn Augustin, MD treated as an internist in Washington, DC during 2015 were hospital care, inpatient care and outpatient care.

Volume of procedures performed by Dr. Tamara Lynn Augustin, MD for Medicare patients.

hospital care	469
inpatient care	434
outpatient care	35

2015 Medicare Patient Data

Information about Medicare patients treated by Dr. Tamara Lynn Augustin, MD.

**Gender**
Male	154
Female	224

**Ethnicity**
Non-Hispanic White	174
Black	166
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	92
From 75 to 84	100
85 and over	100
Less than 65	86

Conditions of Medicare patients treated by Dr. Tamara Lynn Augustin, MD in 2015

Hypertension	75
High Cholesterol	69
Stroke	32
Ischemic Heart Disease	60
Depression	39
Chronic Kidney Disease	62
Asthma	32
Osteoperosis	8
Atrial Fibrilation	26
Heart Failure	51
Chronic Obstructive Pulmonary Disease	37
Diabetes	56
Dementia	38
Cancer	19

Medicare Procedure and Patient Information

2016 Medicare Procedure Volume

The top procedures that Dr. Tamara Lynn Augustin, MD treated as an internist in Washington, DC during 2016 were hospital care, inpatient care and outpatient care.

Volume of procedures performed by Dr. Tamara Lynn Augustin, MD for Medicare patients.

hospital care	903
inpatient care	755
outpatient care	148

2016 Medicare Patient Data

Information about Medicare patients treated by Dr. Tamara Lynn Augustin, MD.

**Gender**
Male	129
Female	177

**Ethnicity**
Non-Hispanic White	41
Black	247
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	92
From 75 to 84	83
85 and over	67
Less than 65	64

Conditions of Medicare patients treated by Dr. Tamara Lynn Augustin, MD in 2016

Hypertension	75
High Cholesterol	72
Stroke	40
Ischemic Heart Disease	63
Depression	29
Chronic Kidney Disease	67
Asthma	32
Osteoperosis	0
Atrial Fibrilation	25
Heart Failure	61
Chronic Obstructive Pulmonary Disease	25
Diabetes	61
Dementia	42
Cancer	15

Medicare Procedure and Patient Information

2017 Medicare Procedure Volume

The top procedures that Dr. Tamara Lynn Augustin, MD treated as an internist in Washington, DC during 2017 were hospital care, inpatient care and outpatient care.

Volume of procedures performed by Dr. Tamara Lynn Augustin, MD for Medicare patients.

hospital care	1203
inpatient care	1084
outpatient care	119

2017 Medicare Patient Data

Information about Medicare patients treated by Dr. Tamara Lynn Augustin, MD.

**Gender**
Male	189
Female	242

**Ethnicity**
Non-Hispanic White	49
Black	358
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	135
From 75 to 84	107
85 and over	77
Less than 65	112

Conditions of Medicare patients treated by Dr. Tamara Lynn Augustin, MD in 2017

Hypertension	75
High Cholesterol	70
Stroke	39
Ischemic Heart Disease	62
Depression	32
Chronic Kidney Disease	71
Asthma	15
Osteoperosis	7
Atrial Fibrilation	25
Heart Failure	62
Chronic Obstructive Pulmonary Disease	31
Diabetes	63
Dementia	44
Cancer	19

Medicare Procedure and Patient Information

2018 Medicare Procedure Volume

The top procedures that Dr. Tamara Lynn Augustin, MD treated as an internist in Washington, DC during 2018 were hospital care, inpatient care and outpatient care.

Volume of procedures performed by Dr. Tamara Lynn Augustin, MD for Medicare patients.

hospital care	1221
inpatient care	959
outpatient care	262

2018 Medicare Patient Data

Information about Medicare patients treated by Dr. Tamara Lynn Augustin, MD.

**Gender**
Male	183
Female	244

**Ethnicity**
Non-Hispanic White	58
Black	346
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	125
From 75 to 84	119
85 and over	68
Less than 65	115

Conditions of Medicare patients treated by Dr. Tamara Lynn Augustin, MD in 2018

Hypertension	75
High Cholesterol	73
Stroke	34
Ischemic Heart Disease	60
Depression	38
Chronic Kidney Disease	75
Asthma	12
Osteoperosis	6
Atrial Fibrilation	20
Heart Failure	57
Chronic Obstructive Pulmonary Disease	28
Diabetes	63
Dementia	41
Cancer	16

Medicare Procedure and Patient Information

2019 Medicare Procedure Volume

The top procedures that Dr. Tamara Lynn Augustin, MD treated as an internist in Washington, DC during 2019 were hospital care, inpatient care and outpatient care.

Volume of procedures performed by Dr. Tamara Lynn Augustin, MD for Medicare patients.

hospital care	874
inpatient care	767
outpatient care	107

2019 Medicare Patient Data

Information about Medicare patients treated by Dr. Tamara Lynn Augustin, MD.

**Gender**
Male	148
Female	200

**Ethnicity**
Non-Hispanic White	54
Black	270
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	125
From 75 to 84	92
85 and over	56
Less than 65	75

Conditions of Medicare patients treated by Dr. Tamara Lynn Augustin, MD in 2019

Hypertension	75
High Cholesterol	71
Stroke	32
Ischemic Heart Disease	60
Depression	33
Chronic Kidney Disease	74
Asthma	12
Osteoperosis	5
Atrial Fibrilation	19
Heart Failure	51
Chronic Obstructive Pulmonary Disease	28
Diabetes	57
Dementia	45
Cancer	17

Medicare Procedure and Patient Information

2020 Medicare Procedure Volume

The top procedures that Dr. Tamara Lynn Augustin, MD treated as an internist in Washington, DC during 2020 were hospital care, inpatient care and outpatient care.

Volume of procedures performed by Dr. Tamara Lynn Augustin, MD for Medicare patients.

hospital care	791
inpatient care	725
outpatient care	66

2020 Medicare Patient Data

Information about Medicare patients treated by Dr. Tamara Lynn Augustin, MD.

**Gender**
Male	140
Female	178

**Ethnicity**
Non-Hispanic White	52
Black	244
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	91
From 75 to 84	85
85 and over	59
Less than 65	83

Conditions of Medicare patients treated by Dr. Tamara Lynn Augustin, MD in 2020

Hypertension	75
High Cholesterol	75
Stroke	43
Ischemic Heart Disease	62
Depression	36
Chronic Kidney Disease	75
Asthma	15
Osteoperosis	5
Atrial Fibrilation	16
Heart Failure	53
Chronic Obstructive Pulmonary Disease	22
Diabetes	67
Dementia	49
Cancer	14

Medicare Procedure and Patient Information

2021 Medicare Procedure Volume

The top procedures that Dr. Tamara Lynn Augustin, MD treated as an internist in Washington, DC during 2021 were hospital care, inpatient care and outpatient care.

Volume of procedures performed by Dr. Tamara Lynn Augustin, MD for Medicare patients.

hospital care	701
inpatient care	629
outpatient care	72

2021 Medicare Patient Data

Information about Medicare patients treated by Dr. Tamara Lynn Augustin, MD.

**Gender**
Male	128
Female	180

**Ethnicity**
Non-Hispanic White	62
Black	231
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	105
From 75 to 84	76
85 and over	72
Less than 65	55

Conditions of Medicare patients treated by Dr. Tamara Lynn Augustin, MD in 2021

Hypertension	75
High Cholesterol	74
Stroke	40
Ischemic Heart Disease	61
Depression	43
Chronic Kidney Disease	75
Asthma	14
Osteoperosis	7
Atrial Fibrilation	21
Heart Failure	54
Chronic Obstructive Pulmonary Disease	30
Diabetes	58
Dementia	50
Cancer	15

Medicare Procedure and Patient Information

2022 Medicare Procedure Volume

The top procedures that Dr. Tamara Lynn Augustin, MD treated as an internist in Washington, DC during 2022 were hospital care, inpatient care and outpatient care.

Volume of procedures performed by Dr. Tamara Lynn Augustin, MD for Medicare patients.

hospital care	737
inpatient care	714
outpatient care	23

2022 Medicare Patient Data

Information about Medicare patients treated by Dr. Tamara Lynn Augustin, MD.

**Gender**
Male	111
Female	129

**Ethnicity**
Non-Hispanic White	50
Black	171
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	88
From 75 to 84	78
85 and over	44
Less than 65	30

Conditions of Medicare patients treated by Dr. Tamara Lynn Augustin, MD in 2022

Hypertension	75
High Cholesterol	75
Stroke	59
Ischemic Heart Disease	53
Depression	30
Chronic Kidney Disease	57
Asthma	16
Osteoperosis	11
Atrial Fibrilation	36
Heart Failure	47
Chronic Obstructive Pulmonary Disease	28
Diabetes	59
Dementia	43
Cancer	18

Medicare Procedure and Patient Information

2023 Medicare Procedure Volume

The top procedures that Dr. Tamara Lynn Augustin, MD treated as an internist in Washington, DC during 2023 were hospital care and inpatient care.

Volume of procedures performed by Dr. Tamara Lynn Augustin, MD for Medicare patients.

hospital care	735
inpatient care	735

2023 Medicare Patient Data

Information about Medicare patients treated by Dr. Tamara Lynn Augustin, MD.

**Gender**
Male	96
Female	148

**Ethnicity**
Non-Hispanic White	47
Black	171
Hispanic	14
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	76
From 75 to 84	74
85 and over	47
Less than 65	47

Conditions of Medicare patients treated by Dr. Tamara Lynn Augustin, MD in 2023

Hypertension	75
High Cholesterol	75
Stroke	51
Ischemic Heart Disease	46
Depression	38
Chronic Kidney Disease	56
Asthma	11
Osteoperosis	11
Atrial Fibrilation	30
Heart Failure	49
Chronic Obstructive Pulmonary Disease	25
Diabetes	58
Dementia	36
Cancer	22

Medicare Procedure and Patient Information

2024 Medicare Procedure Volume

The top procedures that Dr. Tamara Lynn Augustin, MD treated as an internist in Washington, DC during 2024 were hospital care and inpatient care.

Volume of procedures performed by Dr. Tamara Lynn Augustin, MD for Medicare patients.

hospital care	639
inpatient care	639

2024 Medicare Patient Data

Information about Medicare patients treated by Dr. Tamara Lynn Augustin, MD.

**Gender**
Male	116
Female	131

**Ethnicity**
Non-Hispanic White	47
Black	186
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	91
From 75 to 84	63
85 and over	57
Less than 65	36

Conditions of Medicare patients treated by Dr. Tamara Lynn Augustin, MD in 2024

Hypertension	75
High Cholesterol	75
Stroke	55
Ischemic Heart Disease	49
Depression	34
Chronic Kidney Disease	56
Asthma	17
Osteoperosis	11
Atrial Fibrilation	31
Heart Failure	48
Chronic Obstructive Pulmonary Disease	31
Diabetes	58
Dementia	38
Cancer	22

Medicare Procedure and Patient Information

Average Medicare Procedure Volume From 2012 - 2024

Volume of procedures performed by Dr. Tamara Lynn Augustin, MD for Medicare patients.

The highest averages for the top procedures that Dr. Tamara Lynn Augustin, MD treated as an internist in Washington, DC were hospital care, inpatient care and outpatient care.

hospital care	777
inpatient care	713
outpatient care	104

Average Medicare Patient Data From 2012 - 2024

Information about Medicare patients treated by Dr. Tamara Lynn Augustin, MD.

**Gender**
Male	120
Female	166

**Ethnicity**
Black / African American	184
Asian / Pacific Islander	0
Non-Hispanic White	81
Native American / Alaskan Native	0
Hispanic	2
Other	0

**Age**
75 to 84	78
85 and over	67
Less than 65	55
65 to 74	82

Average of Total of Conditions of Medicare patients treated by Dr. Tamara Lynn Augustin, MD From 2012 - 2024

The highest averages of the most common conditions of Medicare patients that Dr. Tamara Lynn Augustin, MD treated were hypertension, high cholesterol, chronic kidney disease and ischemic heart disease.

Hypertension	69
High Cholesterol	66
Stroke	34
Ischemic Heart Disease	52
Depression	32
Chronic Kidney Disease	58
Asthma	15
Osteoporosis	7
Heart Failure	46
Chronic Obstructive Pulmonary Disease	26
Diabetes	51
Atrial Fibrillation	23
Dementia	37
Cancer	16

Education & Training

Dr. Tamara Lynn Augustin, MD graduated from Wayne State University School of Medicine in 2007. She completed residency at North Shore Medical Center. She is certified by the American Board of Internal Medicine, Internal Medicine and has a state license in Connecticut.

Medical School: Wayne State University School of Medicine (2007)

Residency: North Shore Medical Center (2012)

Board Certification: American Board of Internal Medicine, Internal Medicine

Licensed In: Connecticut

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General Payments

These charts describe general payments received by Dr. Tamara Lynn Augustin, MD. Doctors may receive payments for a number of reasons, including meal compensation, travel compensation, and consulting.

**Payments by Company**
AbbVie Inc.	$7,780 UBRELVY $7,756	BOTOX $24
SANOFI-AVENTIS U.S. LLC	$140 TOUJEO $140
Janssen Pharmaceuticals, Inc	$118 XARELTO $101	INVOKANA $18
E.R. Squibb & Sons, L.L.C.	$98 ELIQUIS $98
Pfizer Inc.	$32 CHANTIX $19	ELIQUIS $13
Other	$77 WATCHMAN $23	BRILINTA $20	LifeVest $11	$22

**Types of Payments**
Compensation for services other than consulting, including serving as faculty or as a speaker at a venue other than a continuing education program	$7,088
Food and Beverage	$962
Travel and Lodging	$195

Biography

Dr. Tamara Augustin is a hospital medicine (hospitalist) specialist. Clinical interests for Dr. Augustin include flu shot, atrial fibrillation, and hip pain. Before completing her residency at North Shore Medical Center, Dr. Augustin attended medical school at Wayne State University School of Medicine. Dr. Augustin's hospital/clinic affiliations include MedStar Georgetown University Hospital, MedStar Washington Hospital Center, and MedStar National Rehabilitation Hospital.