Dr. Nirmala Gengatharan

Dr. Nirmala Gengatharan provides comprehensive family medical care for a wide variety of health concerns affecting patients of all ages, including but not limited to:

Preventative Health Topics

• Travel Medicine Advice & Routine/Travel Vaccinations: Providing pre-travel consultations for individuals travelling to common and some less common international destinations. This includes a detailed risk assessment based on itinerary (country, region, urban/rural, length of stay, type of travel); advice on food and water safety, insect bite prevention (e.g., for malaria, dengue, Zika, chikungunya), altitude sickness prevention, and management of common travel-related ailments (e.g., traveler's diarrhea). Also includes administration of necessary routine immunizations (MMR, Tdap, Polio, Flu) and specific travel vaccinations (e.g., Hepatitis A/B, Typhoid, Yellow Fever if a designated center, Rabies pre-exposure, Japanese Encephalitis considerations). Malaria chemoprophylaxis prescription if indicated. Complex itineraries or immunocompromised travelers may require referral to a specialized travel clinic.
• Weight Management & Obesity Prevention/Treatment: Collaboratively discussing healthy weight goals based on BMI, waist circumference, body composition, and overall health status. Providing guidance on evidence-based strategies for weight management including balanced nutrition (calorie awareness, portion control, whole foods), mindful eating, regular physical activity, behavioral strategies (e.g., goal setting, self-monitoring, addressing emotional eating, sleep optimization), and addressing underlying factors contributing to weight issues. Medical options (pharmacotherapy like GLP-1 agonists, orlistat; bariatric surgery referral) may be discussed if appropriate based on guidelines and individual clinical assessment.
• Driver's Medical Examinations (Routine, Age-Related, Commercial): Performing comprehensive driver's medicals to ensure individuals meet the health standards necessary for safe vehicle operation, promoting road safety for all.

Joint Muscle Pain

• Polymyalgia Rheumatica (PMR) - Diagnosis, Management & Monitoring (Often with Rheumatology Co-Management): Often co-managed with or referred to rheumatology, especially for atypical presentations, diagnostic uncertainty, difficulty tapering corticosteroids, frequent relapses, or suspected GCA. Primary care plays a key role in ongoing monitoring, patient education, and supportive care for PMR.
• Repetitive Strain Injuries (RSI), Tendinopathies & Work-Related Musculoskeletal Disorders (WRMSDs) - Initial Assessment & Conservative Management: Initial assessment, diagnosis, and conservative management of musculoskeletal pain and dysfunction related to repetitive tasks, sustained awkward postures, or ergonomic factors at work or during hobbies. This includes common conditions like carpal tunnel syndrome (mild-moderate), de Quervain's tenosynovitis, epicondylitis (tennis/golfer's elbow), trigger finger/thumb, rotator cuff tendinopathy, patellar tendinopathy, Achilles tendinopathy, and non-specific arm/neck/shoulder pain attributable to overuse.
• Fibromyalgia & Other Widespread Chronic Pain Syndromes - Primary Care Diagnosis & Multimodal Management: Initial assessment and diagnosis of fibromyalgia or other widespread chronic pain syndromes based on established clinical criteria (e.g., ACR criteria for fibromyalgia), after appropriate investigation to rule out other underlying systemic inflammatory or medical conditions. Developing a comprehensive, multimodal management plan focusing on patient education about the condition (central sensitization, pain neurophysiology), promoting self-management, graded exercise therapy (low-impact aerobic, strength, flexibility, aquatic therapy), optimizing sleep hygiene, stress management techniques (mindfulness, relaxation, CBT principles), pain coping strategies, and judicious use of medications targeting central sensitization and associated symptoms (e.g., tricyclic antidepressants like amitriptyline, SNRIs like duloxetine/venlafaxine, gabapentinoids like gabapentin/pregabalin). Avoidance of long-term opioid therapy is generally emphasized.

Common Acute Conditions

• Gastrointestinal Infections (Gastroenteritis, Food Poisoning): Managing acute episodes of vomiting and diarrhea to support recovery, ensure adequate hydration, and rule out more serious underlying causes.
• Urinary Tract Infections (UTIs - Cystitis, Pyelonephritis - uncomplicated initial): Management of bladder and kidney infections with appropriate antibiotics based on likely pathogens and local resistance patterns, along with advice on prevention strategies for recurrent UTIs and symptom relief.
• Common Acute Skin Conditions (Rashes, Infections, Bites, Minor Burns): Addressing sudden onset skin problems, providing effective treatment, advising on skin care and hygiene to promote healing, and identifying potential triggers for allergic or irritant conditions.
• Upper Respiratory Tract Infections (URTIs - Colds, Flu, Sinusitis, Pharyngitis): Addressing symptoms such as cough, sore throat (including rapid strep testing where available), nasal congestion, facial pain/pressure, and fever associated with common URTIs.

Adult Common Health Issues

• Restless Legs Syndrome (RLS) - Initial Assessment & Management: Providing initial management strategies for RLS, including lifestyle modifications (e.g., regular exercise, good sleep hygiene, avoiding caffeine/alcohol close to bedtime), checking and correcting iron deficiency (ferritin levels), and considering pharmacological options (e.g., dopamine agonists like pramipexole/ropinirole, gabapentin enacarbil) for moderate to severe, frequent symptoms that significantly impact sleep or quality of life. Referral to neurology or sleep specialist for complex or refractory cases.
• Venous Insufficiency & Varicose Veins (Conservative Management & Lifestyle Advice): Primary care support for managing discomfort and preventing complications associated with venous disease. Referral to vascular specialists or phlebologists for more advanced treatments (e.g., sclerotherapy, endovenous ablation, surgery) if symptoms are severe, progressive, or complicated by ulceration or recurrent phlebitis.
• Benign Prostatic Hyperplasia (BPH) - Symptom Management & Monitoring: Referral to urology for severe symptoms, complications (e.g., acute urinary retention, recurrent UTIs, bladder stones, renal impairment due to obstruction), or if surgical intervention (e.g., TURP) is being considered.
• Anemia (Iron Deficiency, Vitamin B12/Folate Deficiency - Diagnosis & Management): Primary care approach to accurately diagnosing and effectively treating common forms of anemia to improve energy levels, cognitive function, exercise tolerance, and overall health. Referral to hematology for complex or unexplained anemia.

This list offers some examples of common conditions managed in family practice. A diagnosis is always based on an individual assessment by Dr. Gengatharan. If your specific health concern isn't listed, please contact the clinic to discuss your needs.

• Thyroid Disorder Management (Hypo/Hyperthyroidism, Nodules, Hashimoto's): Diagnosis, treatment (e.g., thyroid hormone replacement for hypothyroidism, antithyroid drugs or referral for hyperthyroidism), and long-term monitoring of common thyroid conditions including Hashimoto's thyroiditis, to ensure hormonal balance, manage symptoms effectively, and monitor for complications like thyroid nodules or goiter.
• Chronic Pain Management (Musculoskeletal, Neuropathic - Primary Care Approach): Providing a primary care base for managing complex chronic pain, focusing on patient empowerment and coordinating with other specialists and therapies as needed.
• Driver's Medical Examinations & Other Third-Party Medical Reports: Assisting patients with necessary medical documentation for third-party requests.
• Hospital Discharge Follow-Up & Transitions of Care Management: Providing prompt and comprehensive follow-up care after hospital stays, emergency room visits, or specialist procedures to ensure a smooth and safe transition back to the community. This includes medication reconciliation, review of discharge summaries and specialist reports, management of ongoing issues, addressing any new concerns, and coordination of any further treatment, rehabilitation, or home care services.
• Patient Education on Specific Health Conditions & Self-Management: Educational resources and discussions to help you navigate your health journey confidently and make informed decisions.

Note: This list highlights some of the key services offered by Dr. Gengatharan. For a comprehensive understanding of all services, or to discuss your specific health needs, please schedule a consultation.

All services are provided in accordance with the scope of practice for Family Doctors in ON and the ethical and professional standards set by The College of Physicians and Surgeons of Ontario (CPSO).

At Dr. Nirmala Gengatharan's practice, family medicine is centered on a collaborative partnership to help individuals like you achieve significant improvements in your health, manage ongoing conditions effectively, and enhance your overall well-being. Dr. Gengatharan frequently works with patients towards goals such as:

• Dr. Gengatharan often sees patients whose pain, numbness, or tingling in their hands or wrists that might be carpal tunnel syndrome from computer work limits their enjoyment of effectively managing their personal or household finances, diligently paying bills on time, and competently handling other essential administrative or organizational tasks with sustained mental clarity and focus. The goal of care is to achieve feeling genuinely and consistently supported by Dr. Gengatharan during emotionally difficult health transitions, when facing a serious or life-altering new diagnosis, or when undertaking the demanding role of caring for an ill or aging family member and restore their active lifestyle.
• With Dr. Gengatharan's care, managing experiencing sudden flashes of light or floaters in their vision aims for having their advance care plans and end-of-life wishes thoughtfully discussed, respectfully explored, and accurately documented with Dr. Gengatharan well in advance, ensuring their future autonomy and dignity are preserved, empowering patients to get back to what they love, like being physically and emotionally able to consistently attend and meaningfully participate in important community gatherings, significant religious or spiritual services, and culturally relevant events that foster a sense of belonging and connection.
• For those challenged by feeling generally 'unwell' or 'off' without a clear reason for a while, Dr. Gengatharan offers strategies to reach feeling substantially more hopeful and less overwhelmed about managing a difficult or life-altering health condition after comprehensive consultations and collaborative care planning with Dr. Gengatharan, which can mean rediscovering the joy of thoroughly enjoying the simple yet profound ability to read for pleasure, engage in academic study, or conduct detailed research for extended periods without debilitating eye strain, persistent headaches, or other health issues related to unmanaged vision problems or poor ergonomics.
• The focus for patients with a persistent itchy scalp or dandruff that's not improving at Dr. Gengatharan's practice is achieving having their diverse family structure, unique cultural needs, and individual communication preferences consistently understood, acknowledged, and respectfully incorporated into all aspects of their care by Dr. Gengatharan and the entire clinic team, facilitating a return to meaningful activities like wholeheartedly enjoying a diverse range of seasonal outdoor activities such as cross-country skiing or snowshoeing in winter, beachcombing or lake swimming in summer, vibrant apple picking or leaf-peeping hikes in autumn, and early spring gardening.

Your personalized healthcare plan, developed in discussion with Dr. Gengatharan, will be thoughtfully designed to help you reach your specific functional, preventative, and wellness objectives. She believes in empowering patients with the knowledge and support needed to take an active role in their health journey.

Dr. Gengatharan practices at a family medical clinic in Ajax, situated in the Audley North, Nottingham neighborhood of Ajax. The clinic is conveniently located near Commercial Corridor and is accessible via Durham Region Transit (DRT). Ample parking is generally accessible close to the clinic entrance; please observe local signage.

Do I need a referral to see a family doctor (Family Doctor) in ON?

Generally, you do not need a referral to see a family doctor in Ontario if that doctor is accepting new patients. However, finding a family doctor who is accepting new patients can be challenging. Resources like Health Care Connect, your local health unit's website, or the College of Physicians and Surgeons of Ontario's patient-doctor matching service (if available) may be helpful. A referral from a family doctor is usually required to see specialists.

Is seeing a family doctor (Family Doctor) covered by Ontario Health Insurance Plan (OHIP) in ON?

Medically necessary visits to a family doctor are typically covered by OHIP for eligible Ontario residents with a valid health card. However, some services, such as cosmetic procedures, most travel medicine consultations, sick notes, insurance forms, and driver's medicals, may not be covered and may have an associated fee. Please confirm with our clinic if you have questions about specific services.

What exactly is a family doctor (Family Doctor) and what is their role?

A family doctor (Ontario) is a physician who has completed post-graduate training in family medicine. They are skilled in providing continuous and comprehensive medical care, health maintenance, and preventive services to patients of all ages. This includes diagnosing and treating a vast array of illnesses, managing complex long-term health conditions, offering health education and counseling on lifestyle choices, and acting as your advocate and guide within the broader healthcare system.

How can I find a family doctor (Family Doctor) in ON who is accepting new patients?

Check the College of Physicians and Surgeons of Ontario website; they often have a "Find a Doctor" tool or list. In Ontario, you can register with Health Care Connect. Ask friends, family, or colleagues for recommendations. Contact local community health centres or new patient clinics directly. Finding a family doctor may take time and effort.

1801 Harwood Avenue North
Ajax, ON, L1T 0K8

Phone: (905) 426-5050

Dr. Nirmala Gengatharan is regulated by the Regulated Health Professions Act, 1991 & Medicine Act, 1991 (Ontario) in ON and is a registered member in good standing with The College of Physicians and Surgeons of Ontario (CPSO).

Registration Number: 95352

Verify registration with The College of Physicians and Surgeons of Ontario (CPSO): https://doctors.cpso.on.ca/DoctorDetails/Gengatharan-Nirmala/0272830-95352

Family doctors like Dr. Gengatharan are skilled in managing a wide range of health issues. For urgent or life-threatening emergencies, please call 911 or visit the nearest emergency department. It is always recommended to maintain open communication with your family doctor about all aspects of your health, including any treatments received from other practitioners.