About the Journal

Journal Overview

The Permanente Journal (ISSN 1552-5767) is a peer-reviewed journal of medical science, social science in medicine, and medical humanities published quarterly by The Permanente Press. Journal subscriptions are entered for the calendar year. Advance payment in US dollars is required. The Permanente Journal welcomes requests for reprints and reproduction.

 

Use of any and all material published in The Permanente Journal is copyrighted and protected. The Permanente Journal offers free full-text access for all online content. The Permanente Journal is available online (ISSN 1552-5775) at www.thepermanentejournal.org.

 

Instructions for Authors and Manuscript Submssion Instructions are available along with a link to our manuscript submission center at www.thepermanentejournal.org/authors.html. Instructions for Artists and Artwork Submission Instructions are available along with a link to our submission center at www.thepermanentejournal.org/authors/artwork.html.

 

Physicians may earn up to 1 AMA PRA Category 1 Credit per article for reading and analyzing the designated CME articles published in each edition of TPJ. Each edition has four articles available for review. The Permanente Journal is happy to offer Continuing Medical Education credits for completing manuscript reviews for The Permanente Journal. Physicians are eligible to receive up to 15 AMA PRA Category 1 Credits per year (3 AMA PRA Category 1 Credits per manuscript).

Editorial Board

Tom Janisse, MD, MBA
EDITOR-IN-CHIEF
& PUBLISHER

Lee Jacobs, MD
ASSOCIATE
EDITOR-IN-CHIEF

SENIOR EDITORS

Vincent Felitti, MD
PREVENTATIVE MEDICINE,
BOOK REVIEWS

Arthur Klatsky, MD
ORIGINAL ARTICLES

Scott Rasgon, MD
CORRIDOR CONSULT

Gus M Garmel, MD,
FACEP, FAAEM

CLINICAL MEDICINE

Eric Macy, MD
RESEARCH

 

ASSOCIATE EDITORS

James J Annesi, PhD,
FAAHB, FTOS, FAPA

HEALTH BEHAVIOR
RESEARCH

Lisa Herrinton, PhD
HEALTH SYSTEMS
RESEARCH

John Stull, MD, MPH
SPIRIT OF MEDICINE
DIALOGUES

Ricky Chen, MD
MEDICINE IN SOCIETY

Robert Hogan, MD
FAMILY MEDICINE, HEALTH
INFORMATION TECHNOLOGY
Gretchen Summer, PhD,
RN

NURSING RESEARCH
AND PRACTICE

Gary W Chien, MD
SURGERY

Tom Judd, MS, CPHIMS,
CPHQ, CCE
INFORMATION TECHNOLOGY
AND QUALITY

KM Tan, MD
CONTINUING MEDICAL
EDUCATION

Carrie Davino
-Ramaya, MD

MEDICAL REVIEW

Ashok Krishnaswami, MD,
MAS

CARDIOLOGY

Calvin Weisberger, MD
COGNITIVE CLINICAL
MEDICINE

Charles Elder, MD
INTEGRATIVE MEDICINE

David Riley, MD
CASE REPORTS

Winston F Wong, MD, MS
COMMUNITY BENEFIT,
DISPARITIES IMPROVEMENT
AND QUALITY INCENTIVES

Philip I Haigh, MD,
MSc, FRCSC, FACS

SURGERY

Ruth Shaber, MD
WOMEN'S HEALTH

Scott S Young, MD
CARE MANAGEMENT
INSTITUTE AND QUALITY

EDITORIAL BOARD

Maher A Abbas, MD, FACS, FASCRS
Medical Director, Dubai Colorectal Center, UAE; Professor of Surgery, Case Western Reserve University, Cleveland, Ohio

 

 

Richard Abrohams, MD
Internal Medicine and Geriatrics, The Southeast Permanente Medical Group, Atlanta, Georgia

 

 

Fábio Ferreira Amorim, MD, PhD
Professor of Medicine, Escola Superior de Ciências da Saúde in the Department of Postgraduate and Extension Activities, Brasilia, Brazil

 

 

Stanley W Ashley, MD
Chief Medical Officer, Brigham and Women’s Hospital; Frank Sawyer Professor of Surgery, Harvard Medical School; Attending Surgeon, Gastrointestinal Cancer Center, Dana Farber Cancer Institute, Boston, Massachusetts

 

 

Thomas Bodenheimer, MD
Professor, Dept of Family and
Community Medicine, University
of California, San Francisco

 

 

Brian Budenholzer, MD
Associate Clinical Professor in the Department of Family Medicine at the Brody School of Medicine at East Carolina University, Greenville, North Carolina

 

 

Irene Carvalho, PhD
Clinical Neurosciences and Mental Health Department, School of Medicine, Oporto University, Porto-Portugal, Oporto, Portugal

 

 

Shamir O Cawich, MBBS, DM
Department of Surgery, St Augustine Campus, University of the West Indies, Trinidad and Tobago

 

 

Rita Charon, MD, PhD
Professor of Medicine, Founder and Executive Director of the Program in Narrative Medicine at the College of Physicians and Surgeons of Columbia University Medical Center, New York, New York

 

 

Pranab Chatterjee, MBBS, MD
Scientist, Indian Council of MedicalResearch, National Institute of Choleraand Enteric Diseases, Infectious DiseasesHospital, Beliaghata, Kolkata, India

 

 

Dan Cherkin, PhD
Senior Scientific Investigator, Group Health Cooperative, and Affiliate Professor, Dept of Family Medicine and School of Public Health—Health Services, University of Washington, Seattle

 

 

Mitsuro Chiba, MD, PhD
Department of Gastroenterology, Akita City Hospital, Kawamoto, Akita, Japan

 

 

Robert R Cima, MD, FACS, FASCRS
Associate Professor of Surgery, Division of Colon and Rectal Surgery; Vice Chairman, Department of Surgery, Mayo Clinic, Rochester, Minnesota

Ellen Cosgrove, MD
Vice Dean, Academic Affairs and Education, University of Nevada, Las Vegas School of Medicine, Las Vegas, Nevada

 

 

Quentin Eichbaum, MD, PhD, MPH, MFA, MMCH, FCAP
Associate Director of Transfusion Medicine; Associate Professor of Pathology; Associate Professor of Medical Education and Administration; Director, Fellowship Program in Transfusion Medicine; Member, Vanderbilt Institute for Global Health; Vanderbilt University School of Medicine, Nashville, Tennessee

 

 

Richard Frankel, PhD
Professor of Medicine and Geriatrics, Indiana University School of Medicine, Indianapolis

 

 

James T Hardee, MD
Internal Medicine, Colorado Permanente Medical Group; Associate Clinical Professor of Medicine, University of Colorado School of Medicine, Westminster

 

 

Carol Havens, MD
Family Practice and Addiction Medicine, Director of Clinical Education, The Permanente Medical Group, Oakland, California

 

 

Arthur Hayward, MD
Assistant Clinical Professor, Division of General Medicine, Dept of Internal Medicine, Oregon Health Sciences University, Portland

 

 

Catherine Hickie, MBBS
Director of Clinical Training, Bloomfield Hospital, Greater Western Area Health Service; Conjoint Senior Lecturer in Psychiatry, University of New
South Wales, Australia

 

 

Gunver Sophia Kienle, Dr Med
Senior Researcher, University of Witten/Herdecke, Institute for Applied Epistemology and Medical Methodology, Freiburg im Breisgau, Germany

 

 

Anna Luise Kirkengen, MD, PhD
Department of General Practice Research, Institute of Community Medicine, Norwegian University of Science and Technology, Trondheim, Norway

 

 

Thomas E Kottke, MD
Medical Director for Well-Being, HealthPartners; Consulting Cardiologist, HealthPartners Medical Group; Senior Clinical Investigator, HealthPartners Institute for Education and Research; Professor of Medicine, University of Minnesota, Minneapolis

 

 

Tieraona Low Dog, MD
Fellowship Director, Academy of Integrative Health and Medicine, LaJolla, California; Director, Integrative Medicine Concepts, Pecos, New Mexico; President, My Own Health; Director, Scientific and Regulatory Affairs, Healthy Lifestyle Brands; Tempe, Arizona

Lewis Mehl-Madrona, MD, PhD, MPhil
Director of Geriatric Education, Maine Dartmouth Family Medicine Residency; Director of Education and Training, Coyote Institute, Augusta, Maine

 

 

Colin G Murphy, MCh, FRCSI
Department of Trauma and Orthopaedics, Galway University Hospitals, Newcastle, Galway, Ireland

 

 

Michel M Murr, MD, FACS
Director of Bariatric Surgery, Chief of Surgery, Tampa General Hospital, Florida

 

 

Sylvestre Quevedo, MD
Department of Medicine and Global Health Sciences, University of California, San Francisco

 

 

Ilan Rubinfeld, MD, MBA, FACS, FCCP
Director, Surgical Intensive Care; Associate Program Director, General Surgery Residency; Henry Ford Hospital, Detroit, Michigan; Assistant Professor of Surgery, Wayne State University School of Medicine, Detroit, Michigan

 

 

Marilyn Schlitz, PhD
Chief Executive Officer of Worldview Enterprises, LLC, and Senior Fellow and President Emeritus at the Institute of Noetic Sciences in Petaluma, CA; Professor in and the Chair of the Doctor of Philosophy in Transpersonal Psychology program at Sofia University in Palo Alto, CA

 

 

Tido von Schoen-Angerer, MD, MPH
Researcher, ARCIM Institute, Filderstadt, Germany, Attending Physician, Department of Pediatrics, Fribourg Hospital, Switzerland

 

 

Audrey Shafer, MD
Associate Professor, Dept of Anesthesia, Co-Director, Biomedical Ethics & Medical Humanities Scholarly Concentration, Stanford University School of Medicine, Palo Alto, California

 

 

Mark Snyder, MD
Specialist Leader, Electronic Medical Record Implementation and Physician Adoption; Deloitte Consulting, LLP, McLean, Virginia

 

 

Swee Yaw Tan, MBchB (Edin), MRCP (UK), ACSM, FAMS
Senior Consultant Cardiologist, National Heart Centre, Adjunct Assistant Professor Duke National University of Singapore Graduate Medical School, Singapore

 

 

William L Toffler, MD
Professor Emeritas of Family Medicine, Oregon Health and Sciences University, Portland

Announcements

cme

 

Thank you to our 2017 reviewers:

Randal Aaberg, MD; Maher A  Abbas, MD; Kaja Abbas, PhD, MPH; Antoine Abcar, MD; Nishat Abdul Khader, MDS; Armen Aboulian, MD; Barry Abrams, MD; Richard Abrohams, MD; Annette Adams, PhD, MPH; Sean Adelman, MD; Alan Adelman, MD, MS; Vanita Ahuja, MD; Andrea Altschuler, PhD; Al’ai Alvarez, MD; Fabio Amorim, MD, PhD; Shubha Ananthakrishnan, MD; James Annesi, PhD; Diana Antoniskis, MD; Christopher Aquino, MD; Sharisse Arnold Rehring, MD; Stanley Ashley, MD; Vikram Attaluri, MD; Rajeev Attam, MD; Andrew Avins, MD; Brittany Bachmann; Vernon Barnes, PhD; Matthew Barth, MD; Rowena Bartolome, RN, BSN, PHN, MHA; Joshua Barzilay, MD; Arne Beck, PhD; Sarah Beekley, MD; Mayer Bellehsen, PhD; John Benson, MD; Jane Benton, MD; Ruth Ann Bertsch, MD, PhD; Shelley Bobb, MDiv, MDR; Ritin Bomb, MD; Kimon Bonadie, DM; Lucienne Bouvier, MD; Megan Boysen Osborn, MD; Sherry-Ann Brown, MD, PhD; Kimberly Brown, MSOM, LAc; Delilah Bruskas, PhD, RN; Louis Cantor, MD; Nathan Carlson, MD; Kiersten Carter, MD; Robert Casillas, MD; Maurice Cates, MD; David Cawthorpe, PhD; David Chadwick, MD; Garrick Chak, MD; Christine Chang-Halpenny, MD; Srini Chary, MBBS, CCFP (PC), FRCSEd; Rebecca Chasnovitz, MD; Pranab Chatterjee, MBBS; Vinod Chaubey, MD; Faisal Cheema, MD; Ricky Chen, MD; Puneet Chhabra, MD, MBBS, DM; Eric Chiang, MD; Deborah Chiarucci, MD; Gary Chien, MD; Homer Chin, MD; Reema Chugh, MD; Linda Chun, MD; Colleen Chun, MD; David Clarke, MD; Charles Clemons, MD; Kathryn Clift; Mark Cohen, MD; Felicia Cohn, PhD; Jeff Convissar, MD; Sarah Corathers, MD; Douglas Corley, MD; Alan Cortez, MD; Ellen Cosgrove, MD; Alberto Coustasse-Hencke, PhD; Roxana Covali, MD; Peter Crooks, MD; Thomas Cunningham, MD; Peter Cvietusa, MD; John Damrose, MD, FACS; John Davenport, MD; Carrie Davino-Ramaya, MD; Nancy Davis, PhD; Richard Dell, MD; Richard Della Penna, MD; Jack Der-Sarkissian, MD; Andrew DiFronzo, MD; Ronald Domen, MD; Jonathan Doris, MD; Sara Doster, MD, PhD; Shanta Dube, PhD, MPH; R James Dudl, MD; Ashley Duggan, PhD; Andrew Dutka, MD; Quentin Eichbaum, MD, PhD, MPH, MFA; Charles Elder, MD; Gabriel Escobar, MD; Donna Ettel, PhD; Adriano Facioli, PhD; Gavin Fairbairn, PhD, MEd; Jessie Fan, MD, MBA; Shireen Fatemi, MD; Vincent Felitti, MD; Iva Ferreira, MD; Claudia Finkelstein, MD; Carol Forster, MD; Carlos Franco-Paredes, MD; Deb Friesen, MD; Pascal Fuchshuber, MD, PhD, FACS; Geoff Galbraith, MD; Les Gallo-Silver, LCSW-R; Gus Garmel, MD; Hernando Garzon, MD; Joseph Gascho, MD; Kamal Gera, MD; Derenik Gharibian, PharmD; Lana Gimber, MD, MPH; Louise Glaser, MD; Marcia Glass, MD; Harry Glauber, MD; Paul Glen, MD; Daniel Glor, MD; Richard Godfrey, MD; Robert Goldfien, MD; Ellen Goldstein, PhD; Alexandra Gordon, MD; Shel Gottlieb, MD; Sarah Greene, MPH; Casey Grover, MD; Kern Guppy, MD, PhD; Philip Haigh, MD; Joel Handler, MD; Douglas Hanes, PhD; Ramy Hanna, MD; James T Hardee, MD; Jeffrey S Harris, MD; Paul Hartman, MD; Carol Havens, MD; Arthur Hayward, MD; Christopher Hebert, MD, MS; Ann Hellerstein, MD; Stephen Henry, MD; Lisa Herrinton, PhD; Catherine Hickie, MBBS; George Ho, Jr, MD; Dieter Hoffmann, MD; Robert Hogan, MD; Anthony Holden, MD; Aram Hovanessian, MD; Gary Huffaker, MD; Robert Hughes, MD; Steven Isenberg, MD; Lee Jacobs, MD; Sharon Jakus-Waldman, MD; Marc Jamoulle, MD; Monica Jarrell, NP; Samir Johna, MD; Ping Johnson, PhD, RN; Kermit Jones, MD, JD; Tom Judd, MS; Renate G Justin, MD; Joseph Kahwaji, MD; Michael Kaplan, MD; Alex Kemper, MD, MPH, MS; Laura Kerr, PhD, IMFT; M Kamal Khalid, MD; Afshin Khatibi, MD; Jennifer Khoe, MD; Dimple Khona, MD; Ian Kimmich, ELS; Anna Luise Kirkengen, MD, PhD; Daniel Klaristenfeld, MD; Arthur Klatsky, MD; Nicola Klein, MD, PhD; Vallerie Kolasinski, MPH; Mike Kositch, MD; Thomas Kottke, MD, MSPH; Michael Krall, MD; Ashok Krishnaswami, MD, MAS; Archana Kudva, MD; Dean Kujubu, MD; Jennifer Kuntz, PhD; Howard Kushner, PhD; Karen Kwan, MD; James Lake, MD; Myles Lampenfeld, MD; Ellen Langley; Jens Langsjoen, MD; Sandra Lapham, MD, MPH; Rebecca Larson, PhD; Mark Lassoff, MD; Peggy Latare, MD; Lisa Law, MD; Tam Le, MD; Eric Lee, MD; David Lee, MD; John Lee, MD; Lonnie Lee, MD; Jeffrey Leftwich, MD; Sharon Lehman, MD; Leslie Leighton, MD; Laurie Leitch, PhD; Pamela Lemke, CNM, MS; Martha Levine, MD; Joel Levis, MD, PhD; Gerald Levy, MD; Catherine Lewis, MD; Evelyn Lifsey, PhD; Alice Lin, MD, FACS; George Longstreth, MD; Cindy Lopez, BSN, RN; Teng Lu, MD; For-Shing Lui, MD; Robert Lundstrom, MD; Waleed Lutfiyya, MD; William Lynes, MD; John Maa, MD; Eric M Macy, MD; Gregory Maletis, MD; Christina Mangurian, MD; David Margolius, MD; Peter J Martin, MD; Lindsay Mazotti, MD; Walt McDonald, MD; Ryan McDonough, DO; Michael McFarlane, MBBS, DM, FRCS, FACS; Elisabeth McLemore, MD; Max McMillen, ELS; Donald Mebust, MD; Lewis Mehl-Madrona, MD, PhD; Charles Meltzer, MD; Albert Mikhail, MD; Amy Miller, MS, DrPH; Pooja Mittal, DO; David Moiel, MD; Richard Moldawsky, MD; Kenji Morimoto, MD; Lisa Morrise, MArts; David Mosen, MD; Stephen Munz, MD; Colin Murphy, FRCSI; Sean Murphy, MD; John Murphy, PhD; Arian Nachat, MD; Craig Nelson, PhD; Ruth Neubauer, MSW, LCSW; Carter Neugarten, MD; Kimberly Newell Green, MD; David Newhouse, MD; Emilie Nguyen, MD; Julie Nyquist, PhD; Ahmed Obeidat, MD, PhD; Resmiye Oral, MD; Chun Ouyang, MD; Ashli Owen-Smith, PhD, SM; Gurpreet Padam, MD; Ted Palen, MD; Jo Paluzzi, PhD; Malvinder Parmar, MB, MS; Hetal Patel, MD; Pawan Patel, MD; Jonathan Peng, MD; Cathriya Penny, DNP, FNP-BC, GNP-BC, ACHPN, BC-ADM; Patrick Pezeshkian, MD; William Pfeiffer, MD; Jennifer Phillips, MD; Gregory Plotnikoff, MD, MTS; Suresh Pola, MD; Andrew Pourmoussa, MD; Karlo Quadros, MD; Sylvestre Quevedo, MD; Javier Rangel, MD; Scott Rasgon, MD; Andrew Rassi, MD; Tom Ray, MBA; Albert Ray, MD; Brian Raymond, MPH; Kimberly Reece, MD; David Riley, MD; Alexander Rivero, MD; Craig Robbins, MD, MPH; Joseph Rosen, MD; Lisa Rossignol, MA; Nareg Roubinian, MD; Ilan Rubinfeld, MD, MBA, FACS; Firoozeh Sahebi, MD; Gerald Saliman, MD; Michael Salinsky, MD; Danny Sam, MD; Jonathan Samuel, MD; Hope Sasek, RN; Candice Sauder, MD, MEd; Kimberly Schertzer, MD; Joanne Schottinger, MD; Andrew Schreffler, MD; Lisa Schuman, ARNP; David C Schwebel, PhD; Theodore Scott, FNP; Elizabeth Scruth, RN, PhD; Ruth Shaber, MD; Vishal Sharma, MD; Andrew Shim, EdD; Veronica Shim, MD; Gregorio Sicard, MD, FACS; Dan Siegel, MD; Joana Silva, MD; Matthew Silver, MD; John Sim, MD; Kurt Smidt-Jernstrom, DMin; Herbert Sorensen, MD; Ricardo Spielberger, MD; Odette Spruyt, MBChB, Dip Obs, FRACP, FRAChPM; Bradley Steele, MD; Jill Steinbruegge, MD; John Steiner, MD, MPH; Bradley Steinfeld, MD; Matt Stiefel, MPA; Anne Stone, PhD; Joshua Strait; Hal Strough, PhD; Gina Sucato, MD; Marie Suga, MD; Gretchen Summer, PhD, RN-BC; Clifford Swap, MD, MS; Jean-Luc Szpakowski, MD; Vishwas Tadwalkar, MD; Karen Tallman, PhD; Michael Tam, MD; KM Tan, MD; Dorothy Tarrant, LCSW, MPA; Sara Yee Tartof, PhD, MPH; Talar Tejirian, MD, FACS; Mark Thanassi, MD; Anil Thomas, MD; Micah Thorp, DO; Maria Thurston, PharmD; David Tieu, MD; Ian Tofler, MD; Marco Tomassi, MD; Eric Tong, MD; Sandra Torrente, MD; Shirin Towfigh, MD; Han-Mou Tsai, MD; Joseph Turban, MD; Leah Tuzzio, MPH; Rob Unitan, MD; Sachin Vaid, MD, MS, MRCS; Kees van Boven, MD; Sonja Van Laar, PhD; Tido von Schoen-Angerer, MD, MPH; Daniel Weberg, PhD, RN; Joshua Weil, MD; Allan Weiland, MD; Calvin Weisberger, MD; Wayne Westcott, PhD; Tom Williams, LPC, LISAC; David Witt, MD; Lucia Wocial, PhD; Warren Wong, MD; Winston Wong, MD; Ed Yian, MD; Hyo-Chun Yoon, MD; Zhou Zhang, MD; Sijie Zheng, MD, PhD, FASN

 

thwackcomicbook

Thwack
By Barry Abrams, MD

 

This is the story of a physician with hypertrophic cardiomyopathy being managed by an implantable cardioverter-defibrillator. In the middle of a snowstorm, he receives his first of many staggering shocks from his runaway defibrillator. Learning to live in this new reality includes learning to live with the strong magnet that blocks the defibrillator signal, much to his own chagrin and the amusement of others. (The first Graphic Medicine book.) Available at: www.permanentepress.com.

 

book adverts

 

For rates and information about advertising in The Permanente Journal contact:

Amy Eakin
500 NE Multnomah St, Suite 100
Portland, Oregon, 97232
Phone: 503-813-2623
Fax: 503-813-2348
E-mail: amy.r.eakin@kp.org

 

Journal Subscription

The Permanente Journal advances knowledge in scientific research, clinical medicine, and innovative health care delivery. Journal subscriptions are entered for the calendar year. Advance payment in US dollars is required.

 

Periodicals postage paid at Portland and at additional mailing offices. POSTMASTER, send all address changes to:

 

The Permanente Journal
500 NE Multnomah St, Suite 100
Portland, Oregon, 97232
Phone: 503-813-3286
Fax: 503-813-2348

 

Please include both old and new addresses. For information about subscriptions, missing issues, billing, subscription renewal, and back issues, e-mail: permanente.journal@kp.org.

Reprint Permissions

The Permanente Journal welcomes requests for reprints and reproduction. Use of any and all material published in The Permanente Journal is copyrighted and protected. The Permanente Journal offers free full-text access for all online content. Although individual sharing of content is permitted, reprint permission is required for republishing or reprinting journal content. Use as a handout, reprinting, republishing, adapting, or any other use, requires permission. Usage includes, but is not limited to;

  • Journal Reprints
  • Handouts
  • CD's
  • Online Internet and Intranets

To obtain permission to republish, reprint, or adapt material published in The Permanente Journal, please access and complete the Reprint Permission Form available at: https://www.permj.com/. If you have questions, please contact;

 

Max McMillen, ELS
500 NE Multnomah St, Suite 100
Portland, Oregon, 97232
Phone: 503-813-4387
Fax: 503-813-2348

E-mail: max.l.mcmillen@kp.org

 

Adapted material must be approved by The Permanente Journal, please email a copy of adaptation to: max.l.mcmillen@kp.org. Allow 3-4 weeks for processing.

Contact Us

Tom Janisse, MD, MBA
EDITOR-IN-CHIEF
& PUBLISHER

Merry Parker
MANAGING EDITOR
& PUBLISHER

Lynette Leisure
CREATIVE DIRECTOR

Amy Eakin
BUSINESS & PUBLISHING
OPERATIONS MANAGER

Max McMillen, ELS
SENIOR EDITOR
& STAFF WRITER

Christopher Dauterman, MBA
WEB DEVELOPER
& ANALYST

Ian Kimmich, ELS
COPY EDITOR & PUBLISHING
COORDINATOR

 

Circulation

27,000 print readers per quarter, 11,225 eTOC readers, and in 2017, 1.5 million page views on TPJ articles in PubMed from a broad international readership.

The Permanente Press

The Permanente Journal (ISSN 1552-5767) is a peer-reviewed journal of medical science, social science in medicine, and medical humanities published quarterly by The Permanente Press.

CME

Physicians may earn up to 1 AMA PRA Category 1 Credit per article for reading and analyzing the designated CME articles published in each edition of TPJ.


ISSN 1552-5775 Copyright © 2018 thepermanentejournal.org.

The Permanente Press. All Rights Reserved.