About the Journal


Journal Overview

Sponsored by the National Permanente Medical Groups, The Permanente Journal is a peer-reviewed journal of medical science, social science in medicine, and medical humanities.


The Permanente Press publishes The Permanente Journal and books related to Kaiser Permanente and health care to advance knowledge in scientific research, clinical medicine, and innovative health care delivery. The Permanente Press is owned, published, and copyrighted by the Permanente Federation.


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. Other clinicians for whom CME is acceptable in meeting educational requirements may report up to four hours of participation.


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. Use as a handout, reprinting, republishing, adapting, or any other use, requires permission.

Editorial Board

Tom Janisse, MD, MBA
Publisher and Editor-in-Chief

Lee Jacobs, MD
Associate Editor-in-Chief


Vincent Felitti, MD
Preventative Medicine, Book Reviews



Gus M Garmel, MD, FACEP, FAAEM
Clinical Medicine



Arthur Klatsky, MD
Original Articles


Eric Macy, MD



Scott Rasgon, MD
Corridor Consult



James J Annesi, PhD, FAAHB, FTOS, FAPA
Health Behavior Research



Ricky Chen, MD
Medicine in Society



Gary W Chien, MD



Carrie Davino-Ramaya, MD
Medical Review



Charles Elder, MD
Integrative Medicine



Philip I Haigh, MD, MSc, FRCSC, FACS



Lisa Herrinton, PhD
Health Systems Research



Robert Hogan, MD
Family Medicine, Health Information Technology



Tom Judd, MS
Information Technology

Ashok Krishnaswami, MD, MAS



David Riley, MD
Case Reports



Ruth Shaber, MD
Women’s Health



John Stull, MD, MPH
Spirit of Medicine Dialogues



Gretchen Summer, PhD, RN
Nursing Research and Practice 



KM Tan, MD
Continuing Medical Education



Calvin Weisberger, MD
Cognitive Clinical Medicine



Winston F Wong, MD, MS
Community Benefit, Disparities Improvement and Quality Initiatives



Scott S Young, MD
Care Management Institute and Quality


Maher A Abbas, MD, FACS, FASCRS
Chief, Digestive Disease Institute, Cleveland Clinic, Abu Dhabi, UAE; Professor of Surgery, Cleveland Clinic Lerner College of Medicine of 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



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

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



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

The Editorial Staff have disclosed that they have no personal, professional, or financial involvement in any of the manuscripts they might judge. Should a conflict arise in the future, the Editorial Staff have agreed to recuse themselves regarding any specific manuscripts. The Editorial Staff also will not use the information gained through working with manuscripts for private gain.

Journal Subscription

Journal subscriptions are entered for the calendar year. Advance payment in US dollars is required.


  USA Other Countries
Institutional $70.00 $85.00
Individual $40.00 $55.00


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
E-mail: permanente.journal@kp.org
Subscription Website: http://www.permanentepress.com/


Please include both old and new addresses.


The Permanente Journal (ISSN 1552-5767) is published quarterly by The Permanente Press. The Permanente Journal is available online (ISSN 1552-5775) at www.thepermanentejournal.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. To obtain permission to republish, reprint, or adapt material published in The Permanente Journal, please complete the Reprint Permission Form.


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

Materials include whole articles, abstracts, figures and tables. 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. If you have additional questions about reprint permissions, contact:


Max McMillen, ELS
500 NE Multnomah St, Suite 100
Portland, Oregon, 97232
Phone: 503-813-4387
E-mail: max.l.mcmillen@kp.org
Reprint Permissions Website: https://www.permj.com/

Contact Us


Tom Janisse, MD, MBA
Publisher and Editor-in-Chief

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



27,000 print readers per quarter, 9,725 eTOC readers, and in 2016, 1.4 million page views on TPJ articles in PubMed from a broad international readership.

The Permanente Press

Sponsored by the National Permanente Medical Groups, The Permanente Press publishes The Permanente Journal and books related to Kaiser Permanente and health care.


Articles, editorials, letters to the editor, and other material represent the opinion of the authors. Send your comments to permanente.journal@kp.org.

Copyright 2017 Kaiser Permanente - The Permanente Journal. All Rights Reserved.