Winter 2000 - Volume 4 Number 1



by Brad Becker, MD

This image was created as a holiday greeting card for 1998. Images of sherpas were decolorized and superimposed on a photo taken in the Everest Region of Nepal. The doorway was applied and enhanced with a photo flare to create the sense of a spiritual ascent. The hand was superimposed to capture the sense of struggle involved in life's journeys.






etoc emailClick here to join the E-TOC list or text TPJ to 22828. You will receive an Email notice with the Table of Contents of each issue.


The Kaiser Permanente National CME Program designates this journal-based CME activity for 4 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


27,000 print readers per quarter, 15,350 eTOC readers, and in 2018, 2 million page views of TPJ articles in PubMed from a broad international readership.

The Permanente Press

The Permanente Press publishes The Permanente Journal and books related to healthcare. For information about subscriptions, missing issues, billing, subscription renewal, and back issues, Email:

ISSN 1552-5775 Copyright © 2019

All Rights Reserved.