Editors' Comments

In our 2001 reader survey you suggested improvements in The Permanente Journal that would give you more usable practice information, more interesting general information about medicine, and more about Permanente people and history. Many of your suggestions appear in this issue.

For all of the pediatricians who asked for more pediatrics articles, this is your special issue, with diverse topics and perspectives.

Beginning with the previous issue (Fall 2001) the cover and text paper is thinner (though maintains the quality of print and visual images), and the journal is lighter, more portable, and less expensive to distribute to you. This required that we add several pages to continue to "perfect bind" each issue: a cost trade-off with an information gain.

Our most popular sectionPermanente Abstracts expanded in the Fall 2001 issue. A new "Clinical Implications" box follows several of the abstracts, highlighting the author's comments on how to embed the paper's findings into Permanente Medicine practice.

TPJ's most prized addition, appearing first in the Fall issue, and continuing as an ongoing feature, is the Evidence-Based Clinical Vignettes from the Care Management Institute. The first article focused on Asthma; the current article reviews Depression. These articles bring you CMI best practices in an evidence-based, case study format, easy to understand, and highly usable with boxed highlights, such as treatment goals, criteria for consultation, and practice tips. In addition, you can earn CME credit by completing the form at the back of the journal or online at our Web site: www.kp.org/permanentejournal.

Corridor Consult is a new feature introduced in this issue that springs from reader suggestions to have a specialist briefly review a common practice topic for primary care clinicians. This is something you can read in the three to five minutes it would take to have a consult in the clinic or hospital corridor. The consult includes tips on article references with more information. You can open the TPJ Web site and quickly find the article using the search function. You can then click on hyperlinks to either the MEDLINE abstract or the original resource article referenced in the consult.

With brief "structured abstracts" now appearing before each clinical and health systems study article, and brief article highlights appearing in the form of "Practice Tips," TPJ is responding to your need for quick access to the most important information in an article when you only have a few moments. Later you can return to read in depth for other details.

Focused new technology and pharmacy updates will appear as regular features beginning in the Spring issue. These two areas have a high impact on clinicians practicing Permanente Medicine. New technology questions occur less commonly but are more difficult to answer since information is often not readily available. Patients may pose pharmaceutical questions daily, but the discussion may be difficult because of formulary and benefit coverage issues.

In 2002, TPJ will also explore the successes and failures of implementing best practices in regions. Developing a national guideline is a complex piece of work; transferring the practice into teams has a different set of complexities. Learnings from experience can help clinicians with practice changes.

Two other ongoing features, introduced this year, bring you relevant practice information: Medical Ethics, and Clinician-Patient Communication. To keep you connected to the Permanente culture and what's happening around the KP world, we will continue to include: A Word from the Medical Directors, A Permanente Moment in Time, and will introduce profiles of remarkable Permanente physicians in Physicians in the News. In this issue, we feature inside coverage of the health care response to the Anthrax bioterrorism event in Washington, DC. Permanente direction and clinical care demonstrate the exceptional national character of Permanente physicians.

In the Spring issue, we will feature our fourth annual celebration of the Vohs Awards winners and honorable mentions.

In the Summer issue, we will feature the recent research findings on the clinician work environment to help you with your patients, in your individual practice, with your work in teams, and with colleagues from other departments.

The editors appreciate hearing your ideas for additional ways that the journal can meet your needs in a busy practice with so much changing around you.