The New England Journal of Medicine Downloaded from nejm.org at THE UNIVERSITY OF IOWA on June 28, 2016. For personal use only. No other uses without permission. From the NEJM Archive. Copyright © 2010 Massachusetts Medical Society. All rights reserved.

The New England Journal of Medicine Downloaded from nejm.org at THE UNIVERSITY OF IOWA on June 28, 2016. For personal use only. No other uses without permission. From the NEJM Archive. Copyright © 2010 Massachusetts Medical Society. All rights reserved.

The New England Journal of Medicine Downloaded from nejm.org at THE UNIVERSITY OF IOWA on June 28, 2016. For personal use only. No other uses without permission. From the NEJM Archive. Copyright © 2010 Massachusetts Medical Society. All rights reserved.

The New England Journal of Medicine Downloaded from nejm.org at THE UNIVERSITY OF IOWA on June 28, 2016. For personal use only. No other uses without permission. From the NEJM Archive. Copyright © 2010 Massachusetts Medical Society. All rights reserved.

The New England Journal of Medicine Downloaded from nejm.org at THE UNIVERSITY OF IOWA on June 28, 2016. For personal use only. No other uses without permission. From the NEJM Archive. Copyright © 2010 Massachusetts Medical Society. All rights reserved.

The New England Journal of Medicine Downloaded from nejm.org at THE UNIVERSITY OF IOWA on June 28, 2016. For personal use only. No other uses without permission. From the NEJM Archive. Copyright © 2010 Massachusetts Medical Society. All rights reserved.

Primary medical practice in the United Kingdom and the United States.

The New England Journal of Medicine Downloaded from nejm.org at THE UNIVERSITY OF IOWA on June 28, 2016. For personal use only. No other uses without...
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