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MEDLIB-L  December 2014, Week 2

MEDLIB-L December 2014, Week 2

Subject:

Summary - UpToDate cancellations

From:

"Klawansky, Susan" <[log in to unmask]>

Reply-To:

Klawansky, Susan

Date:

Fri, 12 Dec 2014 22:35:59 +0000

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (184 lines)

~~Please excuse cross-posting~~

Hello - A huge thanks to all of you who took the time to respond to my inquiry regarding cancellations of UpToDate.  Many interesting responses, and some common threads.

The summary follows.

Susan Klawansky
Seattle Children's
[log in to unmask]<mailto:[log in to unmask]>

~~~~~~~~~~~~~~~~~~
We canceled our subscription July of 2013.  Price was the reason.  Reaction was Ugly, Ugly, Ugly.  I had no support from administration even though I had to cut it because of budget reductions.  No one would even tell the physicians that it was being cut.  I had to send out a housewide email.  I went to many department meetings to teach them about Dynamed and First Consult.  Some meetings were not pleasant.  I did have a few physician backers that said if you want it so much, buy an individual subscription.  We are a 250 bed non-profit, non-teaching hospital.

~~~~~~~~~~~~~~~~~~
From what I have heard, the library tried to cancel UptoDate about 6 years ago (I wasn't here at the time).  Apparently when this happened UTD went directly to some physicians and said we were dropping.  The Physicians then went to the president and the subscription was renewed. We get onsite only access.

We have 493 beds and are a solo hospital (not affiliated with anyone) and have an Internal Medicine residency program.

I did bring in Dynamed last year, but the feedback was the people who looked it did not like it as well as UTD.

~~~~~~~~~~~~~~~~~~

Your post caught my eye as we are in the process of considering a change from UpToDate to Dynamed.  Our current situation is UpToDate has canceled our access - I couldn't obtain administrative approval to renew UpToDate and we lost access when our renewal date passed.  We have a trial for Dynamed.  The reason to consider a change was the cost of UpToDate was ever escalating.  The reaction has been surprisingly benign.  In the physicians we surveyed some actually [preferred] the more concise format of Dynamed.  We are a community  2 hospital system with approx. 500 beds.  We have 80 residents.

~~~~~~~~~~~~~~~~~~

I just (this morning!) got a snippy response from our rep doubting the stats we just provided them for our renewal.  It took a ton of time and a ton of favors to get that list of clinicians together and she said, basically, they have ways to get to the truth  -- going through our webpages, etc.   Unbelievable.


~~~~~~~~~~~~~~~~~~
We cancelled UpToDate in Aug. 2013 due to a major price increase, approximately 40% increase. We subscribed to DynaMed instead, and our university affiliated users have access to Clinical Key which includes First Consult. Users have been quite unhappy, not everyone, but most.  The most dissatisfied group are the Internal Medicine residents.  I try to educate them about the issues and the availability of First Consult, but they are still unhappy.

We consist of 4 teaching hospitals affiliated with the University of XXXX, School of Medicine.


~~~~~~~~~~~~~~~~~~

We cancelled at the beginning of the year, a few pockets of upset people, primarily nursing and residents. We cancelled because of the endless price increases that did not include any value-added services other than to line their pockets. We brought back DynaMed and switched to ClinicalKey, which I really like. The procedural videos in CK are used with an increasing level of frequency and I believe giving users access to primary, secondary and tertiary resources in one place is of much more value (and at a substantially lower price tag) than what it available in UTD.



We are a geographically diverse pediatric health system with multiple teaching programs.

~~~~~~~~~~~~~~~~~~
We did it and lived.
We were two community hospitals who merged to form a single, two-hospital system about two and a half years ago.  One of the libraries had UTD (inside-the-walls access only); the other did not - refused by the Med Exec Committee mainly due to cost and access restrictions.  Once merged, the hospitals had shared IP addresses, so we either needed to add access for both hospitals, or ditch it entirely.  We entertained quotes (again) from UTD, and again, senior execs said no (I am so proud of them...).   We purchased Dynamed instead, with full remote access, mobile app availability, and links to it embedded in the physician home page, libraries' home page, and in our EMR dashboard.  User reaction constituted about five docs who got grumpy about it and were cheerfully directed to our VP of Medical Affairs for discussion and advice that if they felt they couldn't live without it, they could subscribe as an individual for less than they spend on coffee in a year and probably tax-deductible.  I still occasionally get calls (primarily from new docs / nurses) who ask if we have it; I tell them no, why, and about Dynamed.  We are two non-teaching hospitals of 315 and 150 beds respectively.
We've since been merged with a large academic institution, so who knows what will happen now.  But UTD is not at the top of anyone's list.

~~~~~~~~~~~~~~~~~~

We first purchased UpToDate in 2007.  We cancelled our UpToDate subscription in 2011.  The reason for cancellation was seven-fold: 1) The metrics the vendor required to prepare a quote kept changing, and became onerous to complete, 2) there was little transparency on how UTD formulated their quote, 3) they could not provide counter-compliant statistics, 4) they offered no consortial pricing (no discount for multiple institutions), 5) they offered no negotiation on price, 6) recent independent studies had shown DynaMed to be more evidence-based, and ironically, more up-to-date, and 7) the cost of the product DOUBLED within four years.  I could no longer justify spending that much money for a single product that provided no full-text ejournals and ebooks, and catered mostly to primary care, and very little to specialists, especially surgeons.



We replaced UTD with DynaMed.  There have been some grumblings.  Most of our hospitalists and primary care physicians still prefer UpToDate, and we still get calls from folks expecting the library to provide UpToDate, but I just explain that the cost of the product is prohibitive.



Some of our folks prefer the outline summary of DynaMed, as opposed to the dense text of UpToDate.



We are a 586-bed tertiary care center with nine residency programs.  We are somewhat unique among hospitals as we also have a large basic science research department.



~~~~~~~~~~~~~~~~~~



I successfully canceled it until there was outcry from one of our larger practices.  We were without this resource for about a year.



~~~~~~~~~~~~~~~~~~
We opted not to renew UpToDate for 2014.  The cost continued to rise and our department head (a physician) was faced with a 10% budget cut, so she chose to eliminate one item rather than try to  cut bits and pieces.  We also felt that our account rep was a bit difficult to deal with and was not always totally up-front with us.

A few users were panicked and angry, others were disappointed but understanding of the financial decisions involved.  Individual physicians had the option of using honorarium $$ for their own subscriptions and a handful have taken that route.  One physician told me we were the 3rd location that had dropped UTD during his tenure with them.

Another factor in the decision to cut UpToDate was the fact that we were adding ClinicalKey as a replacement for MDConsult in January, 2014.  We like the full-text  access to journals and books available in ClinicalKey and the option to search across all the resources at the same time.  We also offer DynaMed as one of our other products.  The point-of-care features of those 2 products have been emphasized in explaining alternatives to UpToDate to our users.

We are a pediatric health system with 2 hospitals and multiple specialty and primary pediatric clinics across 4 states, so our subscriptions to all of these products are multi-site in nature.

With all that being said, the department head is looking for funds to re-subscribe to UTD.  This time we would insist on an on-campus use only arrangement.  Before, we offered VPN access which drove the cost up more.  Now we know that other institutions are able to limit access, which is one of the things UTD had told us was not available or difficult to provide.


~~~~~~~~~~~~~~~~~~



We cancelled UpToDate in May of this year after having subscribed to it for several years.  See my comments below.



*         the circumstances under which that occurred - too high priced; the formula for stats changed & increased; new rep didn't understand healthcare system and was not knowledgeable or customer friendly.  We had many issues with this rep



*         when it occurred - May 2014



*         reactions of users -  we were transparent with the physicians and staff about the renewal costs.  The medical staff were shocked when they knew the cost and many came forward and said UTD was not worth the price.  A few users were disappointed at first but we now offer another point of care - DynaMed.  We gave them info to subscribe to UTD on their own but no one wanted to spend $400 or so to do it.



*         other resources you offer instead - DynaMed - our physicians are liking it and some feedback I've had is that they prefer the succinctness of DynaMed to the long narrative of UpToDate...they are able to find what they want faster - no other complaints.   Many doctors like the fact that our license includes remote  and mobile access at no additional cost



*         brief description of your institution - 400 bed regional hospital.  We are a teaching hospital and have 500+ medical staff/residents and  3000 employed staff. As well as being a community hospital we specialize in Cardiac, Cancer, Mental Health, Obstetrics.



~~~~~~~~~~~~~~~~~~

We are a 591 bed teaching hospital that has no affiliation with an academic health sciences center.  I have worked here since 2010.  We had a site wide, on site only (no remote access) license to UpToDate for many years. We had an UpToDate link within our EMR that allowed onsite access.  The previous library director negotiated the original contract with the vendor.

Since 2010 the site license price increased substantially, about 10% each year, which is more than any other resource I license. I had negotiated a multi year agreement that expired October 2014. In June 2014 we started negotiations for a new license. It was a huge shock--the proposed renewal for the same level of access was 150% more than before.  UpToDate used a different pricing formula this time: not only did they charge per inpatient admission and per attending physician (as in previous years), this year they also started charging per resident.

My chief medical informatics officer attended the sales meeting with me in June, and we were equally shocked and angry. He told the sales representative that the hospital could not afford this increase. Later I spoke with the chief medical officer, who agreed. The proposed price was equivalent to the combined price of all my print books and journals plus my electronic books and journals.

My boss, who is an administrator, suggested that I try to limit access to residents and medical students only (we host third and fourth year students from XXXX medical schools). The CMO declined to purchase licenses for students, so I purchased individual licenses for residents as well as the attending physicians who are residency program directors. The price for these individual licenses was comparable to my original site license cost.

The sales rep was not helpful with negotiations. She was willing to reduce the number of attending physicians (i.e. she encouraged me to misrepresent the headcount of these individuals), but she would not budge on the number of inpatient admissions or the number of residents.

The enrollment process for individual access was very time consuming. UpToDate gave me a group discount for the residents and attending physicians, but they required me to send them one list of all 250+ individuals with their email addresses. Obtaining email addresses was challenging because 99% of individuals do not use work email, so I had to contact each person individually and request their email address. UpToDate also requires a single payment for group orders. They do not pro-rate orders or refund partial orders, so these licenses run October 2014 through October 2015, even though graduating residents will depart June 2015. In addition, UpToDate has not provided good customer support. Each individual should have received a welcome email message from UpToDate with their login credentials, but dozens of residents have told me they did not receive this message. Fortunately I was given a master list of everyone's credentials, but it takes time for me to work with these residents and help them log onto UpToDate.

Reactions to the site wide cancellation have, predictably, been negative, but when I tell users about the 150% price increase, they understand. I gave a presentation to the medical students about alternative resources.  I acknowledge that these resources do not approach UpToDate in comprehensiveness, but they are our only options.

I found it interesting to discover how people really use UpToDate. My previous statistics show that half of the searches were for drug information--even though we have a separate subscription to Micromedex. Some medical students felt entitled to the resource and complained that they did not have time to read articles. (One of the student coordinators later told me that UpToDate is like the Cliff's Notes of PubMed, and students are supposed to read the full article, not take a shortcut!) Attending OB/GYN physicians liked UpToDate because it helped them answer patient questions at the point of care about non OB/GYN topics; it helped them look knowledgeable. No one really seemed to care about whether UpToDate is evidence based. It is more like a current textbook or expert opinion resource, and that should not cost so much.



I talked with my local hospital librarian colleagues about this issue over the summer, and they all reiterated that the decision must be an administrative one--don't let yourself take the fall for it. Our executive VP told attending physicians who complained that it was a "business decision," and she brooks no argument. She, plus the CMIO and CMO, were the ultimate decision makers.


~~~~~~~~~~~~~~~~~~

We are a 157 bed community hospital.  I had a hospital subscription to UtD but no remote access.  We merged with XXX Hospital in 2011 and cancelled the subscription.  The librarian at XXX (we get along famously) and I merged everything, but the cost to provide UtD inside and outside the institution was prohibitive (over $XXX-K per year).  We cancelled UtD and got DynaMed instead. A few people complained and I still get asked "when are we getting UtD?"  I refer them to the Medical Staff Office and say "the libraries are not paying that amount of money.  Go talk to Dr. X, the head of the MSO."   I do have a personal account that only I use in case someone HAS to have a particular monograph, plus it is a useful reference tool.    My personal opinion:  I like it and wish we provided it but that won't happen so I've learned not to raise the issue.  If the MSO wants to pay for it, fine, but the libraries won't pay for it.


~~~~~~~~~~~~~~~~~~
Here are my answers to your questions:

*         brief description of your institution: We are a 593-bed pediatric teaching hospital, affiliated with the University of XXX.

*         when it occurred: We chose not to renew when our subscription was up at the end of 2012.

*         the circumstances under which that occurred: From 2010 to 2012, our subscription cost more than doubled. If we had continued subscribing, by 2014 our cost would have been 3.5 times what we were paying in 2010, and would have taken up 25% of the library's non-salary budget. We would have had to make substantial cuts in other resources just to continue UTD, which I thought was ridiculous and not a good use of hospital finances. My director and the vice president of our division both agreed with me.

*         reactions of users: Within the first year, I got about 6-10 phone calls or emails from people (mixture of MDs, RNs, and clinical nutrition) expressing their disappointment, but almost all of them were understanding when I told them about the significant price increases and the burden it was placing on the library. The faculty physicians, fellows, and residents also have access to the university's medical library, which continued subscribing to UTD, so the MDs were still able to access it by logging in to the university library website. I still get a few emails here and there asking about it, but I just tell them that we no longer have it and direct them to DynaMed. No one has threatened to burn down the library J

*         other resources you offer instead: DynaMed, MD Consult/First Consult


~~~~~~~~~~~~~~~~~~



*When: We stopped UTD at the end of 2011.  The motive was financial, as we (the organization, I mean) were hemorrhaging money at the time.  The subscription for UTD was bouncing along at a tolerable XX-K per year for many years, until the sale to Wolters-Kluwer, when it started rising - 380% in four years.  Our VP termed the increase "usury", and instructed me not to renew.



*Reactions: Reactions varied between reluctant acceptance to irrational incredulity, to shouted demands that I (a lowly librarian) to "Get it back!" In the case of the latter, my correspondent was unphased by the price increase and repeated his demand.



*Alternatives: We offered DynaMed, FirstConsult, and ACP PIER (now ACP SmartMedicine) - is it required that product names be combined words, with the second word capped? ;-) .  DynaMed was the best received and the most used of the three, but all were at levels magnitude below that of UTD.  Even dividing the UTD use by three (I was told by a colleague that is what is actually reported as "use"), it was still far ahead of the other resources.



*Description: We are a group of five hospitals (almost 1,500 beds), several specialty "institutes" (oncology, neurology), and a collection of clinics.  Since the demise of UTD here, we have developed an alliance with YYYY, which provides UTD for the rest of their locations, but not us at present.  But there are very recent rumblings to suggest that we may indeed "get it [UTD] back!"



~~~~~~~~~~~~~~~~~~



Our institution received a new 3-year pricing quote for 2014-16 this past summer. This year our administration approved for AccessAnywhere' newly increased pricing of around XX-K+, up from 2013 pricing. Next year it's going to be about XX-K more, and in 2016 another XX-K+ increase. I don't know if we get approved next and the following years.

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April 2011, Week 5
April 2011, Week 4
April 2011, Week 3
April 2011, Week 2
April 2011, Week 1
March 2011, Week 5
March 2011, Week 4
March 2011, Week 3
March 2011, Week 2
March 2011, Week 1
February 2011, Week 4
February 2011, Week 3
February 2011, Week 2
February 2011, Week 1
January 2011, Week 5
January 2011, Week 4
January 2011, Week 3
January 2011, Week 2
January 2011, Week 1
December 2010, Week 5
December 2010, Week 4
December 2010, Week 3
December 2010, Week 2
December 2010, Week 1
November 2010, Week 5
November 2010, Week 4
November 2010, Week 3
November 2010, Week 2
November 2010, Week 1
October 2010, Week 5
October 2010, Week 4
October 2010, Week 3
October 2010, Week 2
October 2010, Week 1
September 2010, Week 5
September 2010, Week 4
September 2010, Week 3
September 2010, Week 2
September 2010, Week 1
August 2010, Week 5
August 2010, Week 4
August 2010, Week 3
August 2010, Week 2
August 2010, Week 1
July 2010, Week 5
July 2010, Week 4
July 2010, Week 3
July 2010, Week 2
July 2010, Week 1
June 2010, Week 5
June 2010, Week 4
June 2010, Week 3
June 2010, Week 2
June 2010, Week 1
May 2010, Week 5
May 2010, Week 4
May 2010, Week 3
May 2010, Week 2
May 2010, Week 1
April 2010, Week 5
April 2010, Week 4
April 2010, Week 3
April 2010, Week 2
April 2010, Week 1
March 2010, Week 5
March 2010, Week 4
March 2010, Week 3
March 2010, Week 2
March 2010, Week 1
February 2010, Week 4
February 2010, Week 3
February 2010, Week 2
February 2010, Week 1
January 2010, Week 5
January 2010, Week 4
January 2010, Week 3
January 2010, Week 2
January 2010, Week 1
December 2009, Week 5
December 2009, Week 4
December 2009, Week 3
December 2009, Week 2
December 2009, Week 1
November 2009, Week 5
November 2009, Week 4
November 2009, Week 3
November 2009, Week 2
November 2009, Week 1
October 2009, Week 5
October 2009, Week 4
October 2009, Week 3
October 2009, Week 2
October 2009, Week 1
September 2009, Week 5
September 2009, Week 4
September 2009, Week 3
September 2009, Week 2
September 2009, Week 1
August 2009, Week 5
August 2009, Week 4
August 2009, Week 3
August 2009, Week 2
August 2009, Week 1
July 2009, Week 5
July 2009, Week 4
July 2009, Week 3
July 2009, Week 2
July 2009, Week 1
June 2009, Week 5
June 2009, Week 4
June 2009, Week 3
June 2009, Week 2
June 2009, Week 1
May 2009, Week 5
May 2009, Week 4
May 2009, Week 3
May 2009, Week 2
May 2009, Week 1
April 2009, Week 5
April 2009, Week 4
April 2009, Week 3
April 2009, Week 2
April 2009, Week 1
March 2009, Week 5
March 2009, Week 4
March 2009, Week 3
March 2009, Week 2
March 2009, Week 1
February 2009, Week 4
February 2009, Week 3
February 2009, Week 2
February 2009, Week 1
January 2009, Week 5
January 2009, Week 4
January 2009, Week 3
January 2009, Week 2
January 2009, Week 1
December 2008, Week 5
December 2008, Week 4
December 2008, Week 3
December 2008, Week 2
December 2008, Week 1
November 2008, Week 5
November 2008, Week 4
November 2008, Week 3
November 2008, Week 2
November 2008, Week 1
October 2008, Week 5
October 2008, Week 4
October 2008, Week 3
October 2008, Week 2
October 2008, Week 1
September 2008, Week 5
September 2008, Week 4
September 2008, Week 3
September 2008, Week 2
September 2008, Week 1
August 2008, Week 5
August 2008, Week 4
August 2008, Week 3
August 2008, Week 2
August 2008, Week 1
July 2008, Week 5
July 2008, Week 4
July 2008, Week 3
July 2008, Week 2
July 2008, Week 1
June 2008, Week 5
June 2008, Week 4
June 2008, Week 3
June 2008, Week 2
June 2008, Week 1
May 2008, Week 5
May 2008, Week 4
May 2008, Week 3
May 2008, Week 2
May 2008, Week 1
April 2008, Week 5
April 2008, Week 4
April 2008, Week 3
April 2008, Week 2
April 2008, Week 1
March 2008, Week 5
March 2008, Week 4
March 2008, Week 3
March 2008, Week 2
March 2008, Week 1
February 2008, Week 5
February 2008, Week 4
February 2008, Week 3
February 2008, Week 2
February 2008, Week 1
January 2008, Week 5
January 2008, Week 4
January 2008, Week 3
January 2008, Week 2
January 2008, Week 1
December 2007, Week 5
December 2007, Week 4
December 2007, Week 3
December 2007, Week 2
December 2007, Week 1
November 2007, Week 5
November 2007, Week 4
November 2007, Week 3
November 2007, Week 2
November 2007, Week 1
October 2007, Week 5
October 2007, Week 4
October 2007, Week 3
October 2007, Week 2
October 2007, Week 1
September 2007, Week 5
September 2007, Week 4
September 2007, Week 3
September 2007, Week 2
September 2007, Week 1
August 2007, Week 5
August 2007, Week 4
August 2007, Week 3
August 2007, Week 2
August 2007, Week 1
July 2007, Week 5
July 2007, Week 4
July 2007, Week 3
July 2007, Week 2
July 2007, Week 1
June 2007, Week 5
June 2007, Week 4
June 2007, Week 3
June 2007, Week 2
June 2007, Week 1
May 2007, Week 5
May 2007, Week 4
May 2007, Week 3
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May 2007, Week 1
April 2007, Week 4
April 2007, Week 3
April 2007, Week 2
April 2007, Week 1
March 2007, Week 5
March 2007, Week 4
March 2007, Week 3
March 2007, Week 2
March 2007, Week 1
February 2007, Week 4
February 2007, Week 3
February 2007, Week 2
February 2007, Week 1
January 2007, Week 5
January 2007, Week 4
January 2007, Week 3
January 2007, Week 2
January 2007, Week 1
December 2006, Week 5
December 2006, Week 4
December 2006, Week 3
December 2006, Week 2
December 2006, Week 1
November 2006, Week 5
November 2006, Week 4
November 2006, Week 3
November 2006, Week 2
November 2006, Week 1
October 2006, Week 5
October 2006, Week 4
October 2006, Week 3
October 2006, Week 2
October 2006, Week 1
September 2006, Week 5
September 2006, Week 4
September 2006, Week 3
September 2006, Week 2
September 2006, Week 1
August 2006, Week 5
August 2006, Week 4
August 2006, Week 3
August 2006, Week 2
August 2006, Week 1
July 2006, Week 5
July 2006, Week 4
July 2006, Week 3
July 2006, Week 2
July 2006, Week 1
June 2006, Week 5
June 2006, Week 4
June 2006, Week 3
June 2006, Week 2
June 2006, Week 1
May 2006, Week 5
May 2006, Week 4
May 2006, Week 3
May 2006, Week 2
May 2006, Week 1
April 2006, Week 4
April 2006, Week 3
April 2006, Week 2
April 2006, Week 1
March 2006, Week 5
March 2006, Week 4
March 2006, Week 3
March 2006, Week 2
March 2006, Week 1
February 2006, Week 4
February 2006, Week 3
February 2006, Week 2
February 2006, Week 1
January 2006, Week 5
January 2006, Week 4
January 2006, Week 3
January 2006, Week 2
January 2006, Week 1
December 2005, Week 5
December 2005, Week 4
December 2005, Week 3
December 2005, Week 2
December 2005, Week 1
November 2005, Week 5
November 2005, Week 4
November 2005, Week 3
November 2005, Week 2
November 2005, Week 1
October 2005, Week 5
October 2005, Week 4
October 2005, Week 3
October 2005, Week 2
October 2005, Week 1
September 2005, Week 5
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September 2005, Week 3
September 2005, Week 2
September 2005, Week 1
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July 2005, Week 1
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June 2005, Week 2
June 2005, Week 1
May 2005, Week 5
May 2005, Week 4
May 2005, Week 3
May 2005, Week 2
May 2005, Week 1
April 2005, Week 5
April 2005, Week 4
April 2005, Week 3
April 2005, Week 2
April 2005, Week 1
March 2005, Week 5
March 2005, Week 4
March 2005, Week 3
March 2005, Week 2
March 2005, Week 1
February 2005, Week 4
February 2005, Week 3
February 2005, Week 2
February 2005, Week 1
January 2005, Week 5
January 2005, Week 4
January 2005, Week 3
January 2005, Week 2
January 2005, Week 1
December 2004, Week 5
December 2004, Week 4
December 2004, Week 3
December 2004, Week 2
December 2004, Week 1
November 2004, Week 5
November 2004, Week 4
November 2004, Week 3
November 2004, Week 2
November 2004, Week 1
October 2004, Week 5
October 2004, Week 4
October 2004, Week 3
October 2004, Week 2
October 2004, Week 1
September 2004, Week 5
September 2004, Week 4
September 2004, Week 3
September 2004, Week 2
September 2004, Week 1
August 2004, Week 5
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August 2004, Week 3
August 2004, Week 2
August 2004, Week 1
July 2004, Week 5
July 2004, Week 4
July 2004, Week 3
July 2004, Week 2
July 2004, Week 1
June 2004, Week 5
June 2004, Week 4
June 2004, Week 3
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June 2004, Week 1
May 2004, Week 4
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April 2004, Week 5
April 2004, Week 4
April 2004, Week 3
April 2004, Week 2
April 2004, Week 1
March 2004, Week 5
March 2004, Week 4
March 2004, Week 3
March 2004, Week 2
March 2004, Week 1
February 2004, Week 5
February 2004, Week 4
February 2004, Week 3
February 2004, Week 2
February 2004, Week 1
January 2004, Week 5
January 2004, Week 4
January 2004, Week 3
January 2004, Week 2
January 2004, Week 1
December 2003, Week 5
December 2003, Week 4
December 2003, Week 3
December 2003, Week 2
December 2003, Week 1
November 2003, Week 5
November 2003, Week 4
November 2003, Week 3
November 2003, Week 2
November 2003, Week 1
October 2003, Week 5
October 2003, Week 4
October 2003, Week 3
October 2003, Week 2
October 2003, Week 1
September 2003, Week 5
September 2003, Week 4
September 2003, Week 3
September 2003, Week 2
September 2003, Week 1
August 2003, Week 5
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July 2003, Week 1
June 2003, Week 5
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June 2003, Week 1
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May 2003, Week 1
April 2003, Week 5
April 2003, Week 4
April 2003, Week 3
April 2003, Week 2
April 2003, Week 1
March 2003, Week 5
March 2003, Week 4
March 2003, Week 3
March 2003, Week 2
March 2003, Week 1
February 2003, Week 4
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February 2003, Week 1
January 2003, Week 5
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January 2003, Week 1
December 2002, Week 5
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October 2002, Week 5
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September 2002, Week 5
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September 2002, Week 1
August 2002, Week 5
August 2002, Week 4
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January 2002, Week 3
January 2002, Week 2
January 2002, Week 1
December 2001, Week 5
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April 2001, Week 1
March 2001, Week 5
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March 2001, Week 1
February 2001, Week 4
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February 2001, Week 1
January 2001, Week 5
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January 2001, Week 3
January 2001, Week 2
January 2001, Week 1
December 2000, Week 5
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December 2000, Week 3
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October 2000, Week 1
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December 1999, Week 5
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December 1998, Week 5
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January 1998, Week 5
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January 1998, Week 3
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December 1997, Week 5
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December 1996, Week 5
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December 1995, Week 5
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