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There are areas where the expertise and high quality of content are sometimes unnecessary. I speak from personal experience, having debated with friends and neighbors who didn't feel the need for a higher premium product due to their unwillingness to pay. This is mostly because they deal with less complex patients. For practices seeing a specific subset of patients, such as in outpatient facilities, they may not be concerned about the nuances and need for a higher quality product.
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In contrast, if you're a health system with higher levels of complexity, it's non-negotiable. Clinicians accustomed to using UpToDate cannot live without it. I've heard that ClinicalKey is excellent for research, particularly pharmaceutical research, and research professionals generally find it suitable.
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