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The following questions were presented to and completed by physicians (family physicians and all other specialists) in Canada in 2010. Questions marked “FP”, were asked of family physicians/general practitioners only, while those marked “SP” were asked of all other specialist physicians.
| New Brunswick Demographics |
| Current Status | ||
| Q1: Which of these best describes you? | ||
| Q2: Age. | ||
| Q3: Sex. | ||
| Q4a: The following is a list of work settings. Check the category(ies) which best describe(s) the setting(s). | ||
| Q4b: Please indicate which of the above settings is your MAIN patient care setting (i.e. the setting where you spend the most time providing patient care). | ||
| Q5: In which province(s)/territory(ies) do you currently work? |
| Q7: Do you provide patient care? | ||
| Q7b (FP): With respect to your MAIN patient care setting specified in 4b, describe the population PRIMARILY served by you in your practice. | ||
| Q8: What languages do you speak with your patients? | ||
| Q9: What percentage of your gross professional income goes towards running your pratice (e.g. part-time or full-time staff, leases/rent/mortgage, equipment leasing/rental, personal benefits, vehicle costs, professional fees, malpractice dues, other overhead expenses)? | ||
| Q10a: Please indicate how your MAIN patient care setting is organized. | ||
| Q10b: Are you incorporated? | ||
| Q11: Please indicate with whom you REGULARLY REFER or HAVE COLLABORATIVE CARE ARRANGEMENTS: Other FPs/ Other Specialists | ||
| Q11: Please indicate with whom you REGULARLY REFER or HAVE COLLABORATIVE CARE ARRANGEMENTS: Other Health Care Providers | ||
| Q12: Are there any barriers that currently exist to prevent you from engaging a Physician / Clinical Assistant in your practice? | ||
| Are there any barriers that currently exist to prevent you from engaging a Nurse Practitioner in your practice? |
| Q13: Please rate your accessibility to the following on behalf of your patients. | ||
| Q14a: Typically, if a patient contacts your office or is referred to you, how long would that patientwait until the first available appointment WITH YOU OR YOUR PRACTICE? | ||
| Q14b: To what extent is your practice accepting new patients into your MAIN patient care setting? | ||
| Q14c (FP): Approximately how many patients are in your practice? | ||
| Q14d (FP): Please estimate the number of patients you see in a TYPICAL week, EXCLUDING patient visits while you are on-call. |
| Q15 (FP): Please indicate if you OFFER the following to your patients and if this is a SPECIFIC AREA OF FOCUS in your practice. | ||
| Q15a (SP): Are you practicing within the the main areas of the specialty as broadly taught during your residency? | ||
| Q15b (SP): If your practice extends beyond what you were taught during residency, what extra training did you pursue? | ||
| Q15c (SP): Considering the generally accepted domain of practice of your specialty, please describe the main focus of your practice. | ||
| Q16 (FP): Please indicate if you care for the following, or if the following populations represent more than 10% of your practice population: | ||
| Q16 (SP): Please indicate if you care for the following: |
| Q17a: Do you do call? | ||
| Q17b: Please estimate your average number of on-call work hours PER MONTH: | ||
| Q17c: Please estimate how many of your on-call hours each month are actually spent in direct patient care (e.g., phone, email, face-to-face): | ||
| Q17d: Do you ever spend continuous 24-hour periods of on-call time in direct patient care? | ||
| Q17e: Please estimate the number of patients you SEE on-call per month: | ||
| Q18: EXCLUDING ON-CALL ACTIVITIES, how many HOURS IN AN AVERAGE WEEK do you usually spend on the following activities? | ||
| Q19a: In the last year, have you used any locum tenens? | ||
| Q19b: In the last year, have you personally provided locum tenens services for another physician? | ||
| Q20a&b: Do you regularly work as a visiting physician? | ||
| Q21a: Please indicate the frequency of use and impact on your practice of the following. | ||
| Q21b: Please rate how significantly each of the following has served as a barrier to your participation in CME/CPD. |
| Q22: In the last year, approximately what proportion of your professsional income did you receive from each of the following payment methods? |
| Q23: Please indicate which of the following factors are increasing the demand for your time at work. | ||
| Q24: With reference to the LAST 2 YEARS, please check all of the following changes you have already made. | ||
| Q24: With reference to the NEXT 2 YEARS, please check all of the following changes that you are planning to make. | ||
| Q25: If you plan to retire in the near future, which of the following might entice you to practice longer? |
| Q26a: Do you have a practice Web site? If yes, can patients contact your office to request an appointment through it? | ||
| Q26b: Do you refer your patients to any websites? If yes, for what purpose? | ||
| Q26c: Do you use email IN ANY SETTING to communicate wit: | ||
| Q27: Thinking about your MAIN patient care setting, which of these describes your record keeping system? | ||
| Q28a: Where do you access electronic records for your patients? | ||
| Q28b: In which setting do you use electronic records most often? | ||
| Q28c: If you access electronic records in various locations, are the records in these locations electronically connected to each other to allow for access of the same electronic record from different settings? | ||
| Q29: Please indicate which of the following you use, or plan to use, in the care of your patients. |
| Q30: Please rate your satisfaction with each of the following: | ||
| Q31a (SP): Do the referral documents you receive contain sufficient information? | ||
| Q31b (SP): If not satisfactory, which are the most important elements that could be enhanced in the referral documents you currently receive? | ||
| Q32a (SP): Do the consultation reports you receive contain sufficient information? | ||
| Q32b (SP): If not satisfactory, which are the most important elements that could be enhanced in the consultation reports you currently receive? |
| Q31a (FP): Do you have summary information on your patient population with chronic diseases (e.g., percent of diabetes patients due for an eye exam)? | ||
| Q31b (FP): Do you typically use a flow sheet or checklist for chronic diseases? | ||
| Q32a (FP): Do you give your patients with chronic diseases written instructions about how to manage their own care at home? | ||
| Q32b (FP): Do you use electronic tools to manage your patients' chronic conditions? |
| Q33: Where were you born? | ||
| Q34a: Year of your undergraduate graduation: | ||
| Q34a: Year of completion of your MOST RECENT post-graduate medical training (i.e. residency/internship): | ||
| Q34b (FP): Please indicate where you completed your undergraduate medical training. | ||
| Q34b (FP): Please indicate where you completed your most recent post-graduate medical training. | ||
| Q34b (SP): Please indicate where you completed your undergraduate medical training. | ||
| Q34b (SP): Please indicate where you completed your most recent post-graduate medical training. | ||
| Q35: Current medical specialty certification/attestation. | ||
| Q36: In what year did you become licensed to practice medicine in Canada for the first time? | ||
| Q37a: Do you have children? If yes, what is the age of the youngest and how many hours per week do you have primary responsibility of these children? | ||
| Q37b: Do you have any other dependents for whom you personally provide care (grandchildren/elderly/disabled)? if yes, how many and how many hours per week do you spend caring for them? |