Physician Performance Evaluation Template

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1. During a typical office visit, does your doctor spend too much time with you, too little time with you, or about the right amount of time with you?

2. How much do you trust your doctor to make medical decisions that are in your best interests?

3. How helpful is your doctor at explaining your medical condition(s)?

4. How well does your doctor listen to you?

5. How quickly does your doctor's staff help you when you need help?

6. How friendly is your doctor's office staff?

7. How knowledgeable is your doctor's office staff?

8. How easy is it to schedule urgent appointments with your doctor when you're ill?

9. Overall, are you satisfied with your doctor, neither satisfied nor dissatisfied with him/her, or dissatisfied with him/her?

10. How likely are you to recommend your doctor to family or friends?