Community Family Medicine Residency Alumni Survey 2011 Question Title * 1. 1. How many years ago did you graduate from the Community Family Medicine Residency Program? 0-4 years 5-9 years 10-14 years 15-19 years 20-24 years 25-29 years 30-34 years 35 or more years Question Title * 2. Please enter the year of your most recent ABFM recertification. Not currently board certified 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Please list your intial board certification year (if different from most recent). Question Title * 3. Please tell us about your current primary practice site. (Check all that apply.) Please read through ALL choices. Urban Metropolitan Suburban Rural Hospitalist position Academic (Medical School or Residency) I am in a fellowship Administrative role Individual/self-owned practice Group-owned/partnership practice Health Network-owned practice Fed Qual Health Ctr (FQHC); CHC; MUA/HSPA Concierge practice Electronic Medical Records are used in my setting Paper charts are used in my setting My practice has received NCQA Patient-Centered Medical Home Certification I am not currently practicing medicine Question Title * 4. Please tell us about your current primary practice site. (Check all that apply.) Please read through ALL choices. Urban Metropolitan Suburban Rural Solo practice Small group (2-6) Large group (>6) Hospitalist position Academic (Medical School or Residency) I am in a fellowship Administrative role Individual/self-owned practice Group-owned/partnership practice Health Network-owned practice Fed Qual Health Ctr (FQHC); CHC; MUA/HSPA Concierge practice Electronic Medical Records are used in my setting Paper charts are used in my setting My practice has received NCQA Patient-Centered Medical Home Certification I am not currently practicing medicine Question Title * 5. Please tell us about your current primary practice site. (Check all that apply.) Please read through ALL choices. Urban Metropolitan Suburban Rural Solo practice Small group (2-6) Large group (>6) Hospitalist position Academic (Medical School or Residency) I am in a fellowship Administrative role Individual/self-owned practice Group-owned/partnership practice Health Network-owned practice Fed Qual Health Ctr (FQHC); CHC; MUA/HSPA Concierge practice Electronic Medical Records are used in my setting Paper charts are used in my setting My practice has received NCQA Patient-Centered Medical Home Certification I am not currently practicing medicine Question Title * 6. Please tell us about the current composition of your primary practice site. (Check all that apply.) Nurse Practitioner Physician Assistant Clinical Pharmacist Social Worker Nutritionist or Diabetes Educator Nurse Care Manager Registered Nurse (RN) Licensed Practical Nurse (LPN) Medical Assistant (MA) None of the above are in my practice site Other (please specify) Question Title * 7. Please estimate the percentage of each insurance carrier of the patients under your care. 0-10% 10-20% 20-40% 40-60% 60-80% 80-100% Medicare Medicare 0-10% Medicare 10-20% Medicare 20-40% Medicare 40-60% Medicare 60-80% Medicare 80-100% Medicaid Medicaid 0-10% Medicaid 10-20% Medicaid 20-40% Medicaid 40-60% Medicaid 60-80% Medicaid 80-100% PPO/POS PPO/POS 0-10% PPO/POS 10-20% PPO/POS 20-40% PPO/POS 40-60% PPO/POS 60-80% PPO/POS 80-100% HMO HMO 0-10% HMO 10-20% HMO 20-40% HMO 40-60% HMO 60-80% HMO 80-100% Self Pay Self Pay 0-10% Self Pay 10-20% Self Pay 20-40% Self Pay 40-60% Self Pay 60-80% Self Pay 80-100% Question Title * 8. Which of the following do you currently do in your role? (Check all that apply.) Outpatient care of children Outpatient care of adults Inpatient care of children Inpatient care of adults Prenatal Care Vaginal deliveries Newborn nursery rounds Home visits Nursing Home visits Question Title * 9. Please identify areas in which you feel the Residency adequately prepared you for private practice. (Check all that apply.) Pain management Behavioral sciences Practice management Alternative and complementary medicine Chronic disease management Evidence based medicine Patient Centered Medical Home model Question Title * 10. Please identify procedures that you perform in your office or hospital. (Check all that apply.) Ultrasound Pap Smear Wet Mount/KOH Colposcopy Endometrial biopsy LEEP Cryosurgery cervix IUD placement Nexplanon or Implanon insertion Flexible sigmoidoscopy Colonoscopy Upper endoscopy Nasopharyngoscopy Audiometry Tympanometry Exercise stress testing Spirometry Vasectomy Incision of drainage of abscess Punch biopsy Simple lesion removal Laceration repair Cryotherapy of benign skin lesions Joint aspiration/injection Trigger point injection Toenail removal Casting Arterial line Central line Intubation Neonatal resuscitation Circumcision Question Title * 11. How satisfied are you with your overall Residency training? Very satisfied Somewhat satisfied Neutral Somewhat dissatisfied Very dissatisfied Question Title * 12. OPTIONAL: Personal Demographics & Information. (Check all that apply.) Male Female I work full-time (4-5 days per week) I work part-time (3 days per week or less) I practice within Community Physician Network (CPN) I practice in Indiana I practice in Midwest (not Indiana) I practice in Northeastern U.S. I practice in Southern U.S. I practice in Western U.S. I practice outside United States I do not currently practice medicine 100% of survey complete. Submit