Physician burnout is a psychological syndrome in response to chronic interpersonal stressors on the job. The three key dimensions of this response are an overwhelming exhaustion, feelings of cynicism and detachment from the job, and a sense of ineffectiveness and lack of accomplishment.

To help us understand physician wellness and burnout in ACOFP members, please take a few minutes to answer the following questions.  Your answers are anonymous and will help ACOFP design programs and resources to support you in your wellness.

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* 1. Please indicated your age.

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* 2. Please identify your current level of experience as a physician.

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* 3. Please describe your practice setting.

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* 4. Please indicate your practice size.

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* 5. Do you supervise Nurse Practinioners or Physician Assistants in your practice?

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* 6. Do you practice in a recognized Patient Centered Medical Home?

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* 7. Does your practice use Team-Based care?

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* 8. Overall, based on your definition of burnout, how would you rate your level of burnout?”

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* 9. To the extent that you do feel burned-out, please indicate the degree to which each of the following contribute to your feeling of being burned-out.

  Very untrue for me Somewhat untrue for me Neutral Somewhat true for me Very true for me
The inherent stress of being a physician
Not being able to get my patient the care they need
Burden of non-clinical/administrative work
Inefficient/burdensome electronic medical record
Lack of work/life balance
Loss of autonomy in clinical decisions
Loss of physician/patient relationship
Unsupportive administration
Unrealistic patient volume expectations

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* 10. To the extent that you do NOT feel burned-out, please indicate the degree to which each of the following contribute to your feeling of well-being.

  Very untrue for me Somewhat untrue for me Neutral Somewhat true for me Very true for me
I exercise regularly
I regularly get a good night's sleep
I practice meditation/mindfulness
I have a good work/life balance
I follow a well-balanced diet
I have control of my schedule
I am able to get my patients the care they need
My administration is supportive of me
There is meaning in my work
I have a supportive spouse/partner/family
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