Research Survey

Question Title

* 1. Which of the following best describes your role in the ownership of your primary clinical practice?

Sole owner of your practice

Partial owner or shareholder in your practice

No official ownership stake in your practice (100% employed)

Not applicable/not in clinical practice

Question Title

* 2. Who is your primary employer?

You (self-employed, majority practice owner, independent contractor, etc.)

Physicians group (single- or multi-specialty)

University-owned (public or private) clinic or hospital

Private for-profit hospital or health system

Private non-profit hospital or health system

Managed care organization or insurance company

Federal, state, or local government, community board, etc. (not including universities)

Locum tenens group/staffing organization

Other

Question Title

* 3. In what city is your practice located?

Question Title

* 4. Do you currently participate in practice-based research?

Yes

Question Title

* 5. If you do not participate in research, why not?

Never been asked to participate

My practice type is not conducive to research

The management of my practice does not allow it

I do not have sufficient staffing to participate

Other (please specify)

Question Title

* 6. Please rate your interest in these practice-based research related activities on a scale of 1 to 5 with 1 being not interested at all and 5 being very interested.

	Not interested				Very interested
Initiating research projects	Initiating research projects Not interested	Initiating research projects	Initiating research projects	Initiating research projects	Initiating research projects Very interested
Participating in research	Participating in research Not interested	Participating in research	Participating in research	Participating in research	Participating in research Very interested
Reading the results of research in journals and online	Reading the results of research in journals and online Not interested	Reading the results of research in journals and online	Reading the results of research in journals and online	Reading the results of research in journals and online	Reading the results of research in journals and online Very interested
Hearing research presentations as part of clinical CME	Hearing research presentations as part of clinical CME Not interested	Hearing research presentations as part of clinical CME	Hearing research presentations as part of clinical CME	Hearing research presentations as part of clinical CME	Hearing research presentations as part of clinical CME Very interested
Viewing research posters at conferences	Viewing research posters at conferences Not interested	Viewing research posters at conferences	Viewing research posters at conferences	Viewing research posters at conferences	Viewing research posters at conferences Very interested

Question Title

* 7. Would you be interested in receiving information from research networks looking for physicians to participate in upcoming research?

Yes

Question Title

* 8. If yes, please provide your contact information

Name:

Email address:

Thank you for your time! The next meeting of the Section will be during TAFP's Annual Session and Primary Care Summit - Thursday, November, 3 at 12:30 pm in Dallas. All members are welcome to attend.