FIGURE 1.

Survey questions for primary care physicians.

Please think back over the past year and try to remember patients you saw with a problem in this specialty.* Please consider the specialists within the HMO.

1. How long does it take on average to have an outpatient seen (for a non-emergent condition)?

<1 week … 1–2 weeks … >2 weeks

2. How much do you agree with the following?

Scale: 1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree, 5 = strongly agree

a. The specialists in this specialty are equally trying to keep costs down.

b. The quality of service provided is similar among these specialists.

c. Your referral patterns are the same for both HMO patients and other patients.

d. Your preferred specialist is the one who actually sees the patient.

3. Based on your experience with your patients, how satisfied were you with the following:

Scale: 1 = very dissatisfied, 2 = mostly dissatisfied, 3 = indifferent, 4 = mostly satisfied, 5 = very satisfied

a. the consultant's attitude?

b. the extent to which your questions were addressed?

c. the patient benefits of the tests/procedures performed by the specialist in light of the costs?

d. the patient benefits of the tests/procedures recommended by the specialist in light of the costs?

e. your patients' satisfaction with the consultant?

f. the extent to which the consultation enhanced your relationship with the patient?

g. the extent to which the consultant involved you in the decision making?

h. the timeliness of the written consultation?

i. the overall service provided?

4. Consider all the patients you referred to this specialty over the past year. How often did the following affect your decision to refer?

Scale: 1 = none of the time, 2 = little of the time, 3 = some of the time, 4 = most of the time, 5 = all of the time

a. to learn more about a disease or condition

b. to establish a diagnosis

c. to confirm your diagnosis

d. to establish a treatment plan

e. to confirm your treatment plan

f. to have a specific procedure performed that you do not perform yourself

g. to comply with patient or family request

h. to obtain assistance due to the severity of the patient's illness

Survey items were transformed to a scale ranging from 0–100.

Summary SATISFACTION score 5 mean score for items (2b + 2d +3a + 3b + 3e +3f + 3g + 3h + 3i).

Summary COST-EFFECTIVENESS score 5 mean score for items (2a + 3c + 3d).

* Primary care physicians completed a separate survey form for each of the five specialties.