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. 2013 Feb;27(2):83–89. doi: 10.1155/2013/143018

TABLE 1.

SAGE clinician demographic survey

1. Physician sex: □ Male
□ Female

2. Postal code of the institution where you do the majority of your procedures (endoscopy, liver biopsies, etc):

3. Affiliation: □ Predominantly teaching hospital based
□ Predominantly community-based with hospital privileges
□ Predominantly community-based without hospital privileges

4. Your practice is: □ Luminal
□ Liver
□ Both luminal and liver

5. Your practice is: □ Adult
□ Pediatric

6. Your practice is: □ Full-time
□ Part-time: If part-time, what percentage of time do you work?

7. What percentage of your work week is spent in clinical care? Please round to the nearest 10%

8. Have you limited new patient referrals because of the length of your wait list? □ No
□ Yes

9. How long have you been in GI practice?* □ <5
□ 5–10 y
□ 10–20 y
□ 20–30 y
□ 30+ y

10. How satisfied are you with your current wait times?* □ Not at all satisfied
□ Slightly satisfied
□ Somewhat satisfied
□ Very satisfied
□ Extremely satisfied
*

New for SAGE 2012. GI Gastroenterology; SAGE Survey of Access to GastroEnterology; y Years