TABLE 1.
1. Physician sex: | □ Male |
□ Female | |
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2. Postal code of the institution where you do the majority of your procedures (endoscopy, liver biopsies, etc): | |
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3. Affiliation: | □ Predominantly teaching hospital based |
□ Predominantly community-based with hospital privileges | |
□ Predominantly community-based without hospital privileges | |
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4. Your practice is: | □ Luminal |
□ Liver | |
□ Both luminal and liver | |
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5. Your practice is: | □ Adult |
□ Pediatric | |
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6. Your practice is: | □ Full-time |
□ Part-time: If part-time, what percentage of time do you work? | |
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7. What percentage of your work week is spent in clinical care? Please round to the nearest 10% | |
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8. Have you limited new patient referrals because of the length of your wait list? | □ No |
□ Yes | |
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9. How long have you been in GI practice?* | □ <5 |
□ 5–10 y | |
□ 10–20 y | |
□ 20–30 y | |
□ 30+ y | |
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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