Career Decision - Survey 1a

Physician Executives' Big Decision

This survey is intended for physicians in a part-time management / leadership role, and continue to have patient care responsibilities. If you no longer see patients or supervise others who are not independent licensed providers, please click below.

Thank you for your time.  Be sure to click "Submit" when finished

Items with a "*" are required. Average time to complete is 5-6 minutes.

Name *
Your real name is preferred but not necessary. Joe or Jane Doe will work
What year were you born?
How many people, including yourself, depend on you to maintain their standard of living? Not the IRS definition -- children adults, parents, etc.
Please list your minor children's ages.
Community *
Select below the closest description of the community you serve in now.
Why did you go into medicine?
Regardless of board status, what clinical area best fits your current (or previous) clinical focus?
What is your current clinical board status?
What year will you certify / re-certify?
Business Education *
What kind of business training do you currently have? Check all that apply.
Please describe the organization where you work.
Select the range of effort that best describes the percentage of time you currently spend in management / leadership.
Enter the number of years you have been in management / leadership part-time.
Reasons for Change *
What issues / concerns / forces led you to take on a managerial role? (Check all that apply)
Describe anything not included above that contributed to your decision to take on a management role.
Reasons to not Change *
What concerns do you have that tend to keep you in patient care? (Check all that apply)
Describe anything not included above that contributes (or did if already full-time) to your concern about decreasing / ending patient care.