Independent Physician Well-being Survey

1.How would you rate your overall physical and mental health right now? 
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2.How would you compare your own overall health before the pandemic began with how you are feeling now?  i.e., “Right now, my physical and mental l health and well-being is ... [fill in the blank]”:
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3.As you look ahead, how would you describe your overall outlook and general attitude?
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4.How does your current outlook and attitude compare to how you felt:
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More optimisticThe sameMore pessimistic
In January 2021 when vaccinations were becoming available 
In September 2020 when the pandemic was subsiding
In May 2020 during the full onset of the pandemic
In late 2019 before the pandemic 

5.How have you been managing your own physical and mental well-being during the past year? Please select all that apply. 
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*Choose between 1 and 13 selections

*Choose between 1 and 13 selections

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13

*Enter answer

6.What tools/practices/activities have you used to support your staff’s physical and mental well-being? Please select all that apply. 
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*Choose between 1 and 10 selections

*Choose between 1 and 10 selections

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10

*Enter answer

7.Have you seen your primary care physician for regularly scheduled preventive medical care during the past year (e.g., annual check-up, screenings, tests, etc.)? 
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8.Have you participated in a telehealth appointment as a patient?
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8.How would you rate that experience?
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8.Did that experience change how you use telehealth as a provider?
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8.How has it changed your use of telehealth as a provider?
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9.If you have used telehealth to see and care for patients, which of the following statements best describe your experience? Please select all that apply.
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*Choose between 1 and 9 selections

*Choose between 1 and 9 selections

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9

10.Which of the following have been your primary source(s) of work-related stress in the past year? Please select up to 3 answers.
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*Choose between 1 and 11 selections

*Choose between 1 and 11 selections

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11

*Enter answer

11.How has the past year changed how you feel about your medical practice and/or choice of profession? Please select all that apply. 
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*Choose between 1 and 12 selections

*Choose between 1 and 12 selections

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12

*Enter answer

12.Where is your practice located? 

*Enter answer

13.What is the size of your practice?   

14.What type of medicine do you practice? 

15.Thank you for your participation! All 100 Amazon gift cards have been claimed. Congratulations to the first 100 respondents!