Physician Practices Survey Template offers questions for evaluation of hospital and the services provided. This sample can be edited by the survey maker according to the required details about hospitals and their services. Some of the question examples of this questionnaire are "What is your medical specialty", "When a patient needs hospital care, who selects the hospital or other care facility?" et al.
How many years have you been practicing medicine (post-internship)?
Is your practice
The next section refers to the hospital where you admit the most patients.
Strongly agree
Somewhat agree
Neutral
Somewhat disagree
Strongly disagree
No opinion
Administration listens to physician concerns
Administration listens to physician concerns, but responds to the wrong physician groups
I have a good professional relationship with administration
During the last year my professional relationship with administration has improved
Professional referrals may be made based on a number of factors. For each of the following items, please indicate the extent to which you think each is important in selecting a hospital for your patients.
Very Important
Important
Not too Important
Not at all Important
No Opinion
The price of hospital services
Your satisfaction with the medical staff
The reputation of the hospital
The reputation of hospital based physicians
The reputation of specialists practicing at the hospital
Communication between you and the consulting physician
Competence of nursing staff
Past experiences of patients
Economic condition of the patient
Convenience of hospital for patient and family
Very Important
Important
Not too Important
Not at all Important
No Opinion
Patient hospital preference
Religious preference
Patient referral
When a patient needs hospital care, who selects the hospital or other care facility?
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