Physician Work Routine Survey Form
Please complete the Physician Work Routine Survey Form to help us understand typical work patterns and experiences. Your responses are anonymous and will help improve physician work environments.
What is your primary work setting?
*
Hospital
Clinic
Private Practice
Academic/Teaching
Other
How many hours do you typically work per week?
*
Less than 30
30-40
41-50
51-60
More than 60
On average, how many patients do you see per day?
*
1-10
11-20
21-30
31-40
More than 40
How would you rate your overall job satisfaction?
*
1
2
3
4
5
How often do you take breaks during your workday?
*
Rarely/Never
Once
Twice
Three or more times
How do you typically allocate your time during a workday?
*
Rows
Direct patient care
Administrative tasks
Meetings
Research/Teaching
Hours per day
How manageable is your current workload?
*
Unmanageable
1
2
3
4
Very manageable
5
1 is Unmanageable, 5 is Very manageable
How often do you work beyond your scheduled hours?
*
Never
Rarely
Sometimes
Often
Always
How would you rate your work-life balance?
*
1
2
3
4
5
Please share any comments or suggestions about your work routine.
Submit Survey
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