4.19.2023 Board Book
Survey Questions: 1) Which of the following disciplines best describes you? o Physician (MD/DO)—Medical Discipline o Physician (MD/DO)--Surgeon o Nurse Practitioner (NP) o Physician Assistant (PA)/Physician Associate (PA) 2) Do you have other designations? o PhD o MPH o MBA o I do not have other designations o Other (please specify) (Add a free text field here) 3) Which of the selections below best describes your practice?
a) Academic obesity medicine group b) Academic bariatric surgery group c) Private bariatric surgery group d) Private obesity medicine group e) Private solo obesity medicine provider f) Hybrid primary care/obesity medicine g) Other + add free text field here
4) If your practice is a hybrid model, what percentage of your time is spent in Obesity Medicine (OM)? (Add a free text area with a percentage (%) for the respondent to add if they select letter “f”)
5) How many years have you been practicing Obesity Medicine (OM)? o <1 year
o 2-4 years o 5-8 years o 8-10 years o 10-15 years o 16+ years
6) In which state do you primarily practice? (Will add a drop-down of all 50 states here, but will not enable a multi-select function)
Page | 2
Made with FlippingBook flipbook maker