The Burnout Survey: The Medical Practitioner's Burnout Story
RequiredRequired Question(s)
Required 1.
How long have you been a healthcare professional?

Less than one year.
One to three years
Three to five years
Five to 10 years
10 to 15 years
15 to 20 years
20 to 25 years
25 to 30 years
Over 30 years
Required 2.
In what capacity do you serve?

Medical Doctor (MD, OD, DC, DDS, etc.)
Other Doctor (e.g. therapist with PhD, etc.)
Nurse Practitioner
Physician's Assistant
Nurse (RN, LPN, etc.)
CMA
Non-provider role (e.g. Practice/Office Manager, Coder, Receptionist, Insurance/Billing Specialist, etc.)
Other  
Required 3.
In what size office do you work? This refers solely to your particular office location.

1-3 total staff (including all employees)
4-5 total staff
6-10 total staff
11-15 total staff
16-25 total staff
26-50 total staff
Over 50 total staff
Required 4.
In what size company do you work? This refers to the total size of the company, including all locations/offices/headquarters.

1-3 total staff (including all employees)
4-5 total staff
6-10 total staff
11-15 total staff
16-25 total staff
26-50 total staff
Over 50 total staff
Required 5.
Do you personally currently feel the effects of job-related burn-out? Feel free to tell us about it in detail in the comments section.

Yes
No
Other  
  • Comment:

  • 500 characters left.
Required 6.
Have you personally felt the effects of burn-out in the past (but no longer feel such effects)? Feel free to tell us about it in detail in the comments section.

Yes
No
Other  
  • Comment:

  • 500 characters left.
Required 7.
What do you feel are the main contributors to your stress and burn-out? Select all that apply. If you do not personally feel such stressors, feel free to answer based on your observation of colleagues'/peers' experiences. Please provide any details you want in the comments section. 

Bureaucracy / red tape
Management's style of leadership
Outdated technology
User-unfriendly technology
Badly designed / poor-performing technology
Fighting the insurance companies
Repetitive tasks such as benefits / eligibility verification
Difficult patients
Difficult colleagues / workplace conflict
Outdated medical equipment
Long commute/bad traffic
Getting patients to pay their bills / bad patient debt
Patient no-shows
Handling emails / too many emails
Managing workflows / to-do lists
Getting colleagues to execute on their tasks so you can do your job
Managing the waiting room experience / wait times for patients
Excessive documentation / charting time
Insufficient salary / financial compensation
Poor benefits (bad health insurance, not enough PTO, etc.)
Other  
  • Comment:

  • 500 characters left.
8.
Optional:

Please use this section to tell us anything else you want us to know about stress and burn-out among healthcare professionals. Your answers will help us understand this important issue and may lead to new solutions, and this survey is completely anonymous. You will NOT be quoted by name and your personal details will not be published, so be as frank and open as you like.
 

1000 characters left.
Required 9.
What is your gender?
Male
Female
Prefer not to answer
Required 10.

What is your highest level of education?

Did not graduate from high school
High school diploma
Associate's degree
Bachelor's degree
Some graduate work
Master's degree
MD, PhD, or other doctoral degree
Other  
11.
Which category describes your age?
Younger than 18
18 - 24
25 - 34
35 - 44
45 - 54
55 - 64
65 or older
Prefer not to answer
12.
What best describes your employment status?
Employed full-time
Employed part-time
Self-employed
Not employed, but looking for work
Not employed, not looking for work
Retired
Student
Prefer not to answer
Other  
  • Comment:

  • 500 characters left.
13.
Which category best describes your annual income? While not required, we do appreciate an answer because we are also studying the relationship between compensation and burn-out.
Under $15,000
$15,000 - $29,999
$30,000 - $44,999
$45,000 - $59,999
$60,000 - $74,999
$75,000 - $89,999
$90,000 - $99,999
$100,000 - $119,999
$120,000 - $139,999
$140,000 - $159,999
$160,000 - $179,999
$180,000 - $199,999
$200,000 - $249,999
$250,000 or more
Prefer not to answer