January 15, 2004

The Modern Era of House Call Medicine in New York: Three Perspectives

Participant Survey 1/15/04

Welcome to the inaugural meeting of the Metropolitan Area Consortium on House Call Medicine.  This newly formed group, sponsored by the Fan Fox and Leslie R. Samuels Foundation, is for doctors, nurse practitioners, physician assistants and others who participate in home-based primary care programs in New York City.  Our goals are to foster the collegial exchange of ideas on a wide range of topics pertinent to medical care in the home.  Meetings will provide opportunities to meet colleagues, learn from experts, and identify and collaborate on shared challenges.  Each event will consist of a short lecture or panel discussion as well as time for informal meetings and discussions.  Please help direct the activities of the consortium by filling out this survey. 

 


Name__________________________
Affiliation________________________

1.  What topics would you like to learn more about?

TOPIC

LEVEL OF INTEREST

RANK TOP 5

 

0
(NONE)

1
(MIN)

2
(MOD)

3
(HIGH)

 

Practice management issues

         

Billing and documentation

         

Information systems

         

Advanced portable diagnostic and therapeutic technologies

         

Ethics and home-based care

         

Palliative care

         

Interdisciplinary care

         

In-home procedures

         

Provider safety

         

Specialist care in the home

         

Wound care

         

Working with case managers

         

Elder abuse and neglect

         

In-home language translation

         

Bringing trainees into the home

         

Psychiatric issues

         

Bereavement

         

Caregiver support

         

Community resources

         

Other:

         

Other:

         

Other:

         

Other:

         

2.  Are there topics on which you would be interested and willing to address the consortium members?

                                    ______ Yes

            Topics _____________________________

                        _____________________________

                        _____________________________

3.  Please list speakers that would be appropriate to address the consortium members:

Speaker

Affiliation

Topic

     
     
     
     
     

4.  Which days of the week are best for future events (circle all that apply)?

            Monday          Tuesday          Wednesday     Thursday        Friday

5.  What time of day is best for future events?

            Morning          Lunchtime       Afternoon       Evening          

6. Do you have any suggestions or feedback for improving the structure of tonight's gathering?

 

 


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