The Pennsylvania Society for PALTC Medicine
2022 Membership Survey
1. What is your age?
20-30
31-40
41-50
51-60
61-70
71+
2. What is your gender?
Male
Female
Non-Binary
Prefer Not to Answer
3. What is your race?
Please Select
White, Non-Hispanic
Black/African American
Hispanic/Latino
South Asian
East Asian
Southeast Asian
Native American
Native Hawaiian
Two or More Races
Other
Prefer Not to Answer
4. # of Years in PALTC Practice
0-5
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45+
5. Membership Category
Please Select
Medical Director
Physician
Nurse Practitioner
Practice Manager
Physicians Assistant
Doctorally-Prepared Clinician
Allied Health Professionals
Retired/Emeritus
Student
6. Physician Primary Board Specialty
Please Select
Internal Medicine
Family Medicine
Physical Medicine and Rehab
Psychiatry
7. Physician Sub-Board Specialties (select all that apply)
Endocrinology, Diabetes
Geriatric Medicine
Geriatric Psychiatry
Hospice and Palliative Medicine
Pain Medicine
Other
8. NP Board Specialties (select all that apply)
Acute Care
Adult Gerontology
Family Practice
Psychiatric Mental Health
Women's Health
Other
9. Are you a Medical Director?
Yes
No
10. # of Years as a Medical Director
< 5
6-10
11-15
16-20
21-25
26+
N/A
11. What other associations/organizations are you a member of?
AMDA State/Regional Chapter
American Geriatrics Society (AGS)
American College of Physicians (ACP)
American Academy of Family Physicians (AAFP)
American Medical Association/American Osteopathic Association (AMA/AOA)
American Academy of Hospice and Palliative Medicine (AAHPM)
Gerontological Advance Practice Nurses Association (GAPNA)
N/A
Other
12. Percent of Roles in PALTC - Should total 100%
% of Role
% of Centers
Medical Director
Attending Physician
CMP/CCO/VP Medical Affairs
Medical Consultant Provider/Practitioner
Nurse Practitioner
Other
13. Where is your time spent? - Should total 100%
%
Nursing Home
Hospital
SNF/Sub-Acute/Post-Acute
Assisted Living
Hospice
Academia/University
Home Care
Acute Care
CCRC
Post-Acute Care Hospital (LTAC/IRF)
PACE (or other community-based program)
Office
Other, please specify
14. How do you value your PMDA membership?
Very Poor
1
2
3
4
Excellent
5
1 is Very Poor, 5 is Excellent
15. How important are the following PDMA membership benefits?
Very Important
Unimportant
N/A (Not familiar)
Advocacy
Annual Conference Fee Discount
Spring Symposium Fee Discount
CME Credits
CMD Credits
Peer Networking
Your Professional Home
Monthly E-Newsletter
Job Listings
Professional recognition and leadership opportunities
Website
PALTC Forum
16. How well do you believe PMDA advocates on your behalf?
Very Poor
1
2
3
4
Very Well
5
1 is Very Poor, 5 is Very Well
17. What social media channels/outlets do you use most?
Twitter
Linked-In
Instagram
Facebook
Tik Tok
Other
18. Would you be interested in joining the Membership Committee?
Yes
No
If yes, please provide your email address
19. How would you prefer to attend the Annual Symposium (PMDA's premier educational event held annually in the fall)?
Virtually
In person
20. How would you prefer to attend the Regional Meetings (PMDA’s bi-annual evening educational forums broadcasted to multiple in-person satellite locations and for individual viewing)?
Virtually
In person at a satellite location near me
21. What barriers, if any, might you face in attending the PMDA's annual symposium or regional meetings?
Cost
Location
Time of Day
Other
Submit
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