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_http://www.crescendocg.com/surveys/acoem.htm_

(http://www.crescendocg.com/surveys/acoem.htm)

Thank you for agreeing to participate in this study with the American

College of Occupational and Environmental Medicine (ACOEM). We are particularly

interested in hearing from individuals who know how their organization chooses

physicians who provide medical services to employees and provide consultation

to management.

The survey will take less than 15 minutes to complete. Everyone who

completes the survey and provides contact information will receive an executive

summary with the aggregate results for your own use.

Your individual responses will remain confidential. Please feel free to give

your honest and candid opinions.

Please maximize your browser window for easier reading.

1. Which of the following most closely describes your job title or position?

President or CEO

HR executive or manager

CFO

Risk manager

Safety manager

Fulltime Medical Director/Chief Medical Officer

Physician in private practice

Nurse case manager or occupational health nurse

Claims manager or executive

Provider network manager

Insurance broker or consultant

Other (please describe)

2. To begin with, please rate the importance of the following list of

business and health initiatives on a scale of 1-5, with “1†being “not at

all

important†to “5†being “extremely important. " When we say

“important, " we mean

it is important enough that you are either spending some of your company's

money on it now or planning to do so. With that definition in mind, how

important is:

Not at all important Extremely important 1 2 3 4 5 a. Employee

wellness - keeping employees healthy and maximizing workforce productivity

b. Controlling overall workers' compensation and disability costs c.

Company return-to-work programs and other ways of reducing lost workdays due

to medical conditions d. Initial and follow-up medical care of

work-related injuries e. Injury management and/or disability management

for

individual cases f. Managing very complex claims or litigated workers'

compensation cases g. Pre-hire or pre-placement medical or functional

testing exams h. Complying with mandatory regulatory programs like OSHA,

DOT

and so on

3. Which two of the above management initiatives have had the most positive

impact on your business?

4. How often does your organization use the following services in any given

year? Please indicate your frequency of use on a scale from 1-5, with “1â€

being “not frequently†and " 5 " being “very frequently. "

Not frequently Very frequently 1 2 3 4 5 a. Pre-hiring medical

tests b. Surveillance/regulatory compliance (DOT testing, OSHA

screenings)

c. Initial care for injuries d. Return-to-work planning e.

Medical management or disability management f. Independent medical exams

(IMEs) and other medical support for complex or litigated cases

5. What types of physicians or medical specialties do you typically use for

these services?

Employee's usual physician Hospital emergency room/trauma center

Occupational medicine or industrial medicine doctors/clinics Walk-in care

centers

Ortho, neuro or other specialty Other (please specify) a. Pre-hiring

medical tests b. Surveillance/regulatory compliance (DOT testing, OSHA

screenings) c. Initial care for injuries d. Return to work

planning

e. Disability management f. Medical support for complex or

litigated cases

6. If there were one thing you wished more physicians would do (or know)

about your business, what would it be?

7. In your opinion, what percentage of all your organization's work injuries

that need medical care require more than a few days away from work for

strictly medical reasons?

Less than 10%

10% - 25%

25% - 50%

50% - 75%

75% - 100%

8. On a scale of 1-5 with " 1 " being " not valuable " to " 5 " being " extremely

valuable, " how strongly do you value each of these items in a medical

provider?

Not valuable Extremely valuable 1 2 3 4 5 a. Streamlined billing

procedures b. Sympathy to the employer's point of view c. Advocacy

for injured worker d. Willingness to talk to you on the phone e.

Improving employee's return to work performance f. Prompt delivery of

information to support claim management g. Integrity, neutrality,

impartiality h. Board certification in a medical specialty i.

Ability to

give clear advice re: employee medical restrictions j. Knowledge of

workers' compensation system & law k. Knowledge of OSHA and other

regulatory

programs

9. When you think of occupational medicine in general, what comes to mind?

10. Below are some statements about Occupational Medicine physicians. Please

indicate how much you agree or disagree with each statement on a scale of

1-4, with " 1 " being " disagree strongly " and " 4 " being " agree strongly. " How

strongly do you agree with the statement that:

Disagree Strongly Agree Strongly 1 2 3 4 a. Occupational

physicians do a better job than other medical specialties in helping to control

medical care cost increases. b. Occupational physicians do a better job

than

other specialties in helping to keep employees at work or return them to work

as soon as it is safe to do so. c. Occupational physicians understand

employer needs. d. Occupational physicians are strong advocates for the

health and safety of our employees. e. Occupational physicians are

independent and willing to call it as it is, even when we're paying them.

11. When you think of the American College of Occupational and Environmental

Medicine, what is the first thing that comes to mind?

12. Below are some statements about the American College of Occupational and

Environmental Medicine. Please indicate how much you agree or disagree with

each statement on a scale of 1-4, with " 1 " being " disagree strongly " and " 4 "

being " agree strongly. "

ACOEM is:

Disagree strongly Agree Strongly 1 2 3 4 a. A national medical

society dedicated to promoting and protecting the health of workers. b. A

professional society for physicians who are board-certified in occupational

medicine as well as other physicians who share a common interest in the field.

c. A professional society of occupational & physical therapists

d.An educational resource for physicians of all specialties who want to learn

more about the field. e. A resource for employers or insurers who want to

find a qualified occupational medicine physician. f. An important source

for evidence-based medical treatment guidelines and standards for disability

prevention and management.

13. There are a multitude of complex technical, financial, and legal details

surrounding workers' compensation and disability programs today. What do you

see as the most important issues facing Occupational Medicine now and in the

future? (Check all that apply)

Finding physicians who understand workplace issues

Building provider networks based on quality measures

Perceived integrity and independence of the occupational medicine profession

The diminishing role of government enforcement

Unmet need for more physicians who understand disability

prevention/disability management

Other (please specify)

14. Which of the following issues do you think ACOEM could help address?

(check all that apply)

Providing referrals to providers who meet ACOEM standards

Serving as an objective and independent voice regarding complex issues

Training non-occupational physicians regarding workplace issues

Providing backup and support to local physicians regarding disability

prevention/disability management

Other (please specify)

15. Finally, which of the following intiatives do you believe are most

likely to improve the entire U.S. workers' compensation system? (check all that

apply)

Education and training for employers, employees and physicians

Research to find evidence-based methods for better describing work capacity

and job demands

Research to better understand and improve functional outcomes from specific

medical conditions

Incentives for employers to support return-to-work more actively

Practical assistance and support to ill, injured and aging employees

Better communications methods between physicians, employers and insurers

We're almost done now - just a few more demographic questions to go. Thank

you very much for all the help you have given us so far.

16. Which of the following most closely describes the type of organization

in which you work? (you may select more than one)

Insurance carrier

Insurance broker or consultant

Third-party claims administrator

Employer that is self-insured or partially at risk for workers' compensation

Employer that is self-insured or partially at risk for short-term disability

Employer that is full-insured for both workers' comp and disability

Managed care organization or provider network

Other (please describe)

17. In how many of the United States do you operate facilities or have

employees working?

1-4

5-9

10-39

40+

18. In which state are you located?

Two letter postal code

19. Approximately how many individuals work for your organization?

Less than 100

100-499

500-999

1,000-4,999

5,000-9,999

10,000-24,999

25,000-49,999

More than 50,000

20. Some companies have more than one person involved in these kinds of

issues, but from different angles. Is there another person working for your

company we should invite to take this survey in order to understand how your

company sees the issues discussed here?

Name E-mail

21. If you have the name of a colleague at another company you can recommend

to us, please fill in his or her contact information below.

Name Company E-mail

Thank you very much for your time and thoughtful responses to our questions.

22. If you would like to receive a summary of the aggregate results, please

provide the following contact information.

Name Phone Title Company *E-mail

*Your e-mail address will be confidential and only used to send you an

Executive Summary when the survey is completed.

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