| Year
Graduated?:
|
| Years
as a Physician Assistant?:
|
| Years
employed in orthopaedics?:
|
| Program
graduated from?: |
Degrees you have attained?
 None
AA
BS/BA
MS
Ph.D |
| Area
degree or degrees in?: |
What
other area of training do you have?:
|
What area do you practice in?:
General Spine
Hand Shoulder/Elbow Sports
Pediatrics
Adult
Reconstructive Tumors Foot/Ankle Trauma |
Type of Practice?:
Solo
Multi-Specialty Academic
Program Military Other |
| What
state or region of U.S. do you practice?: |
|
Which of the following tasks do you perform? |
| |
Regular
Basis
> 50%
|
Occasionally
< 50%
|
Never
|
|
History |
|
|
|
|
Physical examination |
|
|
|
|
Interpretation of x-rays |
|
|
|
|
Cast application |
|
|
|
|
Wound suturing |
|
|
|
|
Wound management |
|
|
|
|
Assist in surgery |
|
|
|
|
Joint aspiration |
|
|
|
|
Joint injection |
|
|
|
|
Brace application |
|
|
|
|
K-wire insertion |
|
|
|
|
K-wire removal |
|
|
|
|
Wound I&D |
|
|
|
|
Administer digital blocks |
|
|
|
|
Administer regional blocks |
|
|
|
|
Closed fracture reduction |
|
|
|
|
Closed dislocation reduction |
|
|
|
|
Hardware removal |
|
|
|
|
Compartment pressure measurements |
|
|
|
|
Tendon repairs |
|
|
|
|
Percutaneous pinning of fractures |
|
|
|
|
Nail/callus care |
|
|
|
| Other
Tasks: |
|
|
|
|
|
Take Calls:
Yes
No Hours Per
Week:
|
|
Bones:
Yes No How
is this based?: |
| Percent
generated for practice?: |
Job
Performance?:
|
Overall
Practice Performance:
|
Other:
|
|
Benefits |
| |
%
Employer Paid
|
%
Self Paid
|
|
Health Insurance |
|
|
|
Life Insurance |
|
|
|
Professional Dues |
|
|
|
Licenses/Registration |
|
|
|
CME |
|
|
|
Profit Sharing |
|
|
| Other: |
|
|
|
