doctors questionnaire - doctors questionnaire responding is voluntary! ... sub-sample: 1 — family...

Serial number

Doctors

Questionnaire

Responding is voluntary!

Name of settlement: ................................................ district in Type of workplace: 1 — academic clinic

2 — national institution 3 — hospital 4 — surgery 5 — specialist (outpatient) clinic

Sub-sample: 1 — family doctor 2 — paediatrician 3 — physician 4 — surgeon 5 — neurologist and alienist

I hereby declare that I will treat all the data obtained as confidential and will disclose for competent researcher only.

Interviewer’s signature: ........................................................... ID number Date and time at the start of the interview:

………hour………minute day………month………..1999

Doctors questionnaire TÁRKI ______________________________________________________________________________________

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1. Gender of respondent: 1 — male 2 — female X —

2. In which year were you born?

In 19…….

X —

3. In which year did you get your medical degree?

In 19…….

X —

4. How many special examinations do you have?

........... special examination(s) 0 — no special examination Go to 7 X —

SHOW ANSWER SHEET 1 5. What type of special examination do you have?

Code

1.

X

2.

X

3.

X

4.

X X —


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6. IF HE/SHE IS NOT WORKING AS A FAMILY DOCTOR! What is your assignment?

01 — resident 02 — specialist 03 — adjunct 04 — head physician 05 — departmental head physician 06 — director

— In the academic hierarchy:

07 — trainee 08 — clinician 09 — adjunct 10 — docent 11 — professor 12 — professor and head of department

X — 7. What is your marital status? Represent the real state, not just the official one, please!

SINGLE 1 – single, no companion

2 – single, living with a companion MARRIED 3 – married, living with a spouse

4 – married, living with a companion 5 – married, but living separately, no companion

DIVORCED 6 – divorced, no companion 7 – divorced, living with a companion

WIDOW(ER) 8 – widow(er), no companion 9 – widow(er), living with a companion X –

8. IF HE/SHE HAS A SPOUSE OR A COMPANION! Your spouse or companion is…..

1 — also a doctor 2 — not a doctor, but as a graduate he/she is(was) a public health worker, 3 — not graduated but he/she is employed in public health, 4 — manager, or rather an intellectual worker outside public health, 5 — working for another profession?

6 — He/She has never been employed. (still studying, housewife etc.) X —


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9. Were there doctors among your parents, grandparents, or in your wider family?

1 — several 2 — yes there was (one) 3 — no 9 — DOESN’T KNOW X —

10. With which statement could you characterise yourself? Answer from the ANSWER SHEET 2 please!.

3 — I am religious and I follow the doctrines of the Church. 2 — I am religious in my own way. 1 — I can not tell if I am religious, or not. 0 — I am not religious.

X —

11. Now I am going to read a statement! Please tell me about whether you completely agree, somewhat agree, somewhat disagree, or completely disagree! The doctor’s social status has to be more exalted than his patients.

4 — strongly agree 3 — somewhat agree 2 — somewhat disagree 1 — strongly disagree 9 — DOESN’T KNOW X —

12. Do you have a management membership in any medical organisation?

1 — yes 0 — no Go to 14 X —

13. In which medical organisation do you have a management membership?

MENTIONED NOT MENTIONED

a. Hungarian Chamber of Medical 1 0 X

b. MOTESZ 1 0 X

c. Other 1 0 X

X —


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14. Are you a member in a professional board?

1 — yes 0 — no X —

IF HE/SHE IS WORKING AS A SPECIALIST: GO TO QUESTION 30!


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FROM QUESTION 15 TO 29: ASK FAMILY DOCTORS ONLY

15. How many patients did you collect cards from?

................... person(s) 99 — DOESN’T KNOW X —

16. What are the ages of the patient group, you accept card from?

1 — only from adults, 2 — only from children, or 3 — from both?

4 — other X —

17. In what kind of organizational frame do you work? Practising…

1 — as a self-sufficient, 2 — as an entrepreneur, 3 — as an employee at an entrepreneur doctor, or 4 — as a public servant?

5 — other X —

18. Do you have the duty to supply an area?

1 — Yes 0 — No Go to 20 X —

19. Do you have any patients who are not pertaining to your area?

1 — yes 19a Approximately how many?

................... person(s) 99 — DOESN’T KNOW X —

0 — no 9 — DOESN’T KNOW X —


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20. Were you the local doctor here before the introduction of the family doctor-system?

1 — yes 0 — no Go to 22 X —

21. In which year did you start to work here as a local doctor?

In 19……. 99 — DOESN’T KNOW

X —

ASK EVERY FAMILY DOCTOR

22. What percentage of your patients have you known for more than five years?

........................% 999 — DOESN’T KNOW

X —

23. Since when have you been working here as a family doctor?

…….month 19………year

X — X —

24. Have you ever worked for ...

yes no

a. ... a hospital? 1 0 X

a1. a university hospital 1 0 X

a2. a national / regional institution 1 0 X

a3. a county hospital 1 0 X

a4. a town hospital 1 0 X

b. ... a polyclinic? 1 0 X

c. ... another public health institution? 1 0 X

IF YES: What type(s) of hospital(s)

have you worked for?


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25. Nowadays, are you working for a ...

yes no

a. ... hospital (beside sickbed)? 1 0 X

b. ... polyclinic, outpatients’ department? 1 0 X

26. What percentage of your patients in your practice are old (over 60 years)?

........................% 999 — DOESN’T KNOW

X —

27. And what percentage of your patients in your practice are children (under 15 years)?

........................% 999 — DOESN’T KNOW

X —

28. And what percentage of your patients in your practice is healthier than the average of their age group?

........................% 999 — DOESN’T KNOW

29. And what percentage of your patients in your practice do you regard as poor?

........................% 999 — DOESN’T KNOW


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FROM QUESTION 30 TO 35: ASK SPECIALISTS ONLY

30. How long have you been working at this special area?

19 ............. 999 — DOESN’T KNOW

X —

31. How long have you been working for this workplace?

19 ............. 999 — DOESN’T KNOW

X —

32. Have you ever been worked for a ...

yes no

a. ... hospital? 1 0 X

a1. university hospital 1 0 X

b2. national / regional institution 1 0 X

c3. county hospital 1 0 X

d4. town hospital 1 0 X

b. ... polyclinic? 1 0 X

c. ... other public health institution? 1 0 X

33. IF HE/SHE IS NOT A PAEDIATRICIAN What percentage of your patients in your practice are old (over 60 years)?

........................% 999 — DOESN’T KNOW

X —

34. And what percentage of your patients in your practice is healthier than the average of their age group?

........................% 999 — DOESN’T KNOW

IF YES: What type(s) of

hospital(s) have you

worked for?


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35. What percentage of your patients in your practice, do you regard as poor?

........................% 999 — DOESN’T KNOW

TO EVERYONE! 36. One of The mostly discussed topics of the Hungarian public health is the question of gratuity. Please

tell me about whether you completely agree, somewhat agree, somewhat disagree, or completely disagree with the following statements!

Completely agree

Somewhat agree

Somewhat disagree

Completely disagree

DK

a. It is reassuring for patients to give gratuity, because they feel they bought extra attention.

4 3 2 1 9 X

b. Gratuity makes no difference. 4 3 2 1 9 X

c. Gratuity undermines the confidence, which is indispensable in the doctor-patient relationship.

4 3 2 1 9 X

d. Gratuity is a necessary bad thing. 4 3 2 1 9 X

e. Doctors accept gratuity justly until the state pays enough money for them. 4 3 2 1 9 X

f. That doctor who accepts gratuity is morally disapprovable. 4 3 2 1 9 X

g. Gratuity is awkward and humiliating both for doctors and patients. 4 3 2 1 9 X

h. The existence of the gratuity shows that doctors are underpaid according to the society.

4 3 2 1 9 X

i. Gratuity is not a moral question. 4 3 2 1 9 X

37. Doctors are criticised by many people, that they accept extra money for using hospital bed, operating room, instruments etc., which are collective property. It is said it is like the „black taxi” in the time of deficiency economy: the civil servant driver undertook private carriages by the state property car, and kept the income. Do you think this comparison …

1 — is totally correct, 2 — consists some truth, but from one aspect it is imprecise, or 3 — is totally false?

9 — DOESN’T KNOW X —


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38. Gratuity is theoretically a taxable income. In spite of this, there are some doctors who do not, or just partly return this income. Now I am going to read some statements in connection with this. How much do you agree with these? Completely or somewhat agree, somewhat or completely disagree.

Completely agree

Somewhat agree

Somewhat disagree

Completely disagree

DK

a. Such a practice is awkward and humiliating, but humanely understandable. 4 3 2 1 9 X

b. It is immoral that the state who underpays doctors, claims the tax income which originates from them.

4 3 2 1 9 X

c. It is reprehensible that when a doctor does not return his total income, even if a part of that is from gratuity.

4 3 2 1 9 X

39. In your opinion, how many of ten patients would give gratuity...

GIVE GRATUITY DK

a. to a family doctor? 99 X

b. to a paediatrician? 99 X

c. at an outpatient department? 99 X

d. to an obstetrist? (hospital) 99 X

e. to a physician? (hospital) 99 X

f. to a surgeon? (hospital) 99 X

g. to an ophthalmologist? (hospital) 99 X

h. to a psychiatrist? (hospital) 99 X

i. to medical assistants? (hospital) 99 X


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40. In your opinion, what percentages of family doctors regularly accept gratuity? And what percentage of gynaecologists, and...?

PERCENTAGE? DK

a. FAMILY DOCTORS? % 999 X

b. OBSTERISTS, GYNECOLOGISTS? % 999 X

c. physicians? % 999 X

d. surgeons? % 999 X

e. hospital paediatricians? % 999 X

f. psychiatrists? % 999 X

41. According to different surveys, gratuity splits disproportionately among the members of the doctors’ society. Someone receives really much, other receives really little or nothing. In your opinion what percentage of doctors receive really much? And what percentage of doctors receive ...

Percentage? DK

a. REALLY MUCH % 999 X

b. moderately much, % 999 X

c. little, % 999 X

d. nothing? % 999 X

TOTAL 100%

42. What do you think the amount of gratuity depends on? SHOW CARD 3. 1 — speciality 2 — status 3 — reputation 4 — the length of time spent in this profession 5 — whether he/she can decide on assignments, out of turns, and other similarities 6 — aggressiveness 7 — performance

8 — other 9 — DOESN’T KNOW X —

THERE CAN BE SEVERAL ANSWERS


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43. I would like you to estimate that on averages what percentage of a doctor’s net income comes from... percentage? DK

a. ... gratuity? % 999 X

b. And what is the percentage at those who receive the greatest amount of gratuity? % 999 X

c. And what is the percentage at those who receive the least amount of gratuity? % 999 X

44. Could you estimate that 10 years ago what percentage of the doctors...

percentage? DK

a. regularly accepted gratuity? % 999 X

b. And generally what percentage of a doctor’s income came from gratuity? % 999 X

c. And what percentage was at those who received the greatest amount of gratuity?

% 999 X

d. And what the percentage was at those who received the least amount of gratuity?

% 999 X


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45. I would like you to estimate again. In your opinion, how much money does a patient usually give on the following occasions?

How much? nothing DK

a. When the physician in attendance comes at night? HUF 0 9 X

b. For a routine gynaecological examination at a polyclinic? HUF 0 9 X

c. For measuring blood pressure? (at surgery) HUF 0 9 X

d. To a gynaecologist in case of giving birth? (including prenatal care)

HUF 0 9 X

e. For giving an injection? (at the surgery) HUF 0 9 X

f. For a lesson to the physiotherapist? HUF 0 9 X

g. For a radiotherapic treatment? HUF 0 9 X

h. When the doctor put somebody on the sick list even if he/she is not ill?

HUF 0 9 X

i. In case of operation on appendix or on bile to the operating surgeon?

HUF 0 9 X

j. To paediatrician, or to family doctor who comes to the house monthly?

HUF 0 9 X

k. To paediatrician if he/she comes to the house to give the compulsory vaccinate?

HUF 0 9 X

l. For a massage? HUF 0 9 X

m. In case of tonsillectomy? HUF 0 9 X

n. In case of operation on the heart to the operating surgeon? HUF 0 9 X

o. In case of pensioning off, even if he/she is capable of work? HUF 0 9 X

p. In case of X-ray examination? HUF 0 9 X

46. The opinions of population extremely vary in the judgement of doctors. One’s doctor never accepts gratuity, on the other hand, other is complaining because his doctor does even his duty only for money. In your opinion, what percentage of doctors belongs to the latter group?

..................... % do his duty for money 999 — DOESN’T KNOW

X —


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47. And what the percentage of doctors who – sometimes accept gratuity, other time do not - considering his patient’s financial situation?

...................... % sometimes accept, other time do not


48. And what percentage of doctors never accepts gratuity?

..................... % never accept gratuity


49. In the majority of doctors, the quality of service does not depend on getting gratuity or not, or on the amount of the gratuity. But there are some doctors who select according to gratuity. In your opinion what percentage of the doctors select according to gratuity?

..................... % select according to gratuity


50. Public health can go on in different ways in connection with gratuity. First possibility is increasing the income of doctors accompanied by the strict prohibition of gratuity. In your opinion, how much net income would be respectable for a ten year-practising doctor to be able to refuse gratuity? What percentage increase would it mean in comparison with the present incomes? And for...

Net monthly amount Percentile of increase? DK

a. a family doctor? HUF % 999 X

b. a Family paediatrician? HUF % 999 X

c. an obstetrist, gynaecologist?

HUF % 999 X

d. a physician? HUF % 999 X

e. a surgeon? HUF % 999 X

f. a hospital paediatrician? HUF % 999 X

g. a psychiatrist? HUF % 999 X


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51. Another possibility can be that patients could effect an insurance which replaces gratuity. This would be a legal income for doctors. It means there would be no roundabout process in taxation because the insurance company registers all payments. Let us assume that the one third of the amount which is paid out by the insurance company would go for taxation. (from 300 HUF: the doctor gets 200 HUF, and 100 HUF goes for taxation) The insurance company would pay a determined taxable, gross amount for each service. In your opinion, how much gross charge would be respectable in the following occasions:

CHARGE Nothing DK

a. When the physician in attendance comes at night? HUF 0 9 X

b. For a routine gynaecological examination at a polyclinic? HUF 0 9 X

c. For measuring blood pressure? (at surgery) HUF 0 9 X

d. To a gynaecologist in case of giving birth? (including prenatal care) HUF 0 9 X

e. For giving an injection? (in the consulting room) HUF 0 9 X

f. for a lesson to a physiotherapist? HUF 0 9 X

g. for a radiotherapy? HUF 0 9 X

h. When doctor put somebody on the sick list even if he/she is not ill? HUF 0 9 X

i. In case of operation on appendix, or bile to the operating surgeon? HUF 0 9 X

j. To paediatrician, or to family doctor who comes to the house monthly? HUF 0 9 X

k. To paediatrician, if he/she comes to the house to give the compulsory vaccinate?

HUF 0 9 X

l. For a massage? HUF 0 9 X

m. In case of tonsillectomy? HUF 0 9 X

n. In case of operation on the heart to the operating surgeon? HUF 0 9 X

o. In case of pensioning off, even if he/she is capable of work? HUF 0 9 X

p. In case of X-ray examination? HUF 0 9 X

52. Would you feel inclined to participate in such insurance system which would endows you for each

services?

1 — yes 2 — rather yes 3 — rather not 4 — no 9 — DOESN’T KNOW X —


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53. And would you be inclined to participate in an insurance-system where the patient paid for everything and the insurance company repaid her/his costs?


54. Would you be inclined to participate in a system where the insurance company repaid patient’s costs

only for extra services. (to be out of turn, private room etc.)?


55. Another possibility would be that the doctor had a legal private practice exclusively. In case the income from private practise is not supplementary. It is the exclusive origin of the income. So, the accusation of „black taxi” could not arise. In private practise there is free price calculation, so the doctor charges as much as he thinks reasonable, and as much as the patient tend to pay for. Would you approve of this possibility?

1 — yes 2 — rather yes 3 — rather not 4 — no Go to 57 9 — DOESN’T KNOW X —

56. Would you gladly work in this financing system?

1 — yes 2 — rather yes 3 — rather not 4 — no



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57. According to the final version, the doctor or a group of doctors have private practice inside a hospital or a clinic. The doctor charges the cost to her/his patient or her/his insurance company and pays rental fee to the owner of the hospital or the clinic. Would you approve this?

1 — yes 2 — rather yes 3 — rather not 4 — no Go to 59 9 — DOESN’T KNOW X —

58. Would you gladly work in this financing system?


59. To sum up, you would have to choose from the following financing systems.

Which is the most attractive to you? SHOW CARD 4.

1 — Doctors are fixed income employees with raised salary which brings an end to gratuity. 2 — There is a way to legalise gratuity with an insurance system, which compensates that. 3 — The doctor works in a pure private practice. 4 — The doctor pays for using the hospital or clinic equipments and get the patient or his

insurance company to compensate it. 5 — Do not change the actual practice, even if it is bad, but if we interfere this would be even

worse.

6 — other :.............................................. 9 — DOESN’T KNOW X —

60. What is the total area of your flat/house ?

.................... m2 X —


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61. What do you think, how much is the market value of your flat/house (with its garden)?

........................................ HUF 0 — do not live in an own flat (e.g. in sublease) 1 — live in an official residence 8 — refuses to give answer 9 — DOESN’T KNOW X —

62. If you add up all your payments, how much do you think your net monthly income is?

....................................... HUF/month 8 — refuses to give answer 9 — DOESN’T KNOW X —

63. In your circumstances, how much monthly net income would guarantee an acceptable standard of living for you?

....................................... HUF/month 8 — refuses to give answer 9 — DOESN’T KNOW X —

64. Does your total income... 1 — regularly reaches, 2 — occasionally reaches, 3 — never reaches this level?

8 — refuses to give answer 9 — DOESN’T KNOW X —

65. What do you feel about the financial situation of you and your family?

1 — living comfortably, 2 — doing all right if economising, 3 — just about getting by, 4 — having financial problems every month 5 — living in need?



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66. Where would you put yourself on this income scale? SHOW ANSWER SHEET 5.

66.1. comparing to other doctors: 1 2 3 4 5 6 7 8 9 10 worst best paid paid doctors doctors

99 — DOESN’T KNOW

X —

66.2. comparing to other people: 1 2 3 4 5 6 7 8 9 10 worst best paid paid people people

99 — DOESN’T KNOW

X —

67. Did you have any debt or owing money to private persons or workplace, the National Savings Bank, or other banks in March this year?

1 — yes 0 — no 9 — DOESN’T KNOW X —

68. Did anyone owe you any money this March?

1 — yes 0 — no 9 — DOESN’T KNOW X —

69. Do you (your family) have any...

yes no RA DK

a. ... company securities? 1 0 8 9 X

b. ... shares? 1 0 8 9 X

c. ... indemnity notes? 1 0 8 9 X


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70. Do you (your family) have any ...

yes no DK

a. ... transfer accounts? 1 0 9 X

b. ... bank bounds, savings bank accounts? 1 0 9 X

c. ... other bank books? 1 0 9 X

d. ... banking bonds (deposit tickets, treasury notes)? 1 0 9 X

e. ... investment bonds? 1 0 9 X

f. ... government bonds (e.g. government securities, exchequer notes)?

1 0 9 X

g. ... other securities? 1 0 9 X

h. ...savings for housing purpose (with a homing provident company)?

1 0 9 X

71. Do you(your family) have any ...

yes no RA DK

a. ... saved up foreign currency? 1 0 8 9 X

b. ... saved up money kept at home? 1 0 8 9 X

72. Do you(your family) have any...

IF HAS:

yes no RA How much is it worth altogether? RA DK a. ... valuable paintings,

antiquities? 1 0 8 X HUF 8 9 X

b. ... real estates beside this flat/house? 1 0 8 X HUF 8 9 X

c. ... agricultural landed property? 1 0 8 X HUF 8 9 X

d. ... building plot, empty piece of ground?

1 0 8 X HUF 8 9 X

e. ... county-cottage? 1 0 8 X HUF 8 9 X

f. ... car? How many cars do you have?

.....pieces 0 8 X HUF 8 9 X

g. ... trucks, tractors, other working vehicles? 1 0 8 X HUF 8 9 X


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73. From the ANSWER SHEET 6. What kind of things do you have?

yes no

a. HI-FI equipment 1 0 X

b. refrigerator 1 0 X

c. deep freezer 1 0 X

d. microwave oven 1 0 X

e. traditional washing machine 1 0 X

f. automatic washing machine 1 0 X

g. dishwasher 1 0 X

h. colour television 1 0 X

i. home alarm system 1 0 X

j. personal computer 1 0 X

k. IF NO COMPUTER=X! access to internet

1 0 X

l. video recorder and player 1 0 X

m. air conditioning system 1 0 X

n. sports equipment of over 100,000 HUF value 1 0 X

o. musical instrument of over 50,000 HUF value 1 0 X

p. Other machine, or capital equipment of over 100,000 HUF value 1 0 X

74. Do you(your family) have any...

IF HAS:

yes no How many approximately?

DOESN’T KNOW

a. ... books? 1 0 X ps. 9999 X

b. ... CD records? 1 0 X ps. 9999 X

c. ... LP records? 1 0 X ps. 9999 X

d. ... tapes? 1 0 X ps. 9999 X

e. ... videotapes? 1 0 X ps. 9999 X


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75. Thank you for your answers! Would you be willing to answer to our questionnaire at another time as well?

1 — yes 0 — no X —

76. Do you have telephone number?

1 — yes 0 — no X —

77. And would you answer to some short questionnaire on the phone?

1 — yes 0 — no X —

78. IF HE/SHE WOULD ANSWER PERSONALLY/ON THE PHONE

Please, sign this sheet! ADDRESS CARD This is to certify that you contributed your name and

address for us in order to find you at another time. Naturally, your name and address will not be given to other companies!

1 — signed the address card 0 — did not sign the address card X —

79. IF HE/SHE WOULD ANSWER TO A PHONE QUESTIONNAIRE Please, also give your whole telephone number!

Phone number ............... / ....................

Thank you very much, that you helped us with your answers!

Time at the end of interviewing: .......... hour .......... minute

ANSWER SHEET 1

The codes of question „What type of special examination do you have?” 01 - anaesthesiology 31 - thorax surgery 02 - general medical science 32 - locomotor rehabilitation 03 - internal pathology 33 - neonatology 04 - dermatology 34 - nephrology 05 - pedology 35 - neurology 06 - vessel surgery 36 - orthopaedy 07 - infectious diseases 37 - dental microbiology 08 - physiology 38 - oxiology 09 - dental surgery, odontology 39 - parasitology 10 - gastroenteorology 40 - pathophysiology 11 - paediatrician dental 41 - plastic-burn surgery 12 - paediatrician gynaecology 42 - psychiatry 13 - paediatrician psychiatry 43 - radiology 14 - paediatrician neurology 44 - rehabilitation 15 - paediatrician physiotherapy 45 - rheumatology and physiotherapy 16 - paediatrician surgery 46 - surgery 17 - family doctor science 47 - sports physiatry 18 - haematology 48 - radiotherapy 19 - hystology-patohystology-cytology 49 - odontology 20 - human genetics 50 - ophthalmology 21 - forensic medicine 51 - cardiosurgery 22 - judicial psychiatry 52 - tocology-gynaecology 23 - neurosurgery 53 - society medical science, public health organization 24 - immunology 54 - toxicology 25 - cardiology 55 - traumatology 26 - clinical laboratory analysis 56 - tropic diseases 27 - clinical oncology 57 - physiotherapy 28 - pathology-pathological histology 58 - urology 29 - district polyclinic science 59 - factory physician science 30 - public hygiene- epidemology 60 - otolaryngology 77 - other clinical 88 - other theoretical 99 - DOESN’T KNOW

doctors questionnaire - doctors questionnaire responding is voluntary! ... sub-sample: 1 — family...

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