COMS Members Survey
for 2014 Planning
Click check box to enter selection☒; click again to deselect☐
1.How interested are you in the following topics and associated potential speakers for a regular COMS dinner meeting? Note: The scale ranges from 1indicating the most interests and 5the least
MostInterestedLeast
12345 Topic - Potential Speakers
☐☐☐☐☐Physician Performance Evaluation in Central Oregon – SanazAskari, DO
☐☐☐☐☐ICU and Community-Practice Improvement–Keith Harless, MD
☐☐☐☐☐Data Collection for CMS – presenter to be provided by Mike Mastrangelo, MD
☐☐☐☐☐End of Life Care-Physician Assisted Death with Dignity –
Laura Mavity, MD, and/or Rick Maunder, MD
☐☐☐☐☐Volunteers in Medicine Clinic of the Cascades – Ron Carver, MD
☐☐☐☐☐Organizational Culture: How to Diagnose, Change, and Maintain –Marianne Berglund
☐☐☐☐☐Retired Physicians: Life after Retirement - Norwyn Newby, MD, TomCarlsen,MD, and/or Bill Lee, MD
☐☐☐☐☐Serving/Working in Unusual Places – Mike Mara, MD, RayTienMD, KentYundt, MD, and/or DickKoening, MD
☐☐☐☐☐Managing Career Change with Family - Jennifer Blechman, MD
☐☐☐☐☐Community Planning and Concerns - Bend City Manager
☐☐☐☐☐Astronomy and the Star Above – Sunriver or Pine Mt. Observatory presentation
☐☐☐☐☐Boom Varietal (wine from scratch)Documentary-Sky Pinnick, Kirk Ermisch
☐☐☐☐☐Fishing inRussia- David Wood, MD
2.I havesuggestions other topics/speakers for
Our regular dinner meetings:Click here to enter text.
Our Family Day:Click here to enter text.Our Holiday Celebration:Click here to enter text.
3.Medical specialties have increasingly been accepting Physician Assistants (PAs) into their membership. Should COMS expand its membership to includePAs (along with spouses)?
☐Yes☐No☐Uncertain
Comment:Click here to enter text.
4.On Thursday evening, September 19, COMS will host the 3rd Pease Symposium along with St. Charles Foundation,BMC,VIM, COIPA, COCC, OSU-Cascades, and PacificSource at the Riverhouse Convention Center. Would you be willing to serve on one of the planning efforts?
YesApproximate Time Commitment
☐Exhibits (recruit and herd exhibitors)2 hours
☐ Social Committee (including spouse events)3 hours
☐ Marketing (PR) Committee (advertise event)3 hours
☐Pease Recognition(present memories of Brad)1 hours
Please contact me at:Click here to enter text.
5.[Skip this question if you have not visited the COMS website:
The COM website is attracting more visitors (nearly 2000 unique visitors per month).To assess the impact of our website on our own members, please indicate which of the following topics, if any, you have visited?
☐ Homicides, Suicides, Guns
☐ Alternative/Complementary Medicine
☐ Oregon’s Vaccination Debit
☐ Religion and Society
☐ Sports Medicine
☐ Screening Mammography
☐ Prostate Cancer Screening
☐ U.S. Healthcare Reform
☐ Overtreatment
☐ Central Oregon News
☐ Leadership and Collaboration
Website recommendations: Click here to enter text.
6.Please check all categoriesPaidNotDon’t know Not a
that you currently represent:Membermemberpaidif paidmember
COMS☐☐☐☐☐
COIPA☐☐
OMA☐☐
BMC☐☐
7.For a membership drive,Would like to,Prefer
I would be willing to:Definitelybut reluctantly not to No
- Recruit at least one new member ☐☐☐☐
- Recruit a new member if my membership fee
for the year was halved ($75)☐☐☐☐ - Pay 1 year membership for a new, young
member (e.g. within 1st 5 years of practice)☐☐☐☐
8.Please enter any comments that you would like to make and/or your name or spouse's name if you are willing to be identified (optional): Click here to enter text.
Your name (optional): Click here to enter text.Spouse name (optional): Click here to enter text.
May COMS contact your spouse for event info? ☐No☐Yes If yes, how? Click here to enter text.
Thank you for completing and leaving at the sign-in deskor mailing it toP.O. Box 6491, Bend OR 97708
You may complete this survey onlineat .com/s/GQY2PM9
or download a pdf version at
Bleyer COMS Survey 9/11/2018