Skip to main content

Main menu

  • Home
  • Articles
    • Current
    • Published Ahead of Print
    • Archive
    • Supplemental Issues
    • Collections - French
    • Collections - English
  • Info for
    • Authors & Reviewers
    • Submit a Manuscript
    • Advertisers
    • Careers & Locums
    • Subscribers
    • Permissions
  • About CFP
    • About CFP
    • About the CFPC
    • Editorial Advisory Board
    • Terms of Use
    • Contact Us
  • Feedback
    • Feedback
    • Rapid Responses
    • Most Read
    • Most Cited
    • Email Alerts
  • Blogs
    • Latest Blogs
    • Blog Guidelines
    • Directives pour les blogues
  • Mainpro+ Credits
    • About Mainpro+
    • Member Login
    • Instructions
  • Other Publications
    • http://www.cfpc.ca/Canadianfamilyphysician/
    • https://www.cfpc.ca/Login/
    • Careers and Locums

User menu

  • My alerts

Search

  • Advanced search
The College of Family Physicians of Canada
  • Other Publications
    • http://www.cfpc.ca/Canadianfamilyphysician/
    • https://www.cfpc.ca/Login/
    • Careers and Locums
  • My alerts
The College of Family Physicians of Canada

Advanced Search

  • Home
  • Articles
    • Current
    • Published Ahead of Print
    • Archive
    • Supplemental Issues
    • Collections - French
    • Collections - English
  • Info for
    • Authors & Reviewers
    • Submit a Manuscript
    • Advertisers
    • Careers & Locums
    • Subscribers
    • Permissions
  • About CFP
    • About CFP
    • About the CFPC
    • Editorial Advisory Board
    • Terms of Use
    • Contact Us
  • Feedback
    • Feedback
    • Rapid Responses
    • Most Read
    • Most Cited
    • Email Alerts
  • Blogs
    • Latest Blogs
    • Blog Guidelines
    • Directives pour les blogues
  • Mainpro+ Credits
    • About Mainpro+
    • Member Login
    • Instructions
  • RSS feeds
  • Follow cfp Template on Twitter
  • LinkedIn
  • Instagram
Research ArticleResearch

Why are response rates in clinician surveys declining?

Ellen R. Wiebe, Janusz Kaczorowski and Jacqueline MacKay
Canadian Family Physician April 2012; 58 (4) e225-e228;
Ellen R. Wiebe
MD CCFP FCFP
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: ellenwiebe@gmail.com
Janusz Kaczorowski
PhD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jacqueline MacKay
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • eLetters
  • Info & Metrics
  • PDF
Loading

Abstract

Objective To understand why response rates in clinician surveys are declining.

Design Cross-sectional fax-back survey.

Setting British Columbia.

Participants Random sample of family physicians and all gynecologists in the College of Physicians and Surgeons of British Columbia’s registry.

Main outcome measures Accuracy of the College of Physicians and Surgeons of British Columbia’s registry, and the prevalence and characteristics of physicians with policies not to participate in any surveys.

Results Of 542 physicians who received surveys, 76 (14.0%) responded. On follow-up we found the following: the College of Physicians and Surgeons of British Columbia’s registry was inaccurate for 94 (17.3%) listings; 14 (2.6%) physicians were away; 100 (18.5%) were not eligible; and 197 (36.3%) had an office policy not to participate in any surveys. Compared with the respondents, physicians with an office policy not to participate in any surveys were more likely to be men, less likely to be white, more likely to have urban-based practices, and more likely to have been in practice for more than 15 years.

Conclusion Many physicians have an office policy not to participate in any surveys. Owing to the trend of lower response rates, recommendations of minimum response rates for clinician surveys by many journals might need to be reassessed.

Surveys of clinicians are an important source of information when designing, implementing, or evaluating new or existing programs and policies. Surveys are an efficient, inexpensive, and flexible way of collecting standardized information from a large number of respondents. A high response rate is generally seen as key to legitimizing a survey’s results. A number of medical journals, including national journals in the United States and Canada, recommend survey response rates of at least 60% to ensure that nonresponse bias does not threaten the validity of the findings.1,2

Although several systematic reviews have identified3–6 strategies to increase response rates, there has been a steady downward trend in clinicians’ response rates to surveys.7 Although faxed, mailed, and e-mailed surveys have similar response rates, McMahon et al suggest that a combination of these might be better than any one method.8

METHODS

We conducted a fax-back survey of family doctors and gynecologists in British Columbia originally designed to understand their knowledge about, attitude toward, and practices for handling side effects of hormonal contraceptives. We used a modified Dillman tailored design with pretesting, 3 fax or e-mail contacts, but no incentive reward or introductory letter or postcard before the survey (owing to budgetary and time constraints).9 The questionnaire was 2 pages long and included 15 questions. Our sampling frame consisted of every sixth family doctor in the alphabetic listing in the College of Physicians and Surgeons of British Columbia’s (the College) registry between 2008 and 2009 and every gynecologist in the same registry. Descriptive statistics and between-groups comparison were conducted using SPSS software, version 18. All statistical tests were 2-sided at a predetermined α level of .05. The study was approved by the University of British Columbia Behavioural Research Ethics Board. Because we had such a low response rate to the survey, we explored why this might have been the case.

RESULTS

Of 542 physicians who received faxed surveys (faxed 3 times), only 76 (14.0%) physicians responded. The research assistant then telephoned all the physicians who had not completed the surveys to determine whether they had clinical practices in which they saw women for contraception and whether there was an office policy pertaining to participation in surveys. We found that the College registry was inaccurate for 94 (17.3%) listings (eg, physicians were not in practice, wrong fax number). In addition, 14 (2.6%) physicians were away and 100 (18.5%) were not eligible because they did not see women for contraception (eg, their practices were limited to geriatrics or infertility). More important, 197 (36.3%) physicians had an office policy not to participate in any surveys.

Information from the College registry was used to compare the respondents with the eligible physicians with an office policy not to participate in any surveys and the other eligible nonrespondents. Compared with the respondents, physicians with an office policy not to participate in any surveys were more likely to be men, were less likely to be white, were more likely to have urban-based practices, and were more likely to have been in practice for more than 15 years (Table 1). The profile of physicians with an office policy not to participate in any surveys resembled closely the characteristics of nonrespondents.

View this table:
  • View inline
  • View popup
Table 1.

Characteristics of respondents, nonrespondents, and physicians with an office policy not to participate in any surveys: N = 335.*

DISCUSSION

While there is ample evidence about nonrespondents and their characteristics, there is little information on the prevalence and profile of physicians with an office policy not to participate in any surveys. Most of the evidence-based strategies to increase response rates are likely to be ineffective because physicians with such policies would never see any of the surveys addressed to them. The trend toward lower response rates to surveys and the high rate of clinicians who have a policy not to participate in any surveys indicates that conducting a mail or fax survey might no longer be an effective or useful method of collecting information about physicians’ knowledge of, attitude toward, and experiences with various medical practices. Low response rates also mean that it becomes more important to describe the nonrespondents for each survey.

If our results are representative of physician office policies in other jurisdictions, then the response rates of clinician surveys that are recommended by many journals might need to be reassessed. It is disturbing to see that so many clinicians have such policies, as their input is critical when designing, implementing, or evaluating new or existing programs and policies.

Acknowledgments

Dr Wiebe was supported by the Vancouver Foundation through a BC Medical Services Foundation grant to the Community-Based Clinical Investigator Program of the University of British Columbia’s Department of Family Practice.

Notes

EDITOR’S KEY POINTS

  • Clinician surveys are an important source of information to help plan education and policy, and a high response rate is generally seen as key to legitimizing a survey’s results.

  • The trend to lower response rates to surveys and the high rate of clinicians who have a policy not to participate in any surveys indicates that conducting a mail or fax survey might no longer be an effective or useful method of collecting information about physicians’ knowledge of, attitude toward, and experiences with various medical practices.

  • Many journals might need to reassess their recommended response rates for clinician surveys.

POINTS DE REPÈRE DU RÉDACTEUR

  • Les enquêtes auprès des cliniciens sont une importante source d’information permettant de mieux planifier la formation et les politiques, et on considère généralement qu’un taux élevé de réponses constitue un élément clé pour légitimer les résultats de ces enquêtes.

  • La tendance à la baisse des taux de réponse aux enquêtes et l’importante proportion de médecins qui ont comme politique de ne jamais participer aux enquêtes indiquent que les sondages postaux ou par télécopieur ne sont plus des moyens efficaces ou utiles pour recueillir de l’information sur les connaissances, attitudes et expériences des médecins concernant différentes façons de pratiquer la médecine.

  • Plusieurs revues pourraient devoir réévaluer les taux de réponse recommandés pour les enquêtes auprès de cliniciens.

Footnotes

  • This article has been peer reviewed.

  • Cet article a fait l’objet d’une révision par des pairs.

  • Contributors

    All authors contributed to the concept and design of the study; data gathering, analysis, and interpretation; and preparing the manuscript for submission.

  • Competing interests

    None declared

  • Copyright© the College of Family Physicians of Canada

References

  1. ↵
    1. JAMA [website]
    . JAMA instructions for authors. Chicago, IL: American Medical Association; 2012. Available from: http://jama.ama-assn.org/misc/ifora.dtl#SurveyResearch. Accessed 2010 Jul 27.
  2. ↵
    1. Burns KE,
    2. Duffett M,
    3. Kho ME,
    4. Meade MO,
    5. Adhikari NK,
    6. Sinuff T,
    7. et al
    . A guide for the design and conduct of self-administered surveys of clinicians. CMAJ 2008;179(3):245-52.
    OpenUrlFREE Full Text
  3. ↵
    1. Edwards PJ,
    2. Roberts I,
    3. Clarke MJ,
    4. Diguiseppi C,
    5. Wentz R,
    6. Kwan I,
    7. et al
    . Methods to increase response to postal and electronic questionnaires. Cochrane Database Syst Rev 2009;(3):MR000008.
    1. Nakash RA,
    2. Hutton JL,
    3. Jørstad-Stein EC,
    4. Gates S,
    5. Lamb SE
    . Maximising response to postal questionnaires—a systematic review of randomised trials in health research. BMC Med Res Methodol 2006;6:5.
    OpenUrlCrossRefPubMed
    1. Thorpe C,
    2. Ryan B,
    3. McLean SL,
    4. Burt A,
    5. Stewart M,
    6. Brown JB,
    7. et al
    . How to obtain excellent response rates when surveying physicians. Fam Pract 2009;26(1):65-8. Epub 2008 Dec 12.
    OpenUrlAbstract/FREE Full Text
  4. ↵
    1. Edwards P,
    2. Roberts I,
    3. Clarke M,
    4. DiGuiseppi C,
    5. Pratap S,
    6. Wentz R,
    7. et al
    . Methods to increase response rates to postal questionnaires. Cochrane Database Syst Rev 2007;(2):MR000008.
  5. ↵
    1. Cook JV,
    2. Dickinson HO,
    3. Eccles MP
    . Response rates in postal surveys of healthcare professionals between 1996 and 2005: an observational study. BMC Health Serv Res 2009;9:160.
    OpenUrlCrossRefPubMed
  6. ↵
    1. McMahon SR,
    2. Iwamoto M,
    3. Massoudi MS,
    4. Yusuf HR,
    5. Stevenson JM,
    6. David F,
    7. et al
    . Comparison of e-mail, fax, and postal surveys of pediatricians. Pediatrics 2003;111(4 Pt 1):e299-303.
    OpenUrlAbstract/FREE Full Text
  7. ↵
    1. Dillman DA
    . Mail and Internet surveys. The tailored design method. 2nd ed. Hoboken, NJ: John Wiley & Sons; 2007.
PreviousNext
Back to top

In this issue

Canadian Family Physician: 58 (4)
Canadian Family Physician
Vol. 58, Issue 4
1 Apr 2012
  • Table of Contents
  • About the Cover
  • Index by author
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on The College of Family Physicians of Canada.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Why are response rates in clinician surveys declining?
(Your Name) has sent you a message from The College of Family Physicians of Canada
(Your Name) thought you would like to see the The College of Family Physicians of Canada web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Why are response rates in clinician surveys declining?
Ellen R. Wiebe, Janusz Kaczorowski, Jacqueline MacKay
Canadian Family Physician Apr 2012, 58 (4) e225-e228;

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Respond to this article
Share
Why are response rates in clinician surveys declining?
Ellen R. Wiebe, Janusz Kaczorowski, Jacqueline MacKay
Canadian Family Physician Apr 2012, 58 (4) e225-e228;
Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Abstract
    • METHODS
    • RESULTS
    • DISCUSSION
    • Acknowledgments
    • Notes
    • Footnotes
    • References
  • Figures & Data
  • eLetters
  • Info & Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • Pediatric Tracheostomy Safety: Implementation of an Airway Safety Placard
  • Partner notification by family physicians for sexually transmitted infections: Facilitators and barriers
  • Surgeon perceived most important factors to achieve the best hospital performance on colorectal cancer surgery: a Dutch modified Delphi method
  • How do family physicians measure blood pressure in routine clinical practice?: National survey of Canadian family physicians
  • Prevalence of Barriers and Facilitators to Enhancing Conservative Kidney Management for Older Adults in the Primary Care Setting
  • Health workers who ask about social determinants of health are more likely to report helping patients: Mixed-methods study
  • How Patient Demographics, Imaging, and Beliefs Influence Tissue-Type Plasminogen Activator Use: A Survey of North American Neurologists
  • An international survey to identify the intrinsic and extrinsic factors of research studies most likely to change orthopaedic practice
  • Are primary care providers implementing evidence-based care for breast cancer survivors?
  • Surviving Surveys
  • Medical student views on the use of Facebook profile screening by residency admissions committees
  • Knowledge and understanding of urinary incontinence: Survey of family practitioners in northern Alberta
  • Google Scholar

More in this TOC Section

  • Primary care reform in Alberta
  • Administrative burden in primary care
  • Burden of administrative responsibilities in primary care
Show more Research

Similar Articles

Subjects

  • Collection française
    • Résumés de recherche

Navigate

  • Home
  • Current Issue
  • Archive
  • Collections - English
  • Collections - Française

For Authors

  • Authors and Reviewers
  • Submit a Manuscript
  • Permissions
  • Terms of Use

General Information

  • About CFP
  • About the CFPC
  • Advertisers
  • Careers & Locums
  • Editorial Advisory Board
  • Subscribers

Journal Services

  • Email Alerts
  • Twitter
  • LinkedIn
  • Instagram
  • RSS Feeds

Copyright © 2025 by The College of Family Physicians of Canada

Powered by HighWire