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Submission: On October 31 via api from US — Scanned from DE
Submission: On October 31 via api from US — Scanned from DE
Form analysis 1 forms found in the DOM
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<h2 style="font: 24pt Book Antiqua; margin-top: 20px;">American Board of Orthopaedic Surgery </h2>
<h2 style="font: 24pt Book Antiqua; margin-top: 20px;">Peer Review</h2>
<p id="ContentPlace_Main_P2" style="margin-top: 30px;margin-left:150px;margin-right:150px;"> The American Board of Orthopaedic Surgery (ABOS) appreciates Peer Review by orthopaedic surgeons, other physicians, and non-physician
professionals. You need not be an orthopaedic surgeon or be Board Certified by the ABOS to complete this Peer Review Survey.</p>
<p id="ContentPlace_Main_InstructionLabel" style="margin-top: 10px;"> Please complete all of the information before submitting.</p>
<p id="ContentPlace_Main_P3" style="margin-top: 30px;"> Peer Review of:</p>
<p id="ContentPlace_Main_P1" style="margin-top: 10px;">
<b>Dr. Jennifer Dauria</b><br>
<b>3471 Fifth Avenue, Suite 1010</b><br>
<b>Pittsburgh, PA</b>
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<p id="ContentPlace_Main_P4" style="text-align:left;margin-left:165px">Please evaluate Dr. Jennifer Dauria in the following areas:</p>
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<td style="width: 20%"> Unsatisfactory </td>
<td style="width: 20%"> Marginal </td>
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<span class="checkbox"><input id="ContentPlace_Main_EvalFormCare_0" type="radio" name="ctl00$ContentPlace_Main$EvalFormCare" value="EvalFormCare_0"></span><br> UA
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<td style="width: 6%"> </td>
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<td style="width: 20%"> Marginal </td>
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<span class="checkbox"><input id="ContentPlace_Main_EvalFormSkills_0" type="radio" name="ctl00$ContentPlace_Main$EvalFormSkills" value="EvalFormSkills_0"></span><br> UA
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<td style="width: 20%"> Unsatisfactory </td>
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<span id="ContentPlace_Main_LabelEvalFormAllowed">To your understanding, does Dr. Jennifer Dauria practice safe, ethical, and effective orthopaedic surgery and meet the highest standards of practice and conduct?</span><br>
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<span class="checkbox" groupname="Signature"><input id="ContentPlace_Main_Signature" type="checkbox" name="ctl00$ContentPlace_Main$Signature"></span> By checking this box, I attest that the responses recorded above have been
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</form>Text Content
AMERICAN BOARD OF ORTHOPAEDIC SURGERY PEER REVIEW The American Board of Orthopaedic Surgery (ABOS) appreciates Peer Review by orthopaedic surgeons, other physicians, and non-physician professionals. You need not be an orthopaedic surgeon or be Board Certified by the ABOS to complete this Peer Review Survey. Please complete all of the information before submitting. Peer Review of: Dr. Jennifer Dauria 3471 Fifth Avenue, Suite 1010 Pittsburgh, PA 1. Which best represents your relationship to the applicant? (Select one) Orthopaedic Colleague Current Practice Partner Former Practice Partner Chief of Orthopaedics Chief of Surgery Chief of Anesthesiology Chief of Staff Other (please state): 2. Which best represents your familiarity with the practice of Dr. Jennifer Dauria? Not familiar Slightly familiar Moderately familiar Very familiar Please evaluate Dr. Jennifer Dauria in the following areas: PATIENT CARE Unsatisfactory Marginal Satisfactory Excellent Unable to evaluate 1 2 3 4 UA Poor clinical skills; poor judgement; disregard of patient preferences; inappropriate/ineffective care Excellent clinical skills; sound judgement; respect of patient preferences; appropriate/effective care MANAGEMENT OF MULTIPLE COMPLEX PROBLEMS Unsatisfactory Marginal Satisfactory Excellent Unable to evaluate 1 2 3 4 UA Very limited ability to manage patients with multiple complex medical and surgical problems Excellent ability to manage patients with multiple complex medical and surgical problems. SURGICAL SKILLS Unsatisfactory Marginal Satisfactory Excellent Unable to evaluate 1 2 3 4 UA Unsafe, inadequately prepared, indecisive, lacking knowledge, not surgically proficient, limited medical knowledge Safe, prepared, decisive, knowledgeable, surgically proficient, exceptional medical knowledge COMMUNICATION AND INTERPERSONAL SKILLS Unsatisfactory Marginal Satisfactory Excellent Unable to evaluate 1 2 3 4 UA Poor relationships/communications with patients/colleagues; not respectful or compassionate; avoid educating and counseling patients; accepts counsel poorly Excellent relationships/communications with patients/colleagues; respectful and compassionate; educates and counsels patients; accepts counsel well PROFESSIONAL BEHAVIOR Unsatisfactory Marginal Satisfactory Excellent Unable to evaluate 1 2 3 4 UA Not professional/proper, avoids responsibility for errors; lack of respect for patients and colleagues Professional/proper, accepts responsibility for errors; respects patients and colleagues INTEGRITY AND ETHICAL VALUES Unsatisfactory Marginal Satisfactory Excellent Unable to evaluate 1 2 3 4 UA No integrity or ethical values, low character; inadequate commitment to honesty High integrity and ethical values, high character; exceptional commitment to honest To your understanding, does Dr. Jennifer Dauria practice safe, ethical, and effective orthopaedic surgery and meet the highest standards of practice and conduct? Yes, I feel Dr. Jennifer Dauria meets the highest standards of practice and conduct. No, I do not feel Dr. Jennifer Dauria meets the highest standards of practice and conduct. I feel Dr. Jennifer Dauria meets the standards of practice and conduct with the following reservations: If no, or with reservations, please explain and list anyone the board should contact. Please limit entry to 255 characters: (Exceeds character limit) Electronic Signature By checking this box, I attest that the responses recorded above have been provided by Melanie Smith-Fortney and that checking this box constitutes Melanie Smith-Fortney's electronic signature. PHONE NUMBER (Exceeds character limit)