Using a modified Dillman (2007) technique, a cross sectional study was conducted between June 2007 and August 2007. The process by which the survey was conducted is shown in Figure 1. All physicians identified (n = 6,916) were included in the initial mailing. Study inclusion was dependent on physicians having an active ambulatory care practice. Physicians who indicated they were not working in an office-based practice were asked to return the survey without further completion and were excluded from the study (n = 1,345). Thus, the sample frame included 5,571 physicians with an office-based practice. These physicians were asked to complete the survey and return it via postage-paid envelope. Two follow-up mailings along with additional copies of the Survey were sent to those who had not returned the survey; both were mailed at approximately two week intervals. Twenty-seven surveys came back listed as ‘‘return-to sender’’ and were therefore not counted in the final response rate, making the total eligible surveys 5,544 (American Association for Public Opinion Research, 2008). A total of 955 or 17.2% of the eligible surveys were completed and returned.