Within the same emergency department, female physicians ordered more tests and admitted a higher share of patients than male physicians (share of patients with CP admitted: 45.7 vs 44.0%).
HealthDay News — Female emergency department physicians order more tests than male physicians, but these differences may not be unnecessary care, according to a research letter published online July 20 in JAMA Internal Medicine
Dan P. Ly, M.D., Ph.D., from Veterans Affairs (VA) Greater Los Angeles Healthcare System, and colleagues used VA electronic health record data to identify 1.5 million patients (aged 20 years and older) who visited a VA emergency department from 2011 to 2019 with chest pain (CP), shortness of breath (SOB), or abdominal pain. Differences in test ordering and hospital admission between 448 female and 1,078 male physicians were examined.
The researchers found that within the same emergency department, female physicians ordered more tests and admitted a higher share of patients than male physicians (share of patients with CP admitted: 45.7 versus 44.0 percent). Absolute differences ranged from 0.04 to 0.05 for number of radiology tests ordered, 0.21 to 0.33 for number of laboratory tests ordered, and 1.0 to 2.2 percentage points for share of patients admitted across chief concerns. For mortality or likelihood of short inpatient stay (<24 hours), there were no statistically significant differences by physician sex. For patients with SOB, female physicians ordered more potentially low-value computed tomography scans (5.2 versus 4.8 percent). For three of five tests for chief concern scenarios, female physicians ordered more testing, including D-dimer for CP and SOB (12.1 versus 11.0 percent). Across scenarios, there were no differences by physician sex for test positivity.
“Our research finds that in the emergency department setting, female and male physicians may approach diagnostic uncertainty differently, and these differences don’t necessarily represent unnecessary care,” Ly said in a statement
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