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The effect of physician personality on laboratory test ordering for hypertensive patients
S M Ornstein1, G P Markert, A H Johnson
1Department of Family of Medicine, Medical University of South Carolina, Charleston 29425-5820.
Insights
Introverts and intuitive personality types ordered more laboratory tests than extroverts and sensors in a study of resident physicians. This finding suggests personality influences healthcare costs and ordering practices.
Area of Science:
- Healthcare Management
- Medical Education
- Psychology in Medicine
Background:
- Laboratory tests constitute a significant portion of US healthcare expenditures.
- Variability in outpatient test ordering has been observed among physicians.
Purpose of the Study:
- To investigate the association between resident physician personality traits and laboratory test ordering patterns for hypertensive patients.
- To identify potential factors contributing to excessive laboratory test ordering in ambulatory care.
Main Methods:
- Retrospective study of outpatient test orders by residents from 1980-1986.
- Utilized the Myers-Briggs Type Indicator (MBTI) to assess resident personality.
- Employed multiple regression analysis to control for confounders.
Main Results:
- Significant variability in laboratory test ordering was found.
- Introverted residents ordered more tests than extroverted residents.
- Intuitive residents ordered more tests than sensing residents.
Conclusions:
- Resident physician personality, specifically introversion and intuition, is associated with laboratory test ordering habits.
- Understanding personality-ordering links can inform strategies to reduce unnecessary laboratory tests and healthcare costs.
Abstract:
Laboratory tests are responsible for a large percentage of health care expenses in the United States. In a retrospective study of the outpatient test ordering by residents for hypertensive patients between the years 1980 and 1986 at the Department of Family Medicine at the Medical University of South Carolina, we found great variability in laboratory test ordering as well as an association between personality as measured by the Myers-Briggs Type Indicator (MBTI) and test ordering. Introverts ordered more than extroverts, and intuitives ordered more than sensors. This association was confirmed by a multiple regression analysis controlling for potential confounders of test ordering, such as severity of disease, the presence of coexisting diabetes mellitus, the demographic characteristics of the patient population, and the number of initial evaluations for hypertension. Elucidation of a relationship between resident personality and laboratory test ordering has important implications for planning intervention strategies to reduce excessive laboratory test ordering in ambulatory care.