Charges by residents and faculty physicians in a university hospital pediatric practice

The impact of pediatric residents on total patient charges generated in the outpatient pediatric practice of a university hospital was evaluated. Data were collected on 450 consecutive visits covered by two types of third-party category payers, Medicaid and private insurance. Charges were tabulated for visit charges, office-based procedures, and hospital laboratory and radiology tests. Average charges generated for visits to residents were greater than for visits to faculty pediatricians. The difference was attributable to the higher number of hospital laboratory and radiology tests ordered by residents. Patients' age, economic status, and diagnosis did not explain the more frequent use of these tests. These results emphasize that teaching hospitals need to develop specific methods to decrease unnecessary laboratory and radiology tests in pediatrics residency programs. The methodology used in this study provides a means for estimating the economic impact of resident education on the patients they serve.