[Ordering laboratory tests: their quantity and causes of variations among physicians]

Area of Science:

• Medical Economics
• Clinical Practice Patterns
• Physician Behavior

Background:

• Rising laboratory expenditures are a concern in healthcare.
• Variability in diagnostic testing among physicians contributes to increased costs.

Purpose of the Study:

• To investigate physician-level variations in laboratory test ordering.
• To explore the relationship between testing habits and physician psychological traits.

Main Methods:

• Analysis of 317 medical files from 10 residents in an outpatient clinic.
• Correlation analysis (Spearman's test) between physician test-ordering tendencies and interview-based psychological assessments.
• Double-blind interviews recorded and transcribed to identify psychological traits.

Main Results:

• Significant variation in diagnostic expenses (up to 4.9x) based on physician for conditions like back pain.
• Physicians ordering more tests exhibited higher uncertainty, hesitant speech, and difficulty in dialogue.
• No correlation found between testing habits and physician demographics (age, sex, experience, specialty).

Conclusions:

• Physician psychological profiles, particularly uncertainty, are linked to increased laboratory test utilization.
• The physician-patient relationship and physician's internal state significantly influence diagnostic practices.
• Understanding physician behavior is crucial for managing healthcare costs related to laboratory testing.