Female ER Doctors Order More Tests, Admit More Patients: UCLA Study

LOS ANGELES, CA — Female emergency department physicians order more diagnostic tests and admit more patients than their male counterparts, but the additional care appears to be clinically appropriate, according to a UCLA Health study released Monday.

The study, published in JAMA Internal Medicine, examined more than 1.5 million emergency department visits by veterans and compared care provided by female and male physicians working in the same emergency departments.

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Researchers found female physicians ordered 3% to 5% more laboratory and imaging tests and admitted 3% to 5% more patients to the hospital than male physicians.

"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," said lead author Dan Ly, an assistant professor of medicine in the Division of General Internal Medicine and Health Services Research at the David Geffen School of Medicine at UCLA and the VA Greater Los Angeles.

The researchers found the additional testing ordered by female physicians was just as likely to uncover important findings as tests ordered by male physicians, suggesting the additional care was clinically appropriate.

The study also found the increased testing and hospital admissions were not associated with lower mortality rates. Researchers examined short inpatient stays as a possible indicator of unnecessary hospitalizations and found patients admitted by female physicians were no more likely to have brief hospital stays than those admitted by male physicians.

"We find no differences in mortality from this additional care, but mortality rates don't tell the whole story," Ly said.

Previous studies have shown female primary care physicians order more diagnostic tests than their male counterparts. Researchers said emergency departments provide a better setting to examine those differences because patients generally have little opportunity to choose which physician treats them.

The authors said the findings raise questions about how physicians balance diagnostic uncertainty with the use of medical resources.

Future research will examine what factors, including differences in risk tolerance, may contribute to the varying approaches and whether they affect patient outcomes beyond mortality, such as missed diagnoses or quality of life.

City News Service