Residents' self-report on why they order perceived unnecessary inpatient laboratory tests

Mina S. Sedrak, Mitesh S. Patel, Justin B. Ziemba, Dana Murray, Esther J. Kim, C. Jessica Dine, Jennifer S. Myers

Research output: Contribution to journalReview articlepeer-review

Abstract

Resident physicians routinely order unnecessary inpatient laboratory tests. As hospitalists face growing pressures to reduce low-value services, understanding the factors that drive residents' laboratory ordering can help steer resident training in high-value care. We conducted a qualitative analysis of internal medicine (IM) and general surgery (GS) residents at a large academic medical center to describe the frequency of perceived unnecessary ordering of inpatient laboratory tests, factors contributing to that behavior, and potential interventions to change it. The sample comprised 57.0% of IM and 54.4% of GS residents. Among respondents, perceived unnecessary inpatient laboratory test ordering was self-reported by 88.2% of IM and 67.7% of GS residents, occurring on a daily basis by 43.5% and 32.3% of responding IM and GS residents, respectively. Across both specialties, residents attributed their behaviors to the health system culture, lack of transparency of the costs associated with health care services, and lack of faculty role models that celebrate restraint. Journal of Hospital Medicine 2015;11:869–872.

Original languageEnglish (US)
Pages (from-to)869-872
Number of pages4
JournalJournal of hospital medicine
Volume11
Issue number12
DOIs
StatePublished - Dec 1 2016

ASJC Scopus subject areas

  • Leadership and Management
  • Internal Medicine
  • Fundamentals and skills
  • Health Policy
  • Care Planning
  • Assessment and Diagnosis

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