Are We Ordering Too Many Labs?

Anecdotal experience and small single-center studies suggest that physician trainees at teaching hospitals order more laboratory tests than do more experienced attending physicians. Researchers in Texas used a statewide database to compare mean number of laboratory tests per patient per hospital day among 43,000 adult inpatients with principal discharge diagnoses of bacterial pneumonia or cellulitis; patients were stratified by illness severity. Care settings were 11 major teaching hospitals, 12 minor teaching hospitals, and 73 nonteaching hospitals.

Laboratory tests per day differed significantly across all hospital types. After adjustment for length of stay and demographics, patients at major teaching hospitals underwent more testing than …