Comparison of Clinical Practice in the Emergency Department: Female Versus Male Emergency Physicians

Abstract

Background: There are fewer female emergency physicians (EPs) than male ones. This study attempted to analyze the differences in clinical practice between female and male EPs in the emergency department (ED).

Materials and methods: A retrospective, 1-year cohort study was conducted across 4 EDs in the largest healthcare system in Taiwan. A total of 199,757 adult patients without trauma treated by 76 EPs (9 females and 67 males) were included in the study. The clinical practice of female and male EPs was compared. The door-to-order and door-to-disposition times were used to evaluate EP efficiency. Indicators of diagnostic tool use included laboratory examinations and computed tomography scans. Patient dispositions included discharge, ED observation, general ward and intensive care unit admissions and ED mortality rate. Disposition accuracy was evaluated by determining the 72-hour ED revisit rate.

Results: The clinical practice of female and male EPs was similar. After adjusting for the potential confounding factors through a regression model, female EPs showed slight increase in laboratory examination use (adjusted odds ratio = 1.05; 95% CI: 1.01-1.09) compared with male EPs, but no difference in computed tomography use was observed between sexes. Additionally, no differences among patient dispositions and 72-hour ED revisit rates (adjusted odds ratio = 1.0; 95% CI: 0.93-1.06) were observed between female and male EPs.

Conclusions: Female and male EPs had similar clinical efficiency on patient evaluation, and they had no difference in diagnostic tool use. Furthermore, they showed similar patient disposition with the same accuracy.

Keywords: Clinical practice; Emergency department; Emergency physician; Female; Male.