Linkage between the Israeli Defense Forces primary care physician demographics and usage of secondary medical services and laboratory tests

Background: The primary care physicians in the Israeli Defense Forces, as in the Israeli civilian health system, have two major subpopulations. Graduates of Israeli schools of medicine, and graduates of foreign medical schools, most of them in Eastern Europe. Objective: To evaluate differences in the referral patterns of primary care physicians according to their graduation institution and demographic characteristics. Methods: The study took place in one primary care practice in central Israel. The referrals to consultations and laboratory tests over a period of 1 year were evaluated. Physicians that had less than 37 encounters were excluded from the study. Data were extracted from the central computerized databases of the Medical Corps and Israeli Defense Forces. Results: Sixty-eight physicians had a total of 18,402 encounters that resulted in 23,845 outcomes. There were no associations between demographic and training backgrounds of the physicians and their actual referral rates to consultations and laboratory tests. Conclusion: The background data of the primary care physicians does not predict their referral patterns and their role as "gate keepers."