Stay Away From the Hospital in July

Ever since the famous case where a young woman died allegedly because she lay on a stretcher unattended in July, experts have warned about the "July effect."

That's because, in July, newly graduated medical students begin their residencies, and errors go way up.  According to a study done in 2010 of hospital errors in July from 1979 to 2006, medication errors shot up 10% at teaching hospitals in July, though it could not be confirmed whether that was simply because of new doctors entering the fray.

It’s also when the senior trainees, the residents and fellows, graduate to supervisory, self-managed patient care roles. "In other words, it’s when everyone is most inexperienced," Dr. Zachary F. Meisel and Dr. Jesse M. Pines write at Time Health & Family. Naturally, people worry that this inexperience leads to mistakes.

Some of it is patient load, which may have contributed to the woman's death, with new doctors too overwhelmed to accurately diagnose and treat.  In  other cases, it may be poor supervision.

But, according to Drs.Meisel and Pines, some think the "July effect" is a myth.  They note that a recent study "examining 10 years of data on patients undergoing neurosurgery showed that July was no more dangerous than other months."

However, other reports have found that July patients do indeed fare worse.  They point to a study of patients undergoing surgery for spine-related cancer in July, who "were more than twice as likely to have a surgical complication and 81% more likely to die, compared with August or June patients."

But experience can backfire, too.  I'm currently reading a terrifying (but good) book by Danielle Ofri, who frequently writes op-eds in The New York Times about doctors and how their feelings can get in the way of treating patients.  Drs. Meisel and Pines report that psychology does play a part in "experience."

"Doctors are human too, and they fall prey to tricks of the mind — like thinking that an ineffective treatment really works,," they write. Sometimes doctors take mental shortcuts that can "mislead even highly educated, well-seasoned practitioners into making the wrong decisions."

Ofri writes how doctors make judgments about patients that sometimes influence treatment, and this could possibly, too, be part of the "July effect," when new doctors are bombarded with cases and not quite sure how to proceed.

So, does the "July effect" really exist?  I'd tend to believe it does.  But being hospitalized in July does not mean an automatic death sentence.  The doctors advise:

  • Ask questions.  "It may not always be possible to determine that your doctor has fallen victim to an unconscious thinking trap or that she’s practicing outdated medicine. But asking questions does force your doctor to think and justify decisions about your care."
  • Become informed.  Learn as much as you can about your condition and medical issues.  OK, so you're not a doctor; that's fine.  Visit or other Web sites expressly written for patients.
And, just try to be careful in July.


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