Headed to the Hospital? Beware the 'July Effect'
By Kristene Crane
Photo by ABC
There are some things about your health that you just can’t control: when your appendix bursts, or you accidentally step on a rusty nail or a stealth sea urchin pierces your foot on your summer vacation.
Trips to the hospital in the middle of summer are never fun. But are they perilous?
The July Effect is a well-known phenomenon in the medical world. Recent medical school graduates step foot in teaching hospitals as residents for the first time, as the class above them takes on new duties. “If you talk to anyone who works in a hospital … unequivocally they will tell you care is worse in July,” says Anupam Jena, an internist and assistant professor of health care policy at Harvard Medical School. “The interns know less than the physicians who were there two to three months before.”
Related: Could Your Hospital Make You Sick?
Jena recalls his own days as a resident, when an intern gave a diabetic patient five times the amount of insulin the patient needed, and the next day, the patient’s blood sugar level fell to a dangerously low level. “The nurses picked up on it. Here’s a case of something that was potentially deadly, but there were safeguards in the hospital,” Jena says. “The patient only had diabetes and no other problems. Even with a potentially fatal medical error, this person was able to make it through.”
But even small mistakes could result in fatal errors in severely ill patients, Jena continues, so it’s those patients whom the July Effect could potentially affect. To that end, Jena conducted a study of heart attack patients in hospitals throughout the country, and found no mortality difference between patients at teaching and nonteaching hospitals in July. But in May, mortality was lower in teaching hospitals. “For every 100 people hospitalized with a severe heart attack, five more people will die in July than in May,” Jena says. While it’s hard to pinpoint the precise errors that make mortality rise, procedural delays may account for some: For example, even a half-hour delay in stenting – to open up clogged arteries – may be too late.