Patients should always be aware of the possibility for medical negligence or medical malpractice when visiting a hospital or any other medical facility. However, recently reviewed studies show that July may be the most dangerous month for patients in large, teaching hospitals. What has been know as the “July Effect” by many in the medical field describes the spike in medical errors seen when new resident physicians arrive at a teaching hospital.
Prior to the release of a new review of several studies on the matter, what has been known as the “July Effect” was largely unsubstantiated. However, this review, which was co-authored by Dr. John Q. Young, the associate program director for the residency training program in psychiatry at the University of California, San Francisco, found that medical malpractice and patient death rates did indeed increase during the summer months in teaching hospitals, especially in July. The review not only indicated an 8 % increase in patient death rates in July, but it also indicated that patient hospital stays were longer and hospital charges were higher in the month of July.
The review analyzes 39 studies that have been conducted on this issue and is published in the Annals of Internal Medicine. In their review of these studies, Dr. Young and his team focused on the findings of the larger and higher quality studies. The findings confirmed that medical errors and mortality rates in teaching hospitals do increase in and near the month of July.
“The July Effect,” as it has come to be known, is caused by the changeover that occurs at many teaching hospitals in July. During this month, 20-30% of the more experienced resident doctors leave the hospital, and these doctors are replaced with less experienced first year residents. Dr. Young told The New York Times’ Vital Signs: “This changeover is dramatic, and it affects everything. It’s like a football team in a high-stakes game, and in the middle of that final drive you bring out four or five players who never played in the pros before and don’t know the playbook, and the players that remained get changed to positions they never played before, and they never practiced together. That’s what happens in July.” Also according to Dr. Young, it is not just the new residents’ lack of knowledge that may pose risks for patients coming into hospitals in July, but the increase in medical errors and deaths may also be attributed to the new residents’ general lack of familiarity with the hospital and its systems.
According to Young, teaching hospitals may be able to implement several new procedures in order to mitigate the risk of patient injury or death during this change over period. The changes that Young suggested include:
1) Staggering the start schedules for new residents,
2) Enhanced supervision of new residents,
3) Avoiding over night work or first year residents, and
4) Pairing more experienced residents with less experienced residents.
Although patients may not be able to choose when they must visit a hospital , in an interview with the Wall Street Journal’s Health Blog, Dr. Young suggested things that patients may be able to do in order to avoid the risk of medical malpractice as a result of the “July Effect.” Dr. Young suggested that patients bring a friend or family member with them to the hospital, to serve as an advocate. Dr. Young also advised that patients should be aware that every medical team has an experienced attending physician, and the patient may speak with that physician at any time.
In addition to Dr. Young’s suggestions, every hospital patient should know that according to the American Hospital Association Patient Bill of Rights, patients have the right to know if the physician performing any procedure on them is a first year resident. In addition to this, patients also have the right to request that a senior resident be present for any procedure performed on them by a first year resident.
All in all, it may be best for patients to visit a community hospital for treatment if possible. Community hospitals are less likely to suffer the “July Effect,” because they typically do not use residents like larger teaching hospitals. Although community hospitals seem to be the logically safer choice during the summer months, no studies or reviews have been published regarding their relative safety. Thus, it is important for any current or potential hospital patient to be vigilant about their care, and contact a Medical Malpractice attorney in the event they suffer the results of the “July Effect” or the results of any other type of medical negligence.
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