If you get sick in July, you’re more likely to end up in the hands of a novice doctor. Alexandra Robbins writes in Politico, “In July, U.S. death rates in these hospitals surge between 8 and 34 percent.”
Don’t get sick in July. Every year in teaching hospitals at the start of July, medical students become interns, interns become residents and each successive class of residents moves up a level. These new doctors are immediately thrust into direct patient care. As the National Bureau of Economic Research reported, “On day one, new interns may have the same responsibilities that the now-second-year residents had at the end of June (i.e., after they had a full year of experience).”
This upheaval causes what health care workers call “The July Effect” in the United States and “August Killing Season” in the United Kingdom (where the shift happens in August). The changeover harms patient care, increasing medical errors, medication mistakes and the length of hospital stays. In July, U.S. death rates in these hospitals surge between 8 and 34 percent—a total of between 1,500 and 2,750 deaths. UC-San Diego researchers found that fatal medication errors “spike by 10 percent in July and in no other month.” In Britain, August mortality rates rise by 6 to 8 percent as new doctors are tasked with surgeries and procedures that Britons say are “beyond their capabilities.” Patients in English hospitals have a higher early death rate when they are admitted on the first Wednesday in August than patients admitted on the previous Wednesday.
The residents who know enough to know what they do not know—and therefore listen to and seek out nurses for advice—are not the problem here. But too many residents, enamored of their M.D., won’t ask for help. “Nurses are correcting every error and preventing major mistakes every day,” said a Maryland solid organ transplant nurse.
If you must be hospitalized in July for particularly complex procedures, you might consider avoiding teaching hospitals.