YOU MAY WANT TO AVOID HOSPITALS IN JULY

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July is hear, so consider the advice of some seasoned doctors: Avoid the hospital if you can.

Why? Because on or around July 1, fresh, inexperienced interns, residents, nurses and other new health care workers first report to work at many of the nation’s hospitals, eager to start practicing medicine—on you.

In medical circles, it’s known as the “July effect” and there’s evidence—along with popular opinion—that it’s a month with more medical errors in hospitals.

“You may get more personal attention, but the skill level isn’t there,” explains veteran physician David Sherer, M.D., past director of risk management for a large insurance provider and coauthor of Dr. David Sherer’s Hospital Survival Guide. “You have newcomers arriving at hospitals—often placed in a sink-or-swim situation—and they don’t know where anything is or how anything is done. July is not the time to have elective surgery or another procedure that could be postponed.”

As a group, these physicians-in-training are “universally supervised,” says Christopher Landrigan, M.D., who teaches at Harvard Medical School and oversees residents at Children’s Hospital Boston. But individually, “from day one, residents are writing medication orders and doing certain procedures and diagnostic tests with relatively little direct supervision, so there’s always an opportunity for something to slip through the safety net.”

That’s not to say that midsummer is the only time for potential problems. After all, some 100,000 Americans die from hospital medical errors each year—thousands every month. “But there is good evidence that errors are somewhat more common when residents first begin to work,” notes Landrigan.

Until now, most studies exploring the July effect have focused on seasonal error rates at specific hospitals. But the latest and largest study to date examines the July effect on a national level, and some indicate that, indeed, more medical errors of various types occur in July and early August than other months—especially at teaching hospitals, which train medical interns and residents and are connected with medical schools. But July is also a popular month for others, fresh from college, to begin their health care careers at all types of facilities–including nurses, pharmacists and allied health technicians and therapists.

The latest and largest study to date examines the July effect on a national level—with an alarming finding.

After analyzing more than 62 million death certificates issued across the country from 1979 to 2006, researchers found that fatal medication errors consistently spiked in July by about 10 percent—but only in U.S. counties with many teaching hospitals—and then subsided in August to levels on par with other months. Yet there was no measurable increase in counties with facilities that don’t employ residents, such as community hospitals.