In many parts of the world summer is well on the way, but that means brand new doctors are on the way too. In July hundreds of new doctors start their jobs in hospitals in the United States, while hundreds of other doctors take on more responsibility after promotion. Something similar happens in Britain during the first week of August. The fact that a mass of doctors are all new to their roles, at whatever level, at the same time, has given rise to hospital horror stories.
Rumour has it that if you want to survive, you should avoid hospitals during those doctors’ first week at all costs. In the UK medical drama Cardiac Arrest the staff called it “the killing season”. Others refer to the day the new doctors start as Black Wednesday. In the US it’s known as the July Effect. But how much data is there to back up this folklore?
There are some studies which, at first sight, seem to back up the claim that these months are risky. In the US, for example, the National Bureau of Economic Research took data from 700 hospitals between 1993 and 2001. They found that mortality rates at major teaching hospitals rose by an average of 4% in July and August. That means the average teaching hospital saw between eight and 13 more deaths than usual. Patients also ended up staying longer in hospital. Over the next six months of the year, things gradually got better.
It sounds clear-cut. Surely the new doctors made more mistakes that led to patient deaths and then as they became more experienced the death rates went down. But does this mean that all hospitals are more risky at this time? Not at all. The risk only rose in teaching hospitals and even then in the busiest teaching hospitals there was no increase in deaths at all. This shows that if doctors are well-supervised and get the support they need, patient care doesn’t need to get any worse.
But not every study comes up with the same conclusion. Other studies covered every patient attending the emergency room at two Californian hospitals over a five-year period. There was no seasonal difference in summer death rates, but in July and August patients were more likely to suffer from preventable complications than those admitted in May and June.
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