it has become a huge problem for persons coming down with illenss during summer months, as this is holiday time. doctors and nurses are off for the yearly vacations, leaving the hosp and patients in the hands of interns and newbies. when they are not gone vacationing, they sit around making phone calls and talking to fellow workers about the trips, cost, destinations, others experiences and suggestions. and the rest of the year they are caught up with trying to cash in on their "sick" days. if they are not used they do not carry over. so it is difficult to keep the same doctors or people who are familiar with your case around, leaving you to have to go thru expensive unnecessary proceedures because the new people are lost. it would be so much better if hosp staff could stagger their vactions so someone is running the store so to speak.l it frightens me, and has caused me extreme discomfort and fear. and sick days????? people can't get their medical bills paid for while the workers are off using up their deserved days off. what a shame.
New Docs on the Block
According to medical lore, July is the worst time to be hospitalized because that's when inexperienced med students start clinical training. But is summer really riskier for patients?
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A month into Sandeep Jauhar's medical internship at a prominent teaching hospital in New York City, he was asked to drain fluid from the belly of a patient who was HIV-positive. "I was trying to get out of the hospital to keep a dinner appointment," he recalls. "I was sort of rushing. I heard a snap and there was all this fluid leaking all over the floor." Jauher's gloves were too small, he hadn't assembled the tubes for the blood correctly, he was new, he was inexperienced and nobody was watching. "[The patient] was totally oblivious to the disaster, but it was a mess," he says. "These are the mistakes that new, green interns can make."
According to conventional wisdom, a patient's chances of encountering a mistake-prone rookie like Jauhar go way up in the summer. That's because July 1 is the start of the academic year for medical schools: In teaching hospitals around the country, medical students will replace interns, interns will replace residents and residents will move on to fellowships or to become full doctors.
This crucial and sometimes perilous training period can be incredibly difficult for medical students. As Jauhar writes in his recent book, "Intern, A Doctor's Initiation," incoming doctors are not only practicing on patients for the first time, they're also learning the often Byzantine workings of their respective hospitals, new technical language, new procedures and the tedious, yet critical, ways to fill out paperwork. All this learning is packed into 80-hour workweeks and overnight shifts in a busy hospital environment—a far cry from the academic environment they might be coming from. But is it really riskier to go into a teaching hospital during those first few weeks of intern training? Or is the "July phenomenon" a medical myth?
The number of mishaps related to newbie interns is hard to pin down. After all, most doctors may not be as forthcoming as Jauher is about his mistakes. However, no one disputes that hospital errors do occur and they do cost lives. In 1998, the Institute of Medicine found that up to 98,000 deaths annually are caused by medical mistakes, and in the decade since, that number has hardly improved, according to experts in patient safety. In fact, the Institute for Healthcare Improvement (IHI), a Massachusetts-based independent not-for-profit organization, estimates that 15 million incidents of medical harm, both deaths and other "adverse events," occur in the United States each year.
While research into whether those medical mishaps are related to the July phenomenon has been sparse and often ambiguous, one study found that the July medical-training period is associated with between 1,500 and 2,750 accelerated deaths every year. In a study of the July phenomenon from which initial findings were released in 2005 by the National Bureau of Economic Research, Harvard Business School health-care economists Robert Huckman and Jason Barro compared mortality rates in teaching and non-teaching hospitals around the country. They found that there are 4 percent more incidences of accelerated death in average-sized teaching hospitals in July and August.
That, say some experts, may be the unavoidable price of medical-training programs. "New physicians, just like new people in any profession, are going to make mistakes," Huckman says. "There's nothing we can do about that."
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