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Bhattacharya agrees there is sometimes a reluctance on the part of new interns to ask for direction even in those first few months of training. "There's a culture in many medical centers where asking for help is a sign of weakness. You don't want to show that you don't know what you're doing."

However, interns are often acutely aware of their own limitations. Dr. Gregg Meyer, of the center for quality and safety at Massachusetts General Hospital, remembers feeling nervous and out of place when he began his training. "I think of my colleagues during orientation," he says. "The No. 1 question was, 'When are you going to figure out that I don't really belong here? That I'm not good enough?' The reality is that you're never good enough."

But ultimately Meyer, like every other doctor, nurse and researcher contacted for this story, said that he would have no hesitation about going to the hospital in July or sending a family member: "The truth of it is, yes, you're dealing with doctors who are inexperienced. But oversight is higher, too. There's never a good time of year to get sick."

© 2008

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Member Comments

  • Posted By: zuzuglo @ 07/11/2008 9:18:53 PM

    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.

  • Posted By: Nins @ 07/06/2008 11:42:36 PM

    Did you know that if McCain is elected you will have to pay income tax on the value of the medical insurance that your employer gives you? Worse still, he is offering a tax break for people who pay their own insurance, BUT only $2,500 for individuals and $5,000 for families.

    Let's say you have a family of four. Your insurance policy costs would be at least $1,500-2,500 per month under a self-pay plan, which cost more than employer group plans. So, you pay $18,000 -$30,000 per year for insurance, and you get to deduct only $5,000 of that. If you paid $25,000 for you insurance, you would be out of pocket $20,000 per year. This is FAR WORSE than the current system, where if you are self employed you can deduct 100% of you medical insurance costs.

    So, if you're not self employed, you would stick with your Employer's plan. Employer plans for a family of four have a value of $900-$1,500 per month totaling 10,800-$18,000 per year. Surprise! On April 15th, you owe tax on all of that as INCOME to you. Say your bracket is 25%, and the value of your Employer medical plan is $14,000. You will OWE THE IRS an additional $3,500, and that's ON TOP of whatever monthly premium you already pay to your employer for your insurance.

    Many analysts say that McCain's new rules would encourage employers to stop offering health benefits. If that happened, then far fewer Americans would be insured than are insured today, because what family of four can afford $18,000-$30,000 out of pocket per year for self-pay health insurance?

    Furthermore, McCain's plan does not require insurance companies to cover pre-existing conditions of people who self-pay their insurance. People under employer group plans have all of their pre-existing conditions covered. This is a hugely unfair aspect of the current system. Insurance companies can afford to cover the pre-existing conditions of the much larger pool of people with group insurance, but they refuse to pay the pre-existing conditions on the smaller pool of self-pay customers. They have been allowed to price gouge the self-pay customers, which is a form of market manipulation that should be illegal.

    So let's say one of your kids had diabetes and you have high blood pressure, then your employer stops offering insurance. You now have to buy your own, but you and your child are INELIGIBLE due to pre-existing conditions. Oh, yeah, they will let you buy the insurance, but you can't use it for any pre-existing condition until you have paid on time every month for two years. And you know what happens at one year and 11 months? You get a letter saying your policy has been cancelled. I have many patients this has happened to.

    McCain's plan SUCKS.

    It does nothing to help middle class working Americans afford or obtain medical insurance. In fact, it makes the current system WORSE.

  • Posted By: C. MacLean @ 07/02/2008 1:15:13 AM

    Maybe there are checks and balances in place during the day, during the week, in the ICU and on the high-profile surgical floors, but as a former night shift nurse with many years' experience, I can tell you that in the middle of the night and on weekends on many medical floors, it is the first year resident, period. And in July, it is an inexperienced first year resident.

    Yes, they can always wake up their chief resident, but few do. The smart ones rely on the nursing staff, as the article points out. The ones that don't have a clear idea of their limitations make mistakes, sometimes dangerous mistakes - there is no 'system of checks and balances' until the morning, and over the weekend, sometimes not until Monday morning.

    The article also fails to point out that in July, most new graduate nurses are just coming off their orientation, so the nursing staff in a big teaching hospital, particularly on the night shift, may also be new.

    Regardles of what this article claims, I personally advise my friends and family members to avoid admission to teaching hospitals in July. In fact, I generally advise the people I care about to avoid big teaching hospitals in favor of smaller community hospitals any time of the year. My rule of thumb is: only go to a big teaching hospital if you have a rare condition, or have severe trauma; you'll get the physician specialists you can't get any where else. For more routine surgeries, chemo therapy, and medical management, go to a smaller community hospital, it is the superior nursing care that will pull you through.

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