Thursday, July 30, 2015

Why You May Be 12 Percent More Likely to Die This Month

It's a bad month to get sick. That's because in some hospitals, death rates spike in July. In fact, patients are between 4 and 12 percent more likely to die than they are in other months, according to a review from the University of California.

The reason: Even doctors have their first day on the job. And in teaching hospitals, all the new M.D.s start on the same day: July 1.

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Fresh out of medical school, the incoming class of residents--a quarter of the hospital's doctors--is brand new to treating patients. At the same time, all the other trainee docs move up a level when the new crew rolls in: The second-year residents are scrubbing in on their first surgeries; the third-year residents are taking on a new set of responsibilities; and so on.

"It's a huge jump, overnight--and you're the same person!" says study author John Q. Young, M.D., a professor of psychiatry at Hosftra North Shore-LIJ School of Medicine.

The rookies are closely supervised, Dr. Young says, and hospitals have safeguards in place. But still, it's inevitable that the huge turnover will affect patients.

"The team providing your care is going through a transition," Dr. Young says. "There's been a drop in experience. People are in new roles. Your care may be somewhat less organized."

That may result in fatal mistakes: A separate study from the University of California found that deadly medication errors increased by 10 percent in July. And other research has found that complication rates are higher than in other months.

Take the steps to below protect yourself. (And in the meantime, try some of these 50 Ways to Add Years to Your Life.)

Also, it bears noting that none of this is to suggest that young physicians aren't qualified or good care-givers, but rather to shed light on the research and offer advice on how you can get the best treatment possible.

Don't delay healthcare

The gamble of putting off seeing a doctor is far more dangerous than going to a teaching hospital in July, Dr. Young says. If you're sick or need a procedure, don't think twice--just go.

However, if you have an elective procedure that's not time-sensitive--an arthroscopic knee surgery, for example--you may want to consider waiting. But only if there is reason to believe that your care may be compromised. (See below for questions to ask your docs.)

Choose your hospital carefully

Say you need surgery in July, but you have time to research your hospital choices. You could avoid the "July Effect" altogether by crossing all teaching hospitals off your list. (About one in four hospitals in the U.S. is a teaching hospital, Dr. Young says--check a hospital's "About Us" page to find out if it's a training facility.)

"But there are so many other factors to consider," Dr. Young says. Where are the best surgeons? Which hospitals are in your insurance company's network? (If a facility is out of network, you could wind up paying astronomical fees. Beware of these 50 Most Expensive Hospitals in the United States.) Are residents even involved in your procedure?

Bottom line: "Factor it in, but still go for the overall best quality," he says.

Grill your doctors

This goes for any time you're getting surgery, but it can be especially helpful at a teaching hospital in July. Find out:

• Who will be in the operating room?

• Who will prep you for surgery?

• Who will actually be doing the cutting?

• Who will take care of you afterward?

• If residents are involved, how are they supervised?

If trainee docs play a central role in your procedure and they're not closely supervised, it might be worth considering going to another hospital, Dr. Young says.

Speak up for yourself

If you're ever worried that your doctor isn't taking good care of you, you always have the right to ask to speak to the attending (the senior physician on staff), Dr. Young says.

And don't forget about the nurses, says Alexandra Robbins, author of The Nurses: A Year with the Heroes behind the Hospital Curtain. They may have more experience than your resident, and they're there to answer questions and advocate for you if you suspect something is off with your care.

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