Beware the July “perfect storm” in hospitals

You already do whatever you can to stay out of hospitals. But if you do need to visit a doctor or schedule a non-emergency surgery, by all means try not to do it in July. 

And if it turns out that you can’t avoid a July hospital visit, consider asking a family member or friend to be extra vigilant in overseeing your care. 

Why? Well, first of all, this is the month when new interns and residents join hospital staffs, and others depart. That plays havoc with staffing coverage, consistency and scheduling. 

And, to contribute even further to the confusion, many seasoned, senior doctors and nurses still insist on taking their vacations during July. 

Finally, more often than not, the staffing change happens in the middle of the Independence Day holiday, when hospitals tend to already be understaffed. 

All of this creates a perfect storm for a medical disaster. But unlike meteorological hurricanes, “Hurricane Hospital” is totally predictable and comes at the exact same time every year.  

In fact, this phenomenon is so consistent it even has a name: the July Effect. And numerous studies show that the July Effect results in more hospital mistakes, accidents, and deaths throughout the month, and even into August.  

But despite these well-documented problems, neither hospital nor medical school schedules change—even though their mechanisms are outdated…not to mention unsafe. 

And to make matters worse, beginning this July, hospital physician residency programs will be allowed to increase shifts for first-year trainees from 16 to 24 hours, according to the Accreditation Council for Graduate Medical Education.  

As a result, doctors first starting out in a hospital can have shifts that are just as long as those of more senior residents. However, there’s evidence that longer shifts for doctors—especially new doctors—increase sleep deprivation, which boosts the risk of medical mistakes. 

My own experience with the July Effect 

Sadly, my family and I have recently struggled with this deadly July Effect. 

At the beginning of July 2016, our 86-year-old mother was living as she chose, independently, in her home of 50 years. Her father had lived to age 97, and his father to age 98, so we always thought we had more time left with her. 

My mother’s home was high in the mountains above Los Angeles (which sometimes, but not always, was above the persistent smog line). It reminded her of the Mediterranean climate of southern France, where she was born and raised.  

We had often considered moving her to a smaller, safer home that was more accessible for medical care and other community services. But due to the crazy, counterintuitive policies in California, property taxes would have been more than four times higher in a new space less than one-fourth the size of the home she was already living in. 

Understandably, mom did not want to make that move. Just one more example of how unaccountable government policies interfere with people making the logical decisions that are best for them to live their own lives. 

Suddenly, right after the July 4 holiday last summer, mom visited her doctor one day, went to the hospital the next day, and the following day, she was gone. We know she had developed sepsis, but are still trying to figure out what happened. 

As difficult as all of this was and is for us, it did help remind me to view healthcare from a different perspective—as a patient and family member rather than primarily as a doctor. In fact, I decided to write this article to help make others aware of these potential dangers…and hopefully avoid a similar tragic outcome. Indeed, much of the information in this issue, and the article beginning on page 1 in particular, comes from my experiences with my mother’s healthcare over the years. 

So I would like to dedicate this issue…and the important tips it includes…to the memory of my mother, Huguette Picon “Nicky” Micozzi (1930–2016).