Hope you don’t get sick in July

You may think there is a never a good time to get sick. And that’s true. But certain times are worse than others.

Take this month, for instance.

In the current issue of my Insiders’ Cures newsletter, I alert you to a disturbing pattern, which shows medical errors increase every year during July.

There’s a very simple reason why this pattern persists, year after year. And it’s no big secret.

You see, every year on July 1st, all the new doctors around the country finish training and start practicing medicine. And at first, there is a good reason why they call it practicing.

Of course, everyone has to have a “first day” on the job. But doctors have critical “life-or-death” roles. So starting every new doctor across the country on the very same day just doesn’t make sense. Plus, experienced doctors and nurses like to take vacations in July. So, if you went to the hospital this month, the chance of you seeing a freshman doctor was pretty darn high.

The July 4th holiday poses the first major challenge for these new doctors. On this holiday filled with backyard fireworks, alcohol, and patriotism, you can guarantee the hospital ER will be packed. You can also guarantee all the freshman ER doctors will be on call.

Of course, emergency admissions always go up around major holidays anyway. And these holiday admissions result in nearly 50 percent higher fatality rate than admissions on non-holidays.

Without a doubt, July is a dangerous time to go to the ER.

But it’s not just the ER that you should avoid in July.

I don’t suggest “scheduling” any elective procedures this month, either.

Researchers at John Hopkins University found higher rates of complications and mortality during surgeries performed in July. Other studies found that increased vigilance by senior doctors can offset these problems. Unfortunately, as I said earlier, many of the senior doctors go on vacation in July.

But July isn’t the only time you should be concerned about.

You should also avoid afternoons. Yes, ANY afternoon.

With each passing hour of the day, gastroenterologists are nearly 5 percent less likely to detect a colon polyp during colonoscopy. So, always ask for the first appointment of the day when scheduling a colonoscopy. Or any medical procedure, for that matter.

Anesthesia problems also occur more often later in the day. For example, patients in just 1 percent of surgeries that begin at 9 a.m. experience problems with anesthesia. But that number increases to 4.2 percent for surgeries that begin at 4 p.m.

The time of day–and even day of the week– seems to affect whether or not you get surgery in the first place.

For example, women in labor are more likely to undergo an unplanned Cesarean section between 3 p.m. and 9 p.m. on a Friday compared to any other time of the week.

Curious, isn’t it?

Couldn’t be that the doctor on-call wants to go home for the weekend, could it?

Nighttime, in general, is not a good time to have a baby. In fact, babies born at night have 25 percent overall higher mortality rates. Even when you control for emergency and complicated deliveries, there was a still a real 16 percent increase.

Bottom line?

If you need surgery or a medical procedure, get started early. And in July, do what many senior doctors do…stay away from the hospital and go on vacation.

Sources:

1. The impact of July hospital admission on outcome after surgery for spinal metastases at academic medical centers in the United States, 2005 to 2008,” Cancer Dasenbrock HH, Clarke MJ, Thompson RE, Gokaslan ZL, Bydon A.2012;118(5):1429-38

2. “The effect of July admission on inpatient outcomes following spinal surgery,” Journal Neurosurg Spine 2013;18(3):280-8

3. “Emergency medical admissions, deaths at weekends and the public holiday effect,” Emergency Medicine Journal, (www.ejm.bjm.com), January 2013

4. “Queue Position in the Endoscopic Schedule Impacts Effectiveness of Colonoscopy,” American Journal of Gastroenterology 2011; 106:1457–1465

 


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