When the coronavirus pandemic first hit the U.S. earlier this year, some hospitals in a few overcrowded urban areas were overwhelmed with caring for patients with serious respiratory complications. Yet others in more rural areas had to let go of staff and even shut their doors because routine medical procedures were all cancelled. And in both settings, some people put off going to the emergency room (ER), due to the fear of contagion.
Of course, hospitals are dangerous places under all circumstances. And early July is typically the worst time of all to visit one. Here’s why…
Inexperienced doctors at the helm
During a normal year in July, all of the doctors-in-training around the entire country start on duty as new hospital staff physicians, all on the very same day—July 1st. This antiquated practice persists for no good reason, with lots of bad consequences.
At the same time, the more experienced hospital staff physicians move up or move out. And the most-senior, seasoned medical and nursing staff, with years of experience supervising and working with doctors-in-training, typically start taking their vacations during this prime time!
So, if you have to visit the ER in July, you’re far more likely to encounter a green-behind-the-ears doctor, without full back-up.
On top of that, ER visits typically spike around the Fourth of July—thanks to all of the drinking, outdoor fires, fireworks, and even use of firearms. In fact, in southeast Florida, where I worked as a State Medical Examiner for Miami-Dade County, part of the traditional Independence Day celebrations included shooting guns into the night sky.
So when you consider all the people flooding into ERs during this time, which are typically staffed with new, physicians-in-training, without full back-up, it’s really no wonder there’s a nearly 50 percent higher fatality rate on the July 4th weekend compared to ER admissions during non-holidays! And, truth be told, the entire month of July offers more sorry statistics, too.
In fact, Johns Hopkins University in Baltimore, Maryland, did a study that found higher rates of complications and deaths with surgical procedures performed in the hospital during July compared to other times of the year.
It’s really a tragedy, because the hospital system could counteract this July effect by simply staggering new doctor start dates and senior doctor and medical staff vacations.
Now, let’s move on to some other scheduling guidelines…beyond July…that you should know about.
Be careful about the time of day when you schedule elective procedures
If you must undergo a medical procedure, make sure you schedule it early in the day. That’s because complication rates of even “routine” procedures like colonoscopies increase with each passing hour of the day.
Plus, doctors become 5 percent less likely to detect an important finding that’s actually present with each hour of the day that it gets later.
Problems with anesthesia also occur more often when procedures are performed later in the day. In fact, at 9 a.m., just 1.0 percent of surgical patients experience problems. But that figure more than quadruples to 4.2 percent by 4 p.m.
Then there’s the rampant abuse of performing “emergency” cesarean sections (C-sections) on pregnant women late on Friday afternoons. It turns out, women are much more likely to undergo an unplanned, “emergency” C-section between 3 and 9 p.m. on a Friday compared to any other time of the week. That way, doctors don’t need to get called in to the hospital on weekends.
All in all, as always, I suggest you try to stay healthy and stay away from hospitals whenever you can. Especially this year, as our July 4th holiday also falls on a weekend, while for months the entire medical system has been disrupted by pandemic and panic.
So, continue eating a healthy, balanced diet and getting moderate amounts of exercise daily. For more tips on leading a healthy lifestyle, become a subscriber—you’ll have access to all of my past content in the archives.
“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, 2012;118(5):1429-38. doi.org/10.1002/cncr.26347
“The effect of July admission on inpatient outcomes following spinal surgery.” Journal Neurosurg Spine, 2013;18(3):280-8. doi.org/10.3171/2012.12.SPINE12300
“Emergency medical admissions, deaths at weekends and the public holiday effect.” Emergency Medicine Journal, 2014; 31:30-34. doi.org/10.1136/emermed-2012-201881
“Queue Position in the Endoscopic Schedule Impacts Effectiveness of Colonoscopy.” American Journal of Gastroenterology, 2011; 106:1457–1465. doi.org/10.1038/ajg.2011.87