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The July Effect: New Research Questions Fears Over Care Quality

Every summer, teaching hospitals in Ohio and around the nation admit new medical residents. With the influx of inexperienced, young doctors-to-be, observers coined the term "July effect" to describe concerns about a significant drop in patient care.

For example, a number of opinion and editorial articles in the last year recommended that patients should avoid inpatient hospital procedures in July, August and September. Some data suggested that inexperience caused a spike in dangerous medical mistakes in late summer.

According to new research published this week, however, these malpractice fears are exaggerated - at least to the extent that they focus on July as a particularly dangerous time of year.

Based on a review of more than 500,000 hospital admissions, this new study concluded that patients admitted in July did not experience worse outcomes than those admitted during other times. Although the data showed a slightly higher risk of infections, it did not find what it expected to see: a higher rate of complications and problems among higher-risk patients.

The premise of this expectation was that treatment deficiencies should show up in this group of patients more clearly than others. In the words of one of the authors, "if there really was a July effect, we should expect it to manifest in these patients, and we didn't see it."

This conclusion that new residents are not particularly dangerous is certainly welcome - however, this study does rule out one relatively understandable cause of medical mistakes. If experience does not play a role in as many malpractice cases as we thought, then more routine sloppiness and preventable errors are probably at work in Ohio hospitals.

Source: New York Times, "Focus on Hospitals' 'July Effect,'" Nicholas Bakalar, Feb. 4, 2013

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