The ‘July Effect’ — Real Phenomenon or Myth? A study states that medical errors increase 10 percent in teaching hospitals in July as a result of new doctors coming into the profession By Deborah Jeanne Sergeant
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hen something goes wrong in a medical scenario, patients and loved ones want answers. It’s only natural to examine what went wrong to find something or someone to blame. In part, we want to understand why this happened so it can never devastate someone else’s life. Understanding also helps us gain closure about trauma. The “July Effect” is the belief that medical care received in teaching hospitals during the month of July bears a higher risk of complications because it’s when many experienced Sayers medical providers go on vacation and when new physicians begin their residencies. A study published in 2010 in Journal of General Internal Medicine stated that medical errors increased 10 percent
in teaching hospitals, but not other hospitals, during the month of July. The data spanned from 1979 to 2006. Critics of the study assert that the time span goes back to decades predating technology that helps today’s medical personnel cross-check patient care plans. Advances such as electronic medical records have lowered the chances of medical errors, especially for younger, tech-savvy residents. The earlier data from the study would skew the statistics and current-day hospital processes help reduce errors. Margaret Sayers, a private health care advocate serving clients in Buffalo, has worked for decades as a clinician, administraSomerset tor and researcher
in geriatric health care. Regarding residents’ potential for error, she said, “I have not heard the July Effect as being verified as an influence. They’re under the supervision of a university faculty member. “If you’re someone who can schedule their hospitalization, [during the summertime] hospitals are likely shorter staffed, not just because of the July Effect. Just as you wouldn’t want to schedule surgery the week of Christmas, you might have substitutes and you may not feel the care is the same as regular docs.” Although you likely won’t be surprised with a new surgeon for an elective surgery, your care team during your recovery could include members who are new. Especially for patients anticipating a lengthy post-op recovery, receiving care from new physicians may cause alarm, but it shouldn’t make a difference in the quality of care received. Though anecdotally some patients refer to the July Effect, it “has never
been a factor in medical malpractice cases to my knowledge,” said Margaret E. Somerset, attorney specializing in health care with Underberg & Kessler LLP. “But that doesn’t mean it can’t happen.” The firm maintains offices in Buffalo and other areas of Upstate New York. Somerset pointed out that courts rely upon relevant evidence on the day of a particular incident for medical malpractice suits, and the July Effect would not contribute significantly enough to become a factor in a case. Nonetheless, if you’re nervous about an upcoming hospital stay, discuss with your providers the possibility of scheduling for a different month if thoughts of the July Effect concern you.
Buffalo Medical Innovations
Buffalo Has a Long History of Medical Innovation, Discovery By Patrick Broadwater
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tiny device that would have a profound impact on modern cardiology was born in a barn in Clarence. Wilson Greatbatch’s tinkering in the workshop behind his home in the mid-1950s led to his invention of the implantable pacemaker, preserving the lives of millions of patients with irregular or weakened heartbeats. Earlier versions of the pacemaker were big as TV sets and had to be plugged into wall sockets. Greatbatch’s patented device was as small as two cubic inches, resistant to bodily fluids, and could be installed in a 30-minute procedure that left just a thumb-length scar. “It’s been a revolutionary change for hundreds of thousands of people every year,” Georgetown University cardiologist and assistant professor Zayd Eldadah said in The Washington Post’s glowing obituary of Greatbatch. Like many great discoveries, Greatbatch’s success with the implantable pacemaker was shaped by error. Then an assistant professor of electrical engineering at the University of Buffalo, he was working on creating a heart sound monitor when he accidentally installed the wrong size transistor, which emitted a rhythmic electronic pulse that mimicked the human heartbeat. He quickly realized the potential of his discovery and set to work creating prototypes. Innovation was nothing new to Greatbatch. Disappointed with the
relatively short life (two years) of the batteries used in his pacemakers, he later acquired the rights to a lithium iodine battery design and re-engineered it to fuel them for a decade or more. He started his own company, Greatbatch Inc., to make the batteries, and the firm continues today as a leader in the medical device market. Greatbatch himself held more than 300 patents before his death in 2011. While the implantable pacemaker is perhaps the most widely known and far-reaching invention created in the Buffalo area, it is far from the only one. Western New York has a long history of medical innovation and discovery dating back to the mid-19th century. For instance, did you know that the first successful skin graft operation was performed at Sisters Hospital in 1854? Or that Buffalo’s Roswell Park Cancer Institute, opened in 1898 as the New York State Pathological Laboratory of the University of Buffalo, was the first facility in the world dedicated solely to cancer research? Aside from being the oldest such facility, Roswell Park has been an innovator in many other respects. Among the historical firsts and innovations achieved by Roswell Park doctors and researchers: • Pioneered photodynamic therapy (PDT) to treat cancers of the skin, bladder, head and neck • Pioneered the prostate-specific antigen (PSA) test • Pioneered the drug combination
Wilson Greatbatch invented the implantable pacemaker in a barn behind his home in Clarence. 5-FU and Leucovorin for colorectal cancer • Developed the PKU (phenylketonuria) screening test for newborns • Collaborated on the landmark studies of the Human Genome Project According to the former Buffalo Medical Journal, physician Frank Hastings Hamilton conducted his groundbreaking skin graft operation at Sisters in December of 1854. He was able to successfully remove skin from the left leg of a patient and transplant it to the affected area of the patient’s right leg. More recently, Buffalo was the home of Nobel Prize-winning matheJuly 2015 •
matician Herbert Hauptman. The internationally renowned scholar’s research into crystallography (determining the three-dimensional structure of molecules), first published in 1953, was accepted by the scientific community in the 1970s, earning Hauptman and fellow researchers the 1985 Nobel Prize in chemistry. Their work uncovered the structure of thousands of molecules, leading to the development of countless new drugs. Hauptman later became president of the Medical Foundation of Buffalo, which was renamed Hauptman-Woodward Medical Research Institute.
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