Hospitals’ rate of care slow in July

New medical interns enter hospitals across Minnesota.

There is an old saying among doctors: âÄúDonâÄôt get sick in July.âÄù As new medical interns begin work at hospitals across Minnesota this month, many hospitalsâÄô pace of care slows down in a phenomenon referred to by many in the medical community as the âÄúJuly Effect.âÄù Doctors and interns at Twin Cities teaching hospitals including Hennepin County Medical Center , Abbott Northwestern Hospital and the University of Minnesota Medical Center, said the âÄúJuly EffectâÄù does exist, but its impact is minimized by the close supervision of veteran staff. âÄúThere is a pretty big safety net,âÄù said William Browne, Program Director, Internal Medicine Residency Program at the University of Minnesota. He said multiple layers of supervision include residents overseeing medical students, attending physicians watching over both residents and interns, and the nursing staff double checking orders. However, in striving to maintain the usual quality of care, the rate that patients receive it slows. âÄúIt almost takes me twice as long, because I will look up things two, three, four times just to be sure,âÄù said Misty Retzlaff, an intern at the University of Minnesota. âÄúThe residents are all very knowledgeable, but they are not very efficient,âÄù said Louis Ling, associate medical director for medical education at Hennepin County Medical Center and associate dean for medical education at the University of Minnesota . He said the best way for new residents to learn multi-tasking âÄúis being a waiter or a waitress and having to handle a bunch of tables.âÄù He compared patients in July to customers at a restaurant, âÄúorders are still right, they get their food, itâÄôs the right food, itâÄôs just that you might not get to them quickly enough and say âÄòOh, how are things going?âÄô âÄù âÄúPatients probably donâÄôt get feedback they would like to have, or they would get at other times of the year,âÄù Ling said. Interns may not be checking in with patients as often, but they double-check uncertainties with medical staff frequently. âÄúAnything that I am remotely questioning I will ask,âÄù Retzlaff said. Even in the middle of the night âÄúthere is an attending physician and there is also a supervising resident that we can also call âĦ they pretty much say if you have questions donâÄôt hesitate to ask,âÄù Brandon Anderson, an intern at the University of Minnesota , said. âÄúThere [are] some departments that will actually beef up their staffing âĦ they might have an extra chief resident,âÄù said Ling. Although most Minnesota hospitals do not have a policy that increases hours or minimizes vacation time of experienced staff in July, âÄúpeople are a little bit more vigilant,âÄù Bob Miner, internal medicine program director for Abbott Northwestern , said. A study conducted by Harvard researchers and published by the National Bureau of Economic Research showed that from 1993-2001, in 700 teaching hospitals across the United States, the average length of stay increased by 2 percent and average mortality increased by 4 percent following the change of staff. This equaled 1,500 to 2,750 additional deaths each year. Miner said that kind of study has not been conducted at Abbott Northwestern and that âÄúsome hospitals overall have shown that âĦ my feeling is thatâÄôs probably not true here.âÄù There may be other factors involved in the increased deaths, Ling said. He cited drinking-related injuries as a possible cause, âÄúin the summertime there is just more alcohol.âÄù