Though it’s uncomfortable to consider, just about everything about our health care is uneven—your outcome depends on where you live, your income, and even when you go to the hospital. Motherboard covered how you’ll likely be better off if you schedule your surgery for a Monday, rather than a Friday, but if you can manage to plan when you’ll need intensive care, you’re better off going to the hospital in May than in July.
That’s because by July, newly graduated med students are just beginning their careers as interns. And last year's interns? They've just moved up into new roles and responsibilities. Apparently experience, at least at the hospital if not practicing medicine generally, is a big thing, according to a new study in the journal Circulation.
The study compared teaching and non-teaching hospitals, and modeled mortality rates for high-risk patients who had heart attacks. Comparing mortality rates from when the interns just began and when they've got almost a year of experience under their belts, during the green months of summer mortality rates crept up to around 25 percent from 20 percent. The gap between May and July mortality rates was higher in hospitals that had the highest percentage of trainees.
Before you swear off teaching hospitals for fear of intern-related deaths, note that patients at teaching hospitals had a lower risk of dying than patients at non-teaching hospitals. Even in the heady fatal days of July, the risk for patients at teaching hospitals only rose to the same level as the non-teaching.
“The good news for patients is that in most cases, it's very difficult for a physician to make a mistake that results in a patient's death," said lead author of the study, Anupam Jena, who is HMS assistant professor of health care policy and of medicine at Massachusetts General Hospital. "But for severely ill patients, health can be very tenuous. A small error or a very slight delay in care is potentially devastating."
The report suggests that oversight of interns is concentrated on those who are caring for high-risk patients, and that doctors with more experience should keep on their guard as they train up the next generation. Sorry, doc, no Summer Fridays for you.