The July Effect: The Surprising Truth of an Old Superstition

If you’ve worked in healthcare for any amount of time, you’ve likely heard July whispered about as a time of chaos as freshly graduated doctors join the healthcare team at hospitals across the country. With no real way for patients to know if their hospital visit will be met with a seasoned doctor or one who just earned the title mere weeks before, it’s no wonder this transition period is approached with some hesitancy by patients and staff alike.

But is the July Effect just another healthcare superstition, akin to the widely held belief that the full moon guarantees busy or chaotic shifts? Believe it or not, unlike other tales of healthcare peculiarities, the July Effect has been studied for years and there is actual data surrounding the phenomenon (though the results may surprise you).

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A 2016 national survey by The American Journal of Medicine revealed that the majority of physicians believe there is a potential for increased errors while new interns get their feet wet during the summer months. But a 2016 analysis of 4 years worth of data from 120 facilities concluded that despite superstitions, there was no increase in risk or rates of mortality during July². Furthering that opinion, a 2017 study published in JAMA concluded that teaching hospitals may actually be safer during July because of the increased collaboration between interns and their attendings¹.

The reasons for this are multifaceted. For one, patient care in a teaching hospital tends to be checked and double checked, meaning the margin for error is smaller despite the fact that very new doctors may be on the case. Recent years have also seen a shift in treatment of interns, with a greater focus on limiting overtime shifts and ensuring minimum sleep requirements are met. Hospitals are also bolstering supervision and mentorship programs as quality of care comes front and center in healthcare. Despite what may have taken place with past generations of new doctors, it seems that now the influx of interns into the hospital is met with a dedicated effort to integrate them eagerly and safely.

So the next time you hear someone whisper about what they think might be happening in hospital hallways in July, you can let them know the July Effect is real, but not in the way they think.

1. Burke, L. G., Frakt, A. B., & Khuller, D. (2017). Association between teaching status and mortality in US hospitals. JAMA, doi:10.1001/jama.2017.5702

2. Hughes E. (2017). July effect? maybe not. Canadian Medical Association journal, 189(32), E1050–E1051. https://doi.org/10.1503/cmaj.1095466

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