Deadly medication errors increase in July as medical residents begin training programs | Healthland

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A new study from researchers at the University of California at San Diego and Los Angeles suggests that a sharp uptick in fatal medication mistakes in July corresponds with the entry of thousands of trainee doctors into medical residency programs across the U.S.

The study, published in the June issue of the Journal of General Internal Medicine, analyzed all U.S. death certificates from 1979 to 2006. Researchers David Phillips and Gwendolyn Barker found that, in counties with teaching hospitals, on average deadly medication mistakes surged by 10% each July. Phillips and Barker also noted that areas with higher concentrations of teaching hospitals tended to have higher increases in fatal medication errors. No similar jump was seen in counties without medical residency programs.

The authors say that the “July Effect” was limited to medication mistakes, and did not correspond to other types of medical errors or causes of death, including deaths that occurred outside of medical institutions. As Phillips and Barker sum up:

“After assessing competing explanations, we concluded that the July mortality spike results at least partly from changes associated with the arrival of new medical residents.”

The researchers say that their investigation was limited by the fact that they were only analyzing the most severe outcomes of medical mistakes, and that the death certificates provided little detail about the specific circumstances of each mortality. Additionally, they question why fatal medication mistakes surged during July in areas with teaching hospitals, while other types of medical errors — such as surgical mistakes — did not. Still, the authors argue that their analysis of more than 62 million death certificates from nearly three decades points to “a significant public health problem,” and warrants further investigation.

Based on the current findings, Phillips and Barker suggest that three simple steps be taken to diminish any additional risk to patients as new medical residents enter training programs in mid-summer: a re-evaluation of intern responsibilities, increased supervision by more experienced physicians and a greater emphasis on safety when dosing medication.

mkassowitz

So in the month of July we stand a 10% high chance of getting killed by a trainee doctor! Something to bear in mind. Just avoid going to the hospital in July. Actually, it makes one wonder about use of the word “practice” in the medical profession.
jmrph

So where are the hospital pharmacists reviewing these prescriptions?

I am a pharmacist in a town that gets newly minted Doctors. I keep telling my colleagues that I would like to go down and teach these folks prescription writing 101, as July and August are terrible for us filling the prescriptions in the retail market.

We get scripts with just a scribble for the signature, as if we should be able to recognize these folks the minute they are turned loose, and that’s just the beginning.

I once got a prescription for a potent narcotic on a hospital discharge slip. Couldn’t read the Dr’s name, so I spent a fair amount of time playing phone football until the Doctor could be located. I told her that I needed her information, including her DEA license, which allows her to prescribe narcotics. She told me that she didn’t know her number and would I please call the medical school and get it. Instead we were able to make contact with one of the supervising Doctors, who verbally gave me a prescription (much to the relief of the poor person waiting for pain medication after surgery). I assume the baby doc was reprimanded.

Somehow the feeling is that we should be able to figure this all out for them and magically supply the correct prescription.

Fortunately, this learning curve seems to be pretty swift, or we’d all be in trouble
jj5460

I find it interesting that the conclusion of the article is that the arrival of new medical residents is to blame. How can this be? Our lawmakers claim that interns and residents do not, in fact, practice medicine…rather they are merely “working” to learn. At least this is their justification for paying them under $8/hr (the government subsidizes the cost of this “learning” experience). I am unaware of any job that pays so little for 8 years of grueling education and sacrifice, accumulation of hundreds of thousands of dollars in debt, and then (on top of it all) carries the highest level of responsibility of any job, human life. It is very easy for uneducated people like mkassowitz (and our legislators) to overlook this.

It is, in fact, the responsibility of the supervising attending physician to ensure that mistakes are not made. This is, of course, further complicated by the fact that there is a shortage of physicians on the front line and this is only expected to get worse with the ever increasing demands. I assume our government has thought through this extensively with coverage to all and the continued cutbacks on physician payments, etc. All the while, as a physician, I will anxiously await my bailout…

I hope that our young and intelligent do not get dissuaded by these issues and turn away from medicine altogether. It has been shown that business and law have far greater returns on investment over medicine (Weeks et al. Acad. Med. 2002;77:312–319) -thus far it has been the desire to do good over the financial reward that has kept intelligent people in medicine. Let us hope that this does not end as the consequences will be undoubtedly palpable.
http://wellnessmuse.wordpress.com wellnessmuse

Whether there are new doctors or old ones, too many prescriptions are written. Period. Doctors hand them out as if they were vitamins or candy. There’s a crisis. Many of these so called miracle drugs (the purple pill or remicaid, to name a few) cause so much damage to the immune system that they aren’t worth it.

We must urge congress and insurance companies to cover acupuncture and herbal medicine. These are more natural ways to heal. Most drugs have to be taken for the rest of your life and simply mask the problem or cause more health issues.

it’s time to Wake Up America – Drugs are killing us.