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Deaths Up, Care Levels Down at Teaching Hospitals in July
Date:7/12/2011

priate. Many have made an effort to enhance supervision, control the growth of caseloads new residents are assigned, and provide better orientation. So, attention is being paid."

Experts also suggests preventing resident fatigue and staggering start schedules for trainees, so the most experienced residents don't all leave at once.

On his part, Dr. David Dunkin, an assistant professor of pediatrics in the division of pediatric gastroenterology at the Mount Sinai School of Medicine in New York City, concurred that teaching hospitals are aware of the "July Effect" and are taking practical steps to minimize associated risks.

"This is a real issue," said Dunkin. "But I don't think that patients should be nervous about this."

"I say that because there are a lot of layers in an academic situation," he explained. "Yes, in July experienced trainees go and less experienced trainees come. But the hospital faculty doesn't turn over. And there are constant senior levels of supervision that remain in place. And that means that the July turnover is counterbalanced by an increased vigilance, in which senior level people are watching the new people very closely."

That said, Dunkin expanded on Young's advice as to steps patients can take to improve their hospital experience, regardless of when they might visit a teaching hospital.

"Yes, patients should bring someone with them if they can," he said. "And also be prepared to bring in with them anything that will make it easier to make sure that there will be no misunderstandings concerning their medical history. A copy of any records, if they have had medical illnesses. Or even a letter from their primary care physician or specialist stating what their medical issues are and what medications they are on. That kind of succinct summary reduces the chance of an error being made year-round."

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