Conventional wisdom tells patients to avoid the hospital in July. With hospitals teeming with a fresh crop of medical school graduates who have been doctors for less time than it’s been since your last haircut, the fear is that both the quality and efficiency of medical care tanks this time of year.
Explore This IssueACEP Now: Vol 37 – No 08 – August 2018
Of course, there is actually little data to support the notion of a July effect.1 Personally, I am most concerned about September, when a false sense of security may set in.
However, summer is the time when new doctors are most eager to learn and seasoned physicians are at their most committed to teaching. With that in mind, the Twitter hashtag #TipsForNewDocs has become something of an annual tradition in June and July. Here are some of my favorites from this year (lightly edited for clarity).
From Wendy Johnson, MD, MPH (@Artivizm), a family medicine physician and medical director of La Familia Medical Center in Santa Fe, New Mexico: “One of the best axioms I’ve heard re: medicine: ‘Don’t just DO something, STAND there!’ When in doubt, stop for a minute, think about the whole picture, think about the patient’s story. You almost always have time, except in the most emergent situations.”
This is a great reminder that medical school often emphasizes what treatments and tests we might utilize in the most unusual circumstances, but in reality, such heroics are not only unnecessary, they may even prove harmful.
Elianna Saidenberg, MD (@ESaidenberg), a fellow in patient experience in the department of medicine at The Ottawa Hospital in Ontario, added: “Until a patient dies, there is treatment. May not be disease-modifying, but there is treatment of pain and other symptoms. Never, ever tell a patient or family that care or treatment is being withdrawn.”
In other words, it is not a matter of doing everything or doing nothing but rather determining what kind of care a patient needs in each moment.
This tweet by Louis Mullie, MD (@LouisMullie), an internal medicine resident at Centre Hospitalier de l’Université de Montréal, about how to stay out of trouble when performing procedures should probably be posted on the walls in most hospitals. “If you meet resistance, don’t push. If you (or someone else) breaks sterility, speak out—can you swear on your patient’s life that the procedure was clean? If you feel uncomfortable at any step, call for senior help.”
Marleny Franco, MD (@MFrancoMD), a pediatric emergency medicine specialist at Children’s Hospital of Philadelphia and St. Mary Medical Center, tweeted about an all-too-common error. “Don’t use a child as a language interpreter. It’s inappropriate, unfair to the child & family, and unethical. Get a proper in-person or phone interpreter.”