Posts Tagged ‘morbidity’

Don’t Want To Die? Avoid Going to the Hospital in July

July 23, 2011

You are to have elective surgery or you need to go to the hospital for a procedure. You may want to consider deferring this decision the month of July or in early August. Why? Conventional wisdom has long held that the quality of care in hospitals plummets during the month of July. But now a new study published in the Annals of Internal Medicine on July 11 confirms that suspicion.

Most newly minted doctors, interns, residents, fellows, and nurses graduate in June and begin working in hospitals on July 1. Teaching hospitals where doctors and nurses train have little experience caring for patients, often aren’t well supervised and don’t yet know the hospital system. As a result, patients remain in the hospital longer, and risk of complications and even death are higher in early July than the rest of the year. This finding is designated the “July Effect” in medical circles.

As a group, these physicians-in-training are supervised by fully trained doctors but from day one these new doctors are writing medication orders and doing certain procedures and diagnostic tests with relatively little direct supervision, so there’s always an opportunity for something to slip through the cracks and mistakes can be made.

Because on or around July 1, fresh, inexperienced interns, residents, nurses and other new health care workers first report to work at many of the nation’s hospitals, eager to start practicing medicine — on you.

In medical circles it’s known as the “July effect.” The new study reviewed data from 39 previous studies that tracked health results in teaching hospitals — including death rates and complications from medical procedures. The best designed and largest studies, the authors found, showed mortality rates increase 4 to 12 percent in July and revealed that many patients remain in the hospital longer, spend more time in surgery and have higher hospital charges in July than in other months. After analyzing more than 62 million death certificates issued across the country from 1979 to 2006, researchers found that fatal medication errors consistently spiked in July by about 10 percent — but only in U.S. counties with many teaching hospitals — and then subsided in August to levels on par with other months. Yet there was no measurable increase in counties with facilities that don’t employ residents, such as community hospitals.

How protect yourself from the July Effect

• Bring your own health records (including a “Personal Medication Record”).
• Ask a friend, relative or other health advocate to stay with you.
• To lessen the chance of mix-ups, state your name to anyone providing you with care.
• Know the name of the doctor who is ultimately in charge of your care.
• Ask your doctor who will be doing the surgery or the procedure and consider asking him\her if they will promise to do it and have the new doctor serve as an assistant

Bottom Line: All surgery and all medical procedures have risks and complications but you can reduce these risks by avoiding a teaching hospital the month of July and early August.

This article was excerpted from “Why? New doctors and nurses report to work for the first time, eager to ‘practice’ medicine on you”
by: Sid Kirchheimer

Low T Can Lead To a High Risk of D….as in Death!

October 21, 2010

Testosterone is the male hormone produced in the testicles and is responsible for your libido or sex drive.  The blood level of testosterone can also be a marker for heart disease in men.  Low testosterone levels  predict worse outcomes  in men who already have heart disease. 

What isn’t clear is whether low testosterone causes or worsens heart disease-and whether testosterone replacement therapy would help prevent heart disease.  Testosterone replacement therapy may not reduce the risk of heart disease, however, studies demonstrate that you will feel better if your testosterone level returns to a normal level.

There are a lot of actions that you can take to lower your risk of heart disease: Lose weight, lower your blood pressure, exercise regularly, stop smoking, and lower your cholesterol level. The goal of testosterone replacement should be to approximate, not exceed, normal testosterone levels.

Bottom line: Get your testosterone level checked regularly. If it is low get a cardiac risk profile and start exercising!

Excerpt from journal Heart, October 20, 2010