When visiting your physician, there is the basic expectation that you are going to receive the most appropriate and up-to-date treatment for your illness or injury, regardless of who you see and where. You also trust that the physician treating you will treat you in the same way they would treat any other patient suffering from the same illness.
If a physician is unable to provide the necessary treatment within their facilities, or the treatment required is outside of their training and expertise, the expectation is that they will refer you to a location or specialist prepared to meet your medical needs.
How do we know what the appropriate treatment is, how is it decided or standardized, and what are the legal implications of how you are treated?
What is the standard of care?
First and foremost, the standard of care is a diagnostic and treatment process that a clinician should follow for a certain type of patient, illness, or clinical circumstance. In other words, this is the level of care widely accepted in the medical community. While these standards are not warehoused or compiled in any one particular place, they are the common best-practices adopted by healthcare professionals through a variety of training and education, and ultimately inform adopted protocols.
The standard of care is also what medical malpractice cases are built upon and can, in this case, be similarly defined as the type and level of care that any ordinary, prudent, health care professional, with the same training and experience, would provide under similar circumstances, in the same community.
Examples of common standards include:
- The National Standard of Care requires a physician to use the degree of skill and care of a reasonably competent practitioner in their field under the same or similar circumstances
- The Locality Rule requires a physician to have the reasonable caliber of skill and knowledge that is generally possessed by surgeons and physicians in the locality where they practice
- The Respectable Minority Rule says if physician did not follow the same course of therapy that other physicians would have followed, they may show their course is accepted by a respectable minority of practitioners
For example, a national standard of care presupposes that rural physicians will have the same training and exercise the same level of judgment and diligence, as urban practitioners. However, it does not require rural physicians to have the same available medical facilities.
In this case, if a rural community does not have the facilities necessary to perform emergency surgery, physicians cannot be found negligent for failing to perform a surgery. Under these circumstances, the standard of care differs from what would be acceptable in a facility where the resources were available.
However, physicians practicing under a national standard would need to alert patients to the lack of necessary resources, should they exist, and likely make a referral to another physician or facility, to provide the best care for their patient and ultimately avoid liability.
Why is the standard of care important to a medical malpractice case?
The standard of care is important to a medical malpractice case because it is central to determining whether a physician can be held liable for a patient’s injury. The injured party or plaintiff will likely be required to establish the following points:
- The standard of medical care that the physician owed the plaintiff under the particular circumstances
- The physician breached that standard of medical care
- The plaintiff was injured
- That the physician’s negligence caused or contributed to the plaintiff’s injuries
The standard of care can be difficult to determine and can take many expert witnesses to clearly define whether or not a specific patient was injured by the action, or inaction of a physician. Regardless, the standard of care remains central to each and every medical malpractice case.
How is the standard of care established legally?
The requisite standard of care is determined by evaluating the performance and abilities of physicians practicing near the physician accused of malpractice, the exact proximity is determined state by state.
The standard of care in a particular case rests on the expert testimony of practicing physicians in the field of medicine wherein the physician in question is currently practicing. For example, a cardiologist would be an appropriate expert medical witness in a case of unnecessary angioplasty, but not in a case of negligent spinal surgery.
An expert medical witness must first establish what the standard of care is in that particular case. They must then testify as to exactly how the patient’s treatment did not meet the standard of care. Lastly, they must testify as to how the patient was harmed by substandard treatment.
The medical expert speaks to the standard of care in a malpractice case, but it is ultimately the jury who must decide whether or not the injured party was treated to the standard of care or not.
In other words, the critical question in a medical malpractice case is, “Would a similarly skilled health care professional have provided the patient with the same treatment under the same or similar circumstances?” If the answer is no, and the patient may have been harmed as a result of the sub-standard treatment, there may be grounds for a medical malpractice case.
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