Expert Witness Blog
In Clinical Standards in Medicine medical expert witness Barry E. Gustin, MD, MPH, FAAEM, writes:
Medical negligence litigators seek to establish which clinical standards are pertinent to their case, define what these clinical standards are, and then set out to demonstrate how the clinical standards were not followed.
Historically, from the physicians’ point of view, the issue of “clinical standards” has evoked much apprehension and concern. Physicians claim, and with some fervor, that creating specific standards of care can not be done because each patient is unique, the variables are often myriad and complex, and the deductive reasoning and creative process which leads to a successful diagnosis and treatment would be hindered. They further argue that clinical standards will ultimately increase physicians’ liability exposure and thus will do more harm than good.
In spite of this, during the past four to five years the interest level has continually increased throughout the health care system in pursuing the development of standards of care and several dozen specialty boards are now actively involved in standards development. In the final analysis, carefully written standards may actually help physicians control and limit their liability risks. The current lack of formal standards introduces into malpractice actions a definite unpredictability. Formal standards, by contrast, define a set of expectations that are known in advance of a patient’s evaluation. Compare this with the present situation in which each side supports or condemns the level of patient care in a retrospective manner.