The Locality Rule Lives! Why? Using Modern Medicine to Eradicate an 'Unhealthy' Law

Ginsberg, Marc

doi:10.2139/ssrn.2103948

Cited by 1 publication

(3 citation statements)

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“…This geographic dimension of standard of care varies by statute and jurisdiction 10 and calls on physicians to provide the same degree of skill and care that is required of other physicians practicing in the same community. 3,16 On a national level, this creates tremendous inequality and further exacerbates disparities locally. Indeed, despite similarities in training, licensing, and certification, demanding that doctors mimic the behavior of their nearest neighbors could place unreasonable demands on some practitioners while limiting others by putting them at risk of litigation for personalizing treatment or practicing more advanced medicine.…”

Section: The Glaucoma Case That Changed Standard Of Care Lawmentioning

confidence: 99%

“…Although standard of care means something different in a court of law than it does in most health care settings, 16 it is important to note that there is a circular relationship between malpractice law and the adoption of medical standards. Just as common standards help determine the law, the law helps create new standards.…”

Section: The Glaucoma Case That Changed Standard Of Care Lawmentioning

confidence: 99%

“…However, as geographic variations in care were realized, it soon became common for locality rules to play a role in malpractice cases, drawing smaller and smaller circles around the practices that physicians are supposed to parrot. This geographic dimension of standard of care varies by statute and jurisdiction and calls on physicians to provide the same degree of skill and care that is required of other physicians practicing in the same community . On a national level, this creates tremendous inequality and further exacerbates disparities locally.…”

Section: The Glaucoma Case That Changed Standard Of Care Lawmentioning

confidence: 99%

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Challenges in Elucidating Ophthalmology’s Standards of Care

Hellem

VanderBeek

2022

JAMA Ophthalmol

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IMPORTANCE Defining a standard of care is difficult, and physicians don't always agree on what it means in specific contexts. This is, in part, owing to constantly changing treatment patterns; but at the same time, the underlying framework that determines standards of care is continuously evolving. This situation presents clear challenges for all practicing physicians, including ophthalmologists.OBSERVATIONS Complicating the issue of defining a standard of care are the confusing origins and lexicon used to describe 3 related yet distinct ideas: standard of care, practice guidelines, and gold standards. Indeed, each of these terms is defined and influenced by many stakeholders both inside and outside the health care system. The term standard of care is one example that, although used frequently as a medical term, is often decided by courts and industry. Ophthalmology itself has provided one of the most influential cases in standard-of-care law history (Helling v Carey), which standardized the routine use of tonometry after the plaintiff lost vision because of a delayed glaucoma diagnosis. But even the courts' current view of standard of care is far different than it was at that defining moment in eye care history.CONCLUSIONS AND RELEVANCE Today, health care professionals typically equate standard of care with best clinical practices, and yet the law specifies a standard of minimal competence when determining standard of care. These competing definitions are, at best, misleading and, at worst, counterproductive. This narrative review examines how medical guidelines are developed, formalized, communicated, and adopted in the United States. It seeks to clarify ophthalmologists' understanding of the related but distinct ideas of standard of care, practice guidelines, and gold standards. Last, this review argues that quality of care must be distinguished from standard of care and outlines how legal definitions of standards of care can set exceedingly low benchmarks, discouraging innovation without reducing frivolous litigation.

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Section: The Glaucoma Case That Changed Standard Of Care Lawmentioning

confidence: 99%

Section: The Glaucoma Case That Changed Standard Of Care Lawmentioning

confidence: 99%