The medical standard of care is broadly
accepted as determined by printed, evidence-based and expert-opinion
established clinical practice guidelines. The issue is there are thousands of
published guidelines, some narrowly defined for specific diseases, while others
are much more extensive in range. Examples include the "Choosing
Wisely" initiative made to reduce unnecessary tests and worthless
treatments; others including quality indicators issued by the CMS, are meant to
guide practices to better outcomes by regulating insurance payments.
The definition of medical malpractice is "professional negligence by act or omission by a doctor in which the treatment provided drops below the recognized standard of practice..". Many doctors believe that if their treatment options are supported by this "standard of care", that they're protected against malpractice lawsuits. After all, if a doctor is following the latest clinical practice guidelines, how can he/she fall below the standard of practice?
Guidelines in many cases are written for text-book examples, so, without completely assessing a patient, if this guideline is followed by a doctor, they may be guilty of negligence. A guideline normally can't be admitted as evidence in a malpractice lawsuit unless expert witnesses agree that it applies to a specific case.
Before offering guidelines as evidence in a litigation, intent and correctness of individual guidelines have to be considered. Some guidelines are meant to guide insurance payments, not patient care - like the CMS's "never events". Others are based on opinion or consensus instead of real clinical evidence. Some are obsolete before they are even printed because of rapid progress in the medical field. Still others might be tainted by manufacturing company or pharmaceutical interests.
The wisest course of action seems to be for doctors to treat guidelines as general outlines of care likely to change rather than fail safe statements of the standard of care.
The definition of medical malpractice is "professional negligence by act or omission by a doctor in which the treatment provided drops below the recognized standard of practice..". Many doctors believe that if their treatment options are supported by this "standard of care", that they're protected against malpractice lawsuits. After all, if a doctor is following the latest clinical practice guidelines, how can he/she fall below the standard of practice?
Guidelines in many cases are written for text-book examples, so, without completely assessing a patient, if this guideline is followed by a doctor, they may be guilty of negligence. A guideline normally can't be admitted as evidence in a malpractice lawsuit unless expert witnesses agree that it applies to a specific case.
Before offering guidelines as evidence in a litigation, intent and correctness of individual guidelines have to be considered. Some guidelines are meant to guide insurance payments, not patient care - like the CMS's "never events". Others are based on opinion or consensus instead of real clinical evidence. Some are obsolete before they are even printed because of rapid progress in the medical field. Still others might be tainted by manufacturing company or pharmaceutical interests.
The wisest course of action seems to be for doctors to treat guidelines as general outlines of care likely to change rather than fail safe statements of the standard of care.
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