By law and by professional oath, physicians have a duty to provide competent medical advice and treatment. A mistake or lapse can be fatal or life-changing. In a medical malpractice lawsuit, doctors are not judged by whether they are perfect. They are judged by whether they deviated from the “standard of care” owed to the patient.
If the lawsuit goes to trial – as is often the case with medical malpractice – other medical professionals are called upon to testify whether the doctor breached that trust and provided substandard medical care. The standard of care varies with the situation, but it can be defined.
What is meant by “standard of care” in medical practice?
In other negligence cases (such as a car crash), the standard of care refers to what a “reasonable person” would do to avoid harming others. In medicine, standard of care refers to the accepted practices or course of action within the medical community. Did the doctor stray from standard protocol, causing harm to the patient? Would another doctor have made the same mistake or misjudgment in similar circumstances?
In surgery or childbirth, for example, there are standard practices that are considered acceptable within that specialty. The physician should stick to the pre-op plan, rather than taking shortcuts or unnecessary risks, or experimenting with unproven techniques. But once the operation is underway, there may be complications that cause the surgical team to improvise or react quickly. The standard of care is more lenient for urgent or unforeseen situations, but it doesn’t mean the surgeon or doctor is off the hook. There are still medical guidelines and hospital rules for those scenarios.
Factors in assessing the standard of care
The standard of care is the expectation for a given medical professional in a given circumstance. Nurses are held to a different standard than physicians. General practitioners are held to a different standard (not necessarily a lower standard) than specialists. For example, an emergency room physician or family doctor would be expected to conduct an exam and order certain tests on an accident victim. But those doctors would not be held to the same standard as a neurologist or neurosurgeon for identifying and appropriately treating a traumatic brain injury. Conversely, a neurologist would not be expected to diagnose a patient’s fractured rib.
In other words, the standard of care is based on the skill, expertise and care that would be expected of peers in the same field and similar circumstances. Through professional associations and government regulations, medical standards are more uniform and clearly defined. In a medical negligence lawsuit, the question becomes whether the doctor’s actions and decisions were consistent with the expectations of the medical community. One example is exceeding the generally accepted dosage of strong medications or off-label use of drugs that is frowned upon by fellow medical providers.
Making the case for malpractice
In order to prove that a doctor failed to provide you with the proper care, your lawyer will need to find an expert witness (or two) to support your case. Because doctors are a tight-knit community and reluctant to get involved in malpractice litigation, this can be a tall order.
This doesn't mean that you can't make your case. It means that you might need to find the doctor who is willing to stand up to his or her peers for the good of patients and the profession. Fortunately, there are doctors who are willing to speak up against incompetence and malfeasance by their peers.
In addition to medical experts, you have to establish the underlying case. This includes securing medical records and gathering other information about your condition and acceptable treatments. You need to show exactly what the doctor knew when he or she made the wrong diagnosis, took the wrong action or otherwise deviated from the standard of care.
Not every bad outcome constitutes malpractice. Even medical errors are not necessarily grounds to sue. In a successful lawsuit, it’s not a question of what happened but pinpointing why it happened. It happened because someone didn’t adhere to the rules.