The Locality Rule In Medical Malpractice Cases - Never Intended To Produce Justice
Category: Gaming The System
A commentary in the Journal of the American Medical Association discusses the absurdity of the Locality Rule in determining the standard of care in medical malpractice cases. This is an absurdity which persists purely for the benefit of the medical profession and to the disadvantage of a victim of malpractice.
Courts in 21 states adhere to a local or community standard of care in medical malpractice cases, slowing implementation of evidence-based, resource-based, nationwide standards.
So said Michelle Huckaby Lewis, M.D., J.D., of Johns Hopkins and Georgetown University, and colleagues in a commentary in the June 20 issue of the Journal of the American Medical Association.
The locality rule was a 19th century concept intended to protect rural physicians from being held to the same standards as physicians working in urban areas or at academic institutions, the authors said.
But, they note, modern communication has removed barriers to standardization -- no place is more than a phone call or a mouse click away from the latest evidence-based findings.
As a result, a rule originally intended as a protection now "imposes additional duties and legal risk on physicians. Not only must they remain aware of advances in their own specialty, physicians must also be aware of the standard of care in their locality, whether or not that standard is considered substandard at the national level," the authors wrote.
Dr. Lewis and colleagues contend that the locality rule is also ethically suspect. In the communities that use it, "basic principles of justice may not be met for patients who have been harmed as the result of suboptimal local care standards," they wrote.
That's because patients may be unable to find expert witnesses who'll establish what the standard of care is in that locality -- either because there are too few physicians in the area in that specialty, or the local physicians will be unwilling to testify against one of their own. [BINGO!]
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