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What is the relationship between clinical practice guidelines and standard of care?

In recent posts, we’ve been discussing cancer screening guidelines in the context of medical malpractice litigation. One important point to highlight in this discussion is that cancer screening guidelines do not, in and of themselves, constitute a standard of care.

Cancer screening falls within what could generally be termed clinical practice guidelines. There is, to be sure, a difference between clinical practice guidelines and the legal standard of care. The latter is determined by how a reasonable practitioner would act in given set of circumstances, and is the proper subject of medical malpractice litigation. Clinical practice guidelines, on the other hand, are intended to synthesize the evidence and guide physicians in making evidence-based decisions in caring for patients. 

As we’ve noted before, expert witnesses can use clinical practice guidelines to illustrate the standard of care in medical malpractice litigation, but such guidelines do not of themselves establish the standard of care. What makes a clinical practice guideline a standard of care is demonstrating to the court that the guideline represents how a reasonable practitioner would act in a similar set of circumstances.

In practice, drastically conflicting clinical practice guidelines are rare. Typically differences are relatively minor, but differences do exist and may, at least in some cases, be enough to make a difference in outcome for the patient. Medical malpractice litigation is very fact-specific, and proving that following an alternative course of care would have resulted in a different outcome can be challenging. Those who seek to recover compensation from a negligent physician should, again, always work with an experienced attorney to build the strongest possible case.

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