What is the "Standard of Care" in a Medical Malpractice Case?

A medical malpractice case is based on a health care provider's actions (or their failure to act), but the question that must be answered is whether the provider's conduct amounted to medical negligence. That usually means that the health care professional failed to meet the applicable medical standard of care under the circumstances.

Negligence and Standards of Care

In personal injury law, negligence means the failure to exercise the proper amount of care under what's known as the "reasonable person" standard. To simplify, if a reasonable person would have taken a certain action, then not taking that action would be considered negligence. And on the other side of the coin, if a reasonable person would not have done a certain thing, then doing it would be considered negligent.

In medical malpractice cases, a doctor's action (or inaction) is measured against a special yardstick known as the "medical standard of care." This is a legal term, not a medical term. That means it's primarily lawyers, not doctors, who use it. In general, the only times that most doctors talk or think about the medical standard of care is when they're testifying in court on medical malpractice cases, or when they're attending medical malpractice seminars.

The "Medical Standard of Care" Defined

Different states define it in slightly different ways, but the medical standard of care usually means the degree of care and skill of the average health care provider who practices in the provider's specialty, taking into account the medical knowledge that's available in the field.

So, the standard of care is typically based on the hypothetical practices of a reasonably competent health care professional in the same or similar community. (See examples of medical malpractice to understand what sub-standard care looks like.)

An Expert Witness Usually Sets the Standard of Care

In most medical malpractice cases, it's a qualified medical expert witness who tries to establish the appropriate standard of care that applies to the defendant health care provider's conduct in treating the patient (the plaintiff). In some states, this kind of expert testimony must be provided alongside the lawsuit, in a sworn filing known as an "affidavit of merit."

As the lawsuit progresses, multiple experts (often at least one for each side of the case) will likely provide testimony on what they think is the appropriate standard of care against which the defendant's treatment of the plaintiff ought to be assessed.

'Customary Practices of the Average Provider' vs. the 'Reasonable Provider'

Remember that "reasonableness" is the standard for ordinary negligence, but doctors and other health care professionals are judged by the customary practices of similar care providers. These standards may sound the same, but there are distinctions. Physicians and other professionals are often afraid that lay people, including patients and jurors, might interpret "reasonable care" as ideal care, or perfect care, a standard that's not possible to meet. Learn more about when it's medical malpractice and when it isn't.

Health care professionals know that most medical procedures and treatments involve some risk and/or complications, or that anything other than a full, setback-free recovery must amount to medical malpractice.

Complications Are Sometimes Unavoidable

One good example of complications in standard medical treatment is anesthesia. The administration of anesthesia always involves risk. There is nothing that even the best anesthesiologist in the world can do to reduce the risk of anesthesia to zero. Sometimes the anesthesiologist can do everything by the book, and the patient will still have a bad reaction to the anesthesia.

Another way to look at the difference is to compare the legal and medical viewpoints on standard of care. While health care professionals tend to believe that reasonable care includes the customary practices of the average provider, the typical legal viewpoint is that reasonable care and the customary practices of a provider in the same or similar community are separate standards of care, although with some overlap.

Does the 'Reasonableness' Standard Ever Apply in Medical Malpractice Cases?

Despite what physicians may want, some states have been moving toward the standard "reasonableness" definition in assessing liability in a medical malpractice lawsuit. Other states use what is called the "second school of thought" or the "respectable minority" definition, in which doctors and lawyers recognize that there may be more than one acceptable method of providing care to a patient in a given situation.

Establishing the Standard of Care Is Just the Start

Most medical malpractice cases hinge on what happens next: a so-called "battle of experts" in which the plaintiff's side uses medical evidence and qualified expert witnesses to show why the defendant's conduct fell short of the medical standard of care, and the health care provider's side offers its own experts to argue that the care provided was in line with that standard. This is one big reason why medical malpractice cases are so complicated, and difficult to win.

If you have specific questions about your situation, or you just want to understand your options if you think you've been harmed by sub-standard care, it may be time to reach out to a medical malpractice attorney.