In Clinical Standards in Medicine medical expert witness Barry E. Gustin, MD, MPH, FAAEM, writes:
Although this clinical policy standardizes the approach to evaluating chest pain, the researchers responsible for its development emphasized its limitations stating that the reality of medical practice is that the physician is often gathering data, performing interventions and making decisions simultaneously, sometimes within a short period of time. Once again, the clinical policy is a reasonable standardized approach to the evaluation of chest pain but can never supersede the physician’s clinical judgement which, because of the immense number of clinical variables and continually changing circumstances, must be taken as the final word in making patient care decisions.
Clinical standard development is here to stay. Although they are a cause of consternation among many physicians because of their potential for use against physicians in medical malpractice lawsuits, they will, in the long run, help physicians continue to practice higher quality medicine, avoid malpractice, and more easily defend against frivolous or spurious lawsuits.