From the blog of medical expert witness Dr. Barry E. Gustin, MD, MPH, FAAEP:
Locality Rules and Qualifying Medical Experts
By the 1970’s, jurisdictions began modifying the locality rule. One problem the courts faced had to do with whether a medical specialist practicing in a rural area was in any way deprived of the conditions enjoyed by medical specialists practicing in urban areas where teaching centers were located. Their concern was that if the answer was yes, then eliminating the locality rule might discourage medical specialists from practicing in rural areas. Courts eventually decided to compromise and instead of adopting a national standard, they converted the locality rule to a state standard. But over time, it became clear that this made no sense because the standards were truly national standards, and so courts began abandoning the locality and statewide rule for all physicians.