In Clinical Standards in Medicine medical expert witness Barry E. Gustin, MD, MPH, FAAEM, writes:
The existence of clinical standards would enable malpractice litigators to be more selective in their choice of cases. In situations where a clinical standard was followed but where there was an adverse patient outcome, litigators would be less inclined to pursue the matter. In situations where deviation from clinical standards, the litigation process would still allow physicians to explain their reasoning and, in and of itself, is not de facto proof of negligence.
The actual development of clinical standards is complex, time consuming and expensive. In general, these standards should be developed by physician organizations, particularly the specialty societies utilizing appropriate ancillary input from administrators, economists, etc. They should be based on current information and clinical experience and be as comprehensive and specific as possible. They should be periodically reviewed and revised and widely disseminated.
The “standard” should be thought of as a guideline or parameter rather than something that should be adhered to at all times without exception. This more accurately reflects the reality of medicine where nothing is absolute. The “standard”, therefore, is equivalent to a recommendation about the management of a particular problem. This definition is broad enough to provide a framework for the development of applicable, non-rigid approaches to clinical problems in medicine.