The Locality Rule and the Physician’s Dilemma | JAMA | 6.20.07
The purpose of medical malpractice law is to protect patients from substandard medical care and to compensate them for injuries sustained as a result of substandard care. Each medical malpractice case serves an additional function by further delineating the medical care that is legally acceptable in a particular field.
Although medical school training, medical licensing requirements, and board certification requirements are based on national standards, many states rely on local practice standards to determine the applicable standard of care in medical malpractice lawsuits. Jurisdictions that maintain local practice standards may inhibit the incorporation of scientific progress into practice standards. In addition, adherence to the locality rule can create uncertainty for physicians when they must choose between following local practice standards and national, evidence-based standards for care.
With apologies to Einstein, the medical-equivalent of the locality priniciple is being replaced by a nonlocality equivalent—well described in the article cited above. An excellent read. When most aspects of healthcare are regulated and paid for on a national level is it unreasonable to hold the providers of that care to anything less than national standards of care? Is the medical locality rule anything more than the residual vestige of non-specialization and non-board-certification in medicine. Specialization and certification seem to be the professional adoption and endorsement of a nonlocality rule.
