The standard of care is designed to protect patients from unreasonable risk of harm. Yet, the physician is not required to possess extraordinary skill or learning, but only “average.”  

The standard of care, however, is not met merely by a physician’s good faith efforts; the fact that a physician practiced to the best of his/her ability is irrelevant.

A physician’s conduct is generally evaluated by standards determined by the medical profession; therefore, what is objectively appropriate does not always yield to consensus. In a profession as complex as medicine, physicians may not agree on the clinical approach in a particular case.  The fact that a physician chose a particular method which resulted in an unsatisfactory outcome does not necessarily lead to the conclusion that an inappropriate method was chosen.  The issue is whether a competent physician would have done so, even if another specific physician would not.

A physician is not an insurer of medical results. Alternative approaches which might not be adopted by a majority of physicians may still be acceptable, if a competent, qualified physician would have selected such an approach and the procedure met a minimal threshold of due care.

A specialist or a physician, who undertakes to perform services requiring a specialist, is generally held to a higher standard of knowledge and skill.

Determining Standards of Care
Professional custom is relevant in determining a standard of care because it suggests an appropriateness of which the physician should be aware, and it warns of consequences when a higher standard is required. 

Standards of care are determined by retrospectively deciding how a physician should have conducted himself/herself in a particular situation, i.e., what is customarily acceptable in the medical profession.  Ordinarily, a physician who conforms to the standard of care of similarly situated physicians has met the standard of care.  In general, the quantitative formulation of the required standard of care is delegated to the medical profession.

Professional custom, however, is not conclusive, unless it is reasonable clinical practice. What is usually done in a given situation is not an objective standard of what ought to be done.

Situational Analysis
The standard of care is judged within the contextof clinical facts/circumstances, rather than by categorical principles.

Because it is usually impossible to state categorically an overall standard for every clinical situation, there are few instances in which a purely objective, standardized diagnosis or treatment can be given.  Therefore, physicians are given the latitude of exercising their best judgment in clinically managing a patient. 

Because clinical management is technical and specialized, only when a physician’s lack of care is so obvious as to be within the common knowledge or experience of a layperson may substandard care be established without expert medical testimony.

Reasonable Prudence
Where serious illness or injury could be prevented by a physician’s application of simple, harmless, dependable and inexpensive tests and services, profession-developed medical standards of care may be subject to a public policy analysis.  Typically, these clinical situations are not so complex that a jury, with guidance from a judge, is required to defer to medical judgment.  These situations involve the failure to use easily understandable tests or services, or the failure to render medical advice which laypersons are capable of sufficiently understanding and appreciating.  Under these circumstances, the courts may make determinations concerning the appropriateness of the medical profession’s standard of care.

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