In order to become a doctor in the United States, you have to put in a lot of work. You have to go to college. Then you have to go to medical school. Then you must go through a residency program (more training!).

Finally, after finishing all that, most doctors also earn a board certification in a given specialty (such as anesthesiology or family medicine). These are national examinations – if you are board certified in plastic surgery in the US, you have successfully passed the same rigorous testing if you actually practice in Alaska or New York.

Then, after all that, you get your state license.

While the state licensing requirements may vary from state to state, the standards applicable to doctors do not. The same standards – based on all of the above universally required education, training and board testing – apply no matter where you practice.

A long time ago, it was true that the standards for medicine differed depending on where you were. You could expect a different standard walking into a hospital in Seattle versus one in Tonasket. BUT THAT WAS LONG, LONG AGO. It’s not like that anymore.

Which is what makes a recent court decision in Washington so puzzling to those attorneys who represent people injured by medical professionals.

The case originated out of Division III (in Washington state, there are trial courts in every county. If there is a decision at the trial court level that one party doesn’t believe was right, he or she can appeal that decision to an appeals court. In Washington there are three. Division III is basically everything east of the Cascades).

In every Division in Washington, it is understood that, for a doctor witness to testify at trial about whether or not a defendant doctor was negligent, she had to testify that she is familiar with the applicable “standard of care” (with some additional testimony as to how she is familiar with it).

For years, Divisions I and II have recognized that such testifying doctors could confirm they had sufficient knowledge of the applicable standard of care in Washington by testifying that they are familiar with the standard that applies to the defendant, and that the standard is a national standard. Because it is. For all the reasons at the beginning of this post. Unequivocally. Without a doubt.

However, Division III has for years not caught up with the reality of medicine (i.e. IT’S A NATIONAL STANDARD). This recent court case is another example of that, where the appellate court confirmed that the trial court in Spokane was right to throw out an injured person’s case because her doctor witness did not provide the court with sufficient testimony about how he knew what the standard was in Washington State.

It is not enough (unless the Washington Supreme Court wants to take this issue up and lay it to rest. Please do . . . ) to testify that the standard is a national standard. The expert must go further. What I have done in the past, which I believe satisfies this antiquated, incorrect standard, is to find a doctor in Washington State who is the same kind of doctor as my witness, have my witness call this Washington State doctor and have the following exchange:

Hello, Dr. Smith?

Yes hi this is Dr. Smith from Washington.

Hello! Thank you for taking my call. This is Dr. Jones from California. I understand you are a (insert particular type of doctor, such as neurosurgeon). Is that right?

Why yes, I am a neurosurgeon.

Excellent. Hey Dr. Smith, could you confirm for me that the standard of care in Washington is a national standard?

Why yes, I do believe it is a national standard.

Thank you very much Dr. Smith. Have a great day!

You too!

(click)

Folks who read this blog or who have had occasion to know anything about how to bring claims for medical malpractice on behalf of injured people know how many ways there are to lose. Some ways to lose have more merit than others.

I’ll leave it to you to decide how much merit this Division III “rule” has.

The court case is [Boyer v. Morimoto](http://www.courts.wa.gov/opinions/pdf/361667_pub.pdf)