Sometimes a patient is forced to file a lawsuit to attempt to fix or make up for the harm caused them by what they believe was wrongful medical care. When a jury hears their case, it must decide whether the care was wrongful. The legal standard the judge asks them to apply is called the “standard of care”. If a provider meets the applicable standard of care, he or she is not negligent and thus not responsible for the patient’s injuries. If the provider does not meet this standard, he or she is negligent and may be responsible (depending on whether the patient can also prove that the negligence caused the harm the patient is complaining of). So, should you expect the same level of care everywhere?

This “standard of care” is defined by statute, and boils down to reasonable prudence under the circumstances. The provider doesn’t have to be perfect, but does have to be reasonably careful under the circumstances.

Now, the jury typically hears from experts – the same kind of doctors as the one whose care is alleged to have been wrongful. If the case involves an emergency medicine doctor, then the jury hears from emergency medicine doctors who have expertise to tell the jury why this particular doctor either met the standard of care (experts for the defendant) or fell below it (experts for the plaintiff).

Often times, particularly on the plaintiff side, those experts come from out of state (it can be difficult for local doctors to point the finger at a colleague and testify that he or she was negligent).

Almost always, these out of state experts must testify that they are familiar with the standard of care IN WASHINGTON (because that’s where the case is). And almost always, it’s the case that they are familiar with our state’s standard because it’s a national standard. Because every emergency room doctor takes the same board exams across the nation, the standards they are held to are typically the same whether they are in Seattle or Boston.

Similarly, hospitals themselves have standards of care they must follow, and if they don’t, they can be found negligent. And often times it’s the same – Harborview is held to the same standard as Johns Hopkins, for example. Patients who present to either hospital can expect the same or similar level of care from the doctors who treat them.

But not always.

Specifically, where a hospital is located can greatly affect the standard of care it must provide its patients. That is in large part due to the differences in resources available. Take for example Harborview: it is the largest trauma hospital in the state, and takes patients from neighboring states too. Because it is so large and so well equipped, it can offer a level of care different than, say, Mason General Hospital in Shelton.

Recently I evaluated a claim involving care provided at a Washington hospital in a relatively rural part of the state. There was a delay in care provided, and the patient suffered harm as a result. Part of the patient’s reason for being upset was that there was no surgeon immediately available, and instead had to drive into the hospital to perform the emergency surgery. As a result of the delay, the patient believed (probably rightly, in my view) that harm occurred.

I had a consulting expert with whom I’ve worked in the past review it. Although tragic, he pointed out the impracticability of offering “Harborview-level” care at every hospital in the state. The fact is, he noted, “no county on earth has the resources to provide 100% of appropriate care to 100% of the population.”

The reality is, where you live matters in terms of the health care available, and what standard of care you can expect.