An article I saw in the New York Times this morning had me thinking about the difference between the standard of care and what we all want for treatment. Advances are being made every day in the treatment of diseases and in development of new technologies to prevent them. But, while these new advances may be exciting and promising, they do not represent what practitioners are expected to do when actually treating a patient. The standard of care is in fact a much lower standard for treating a patient. In other words, the standard of care is not the cutting edge of medicine.
This is a truth that may be hard to swallow for some patients who feel wronged by the care they received (or did not receive). We are entitled to at least the standard of care, sure. But, honestly, the standard of care is not even “average” care, in many scenarios it’s probably considered well below that. And, while we want to get the best care, and we are allowed some freedom to shop around for it, the law provides that (for purposes of evaluating negligence) we are entitled to (probably) well below average care. So, technologies like this addressed in the Times article are far beyond what is expected or will be expected for treatment in the near future.
The standard of care is itself an amorphous concept, but in the state of Washington, statute provides that in order to prevail the plaintiff must prove that the defendant “failed to exercise that degree of care, skill, and learning expected of a reasonably prudent health care provider at that time in the profession or class which he or she belongs, in the state of Washington, acting in the same or similar circumstances.” RCW 7.70.040. This standard of care is detailed by expert testimony.
The article that touched off this line of thinking was about new technology being developed to identify cancerous prostate cells. Now, you may well know that the standard of care regarding screening for prostate cancer has fluctuated somewhat in the past ten years. The disease is generally considered a slow growing cancer that has a high survival rate. Even so, many men may end up with metastatic spread that lowers their quality of life, even if it does not shorten it.
Well, some cutting edge technology is being developed to help identify individual metastatic prostate cancer cells before they have a chance to create significant metastatic spread of the disease. This is certainly exciting, and promising for men with prostate cancer (and their families). But, it is still available for only a few men, not yet approved by the FDA, and likely years away from being widely used in the medical community. Even then, it will probably still not be the standard of care.
