Understanding what your doctor means when they say, Standard of care, or I follow the guidelines.
Channel: BioBalance Healthcast
Date: 08/02/2021

See all the Healthcast’s at https://www.biobalancehealth.com/healthcast-blog/

Doctor lingo is often confusing to those patients who don’t work in the medical profession, and even to some of us who work in medicine, so I believe it is important to translate some of the phrases your doctor uses when explaining why he or she has chosen a particular treatment plan for you.  This Blog addresses what your doctor means when he chooses a treatment plan based on the Standard of Care or the Guidelines written by his particular specialty group. These two terms are often misleading and often following guidelines or Standard of Care is an excuse for doing less than excellent care or even out of date care! Read on to understand how to interpret these phrases when choosing the best medical treatments for you or your family.

Over 25 years ago I decided to offer my help to patients who were injured and to doctors who were being sued without merit, by becoming an expert witness.  My husband is an attorney and I had always gotten many requests to review medical records for his attorney friends to determine whether a doctor had treated a patient with neglect or had injured a patient secondary to an act of malpractice.  Before engaging in this endeavor, I sat down with my husband and asked some necessary questions about what a patient could sue over and what a doctor could use to defend herself if she were sued without merit. 

He taught me that doctors are held to a standard that is called the “standard of care” and if he or she fell below that level of care then she (let’s call all doctors “she” for this blog since I am a woman doctor) would be held negligent if there was lasting damage to a patient.  To my surprise he defined the medical standard of care as the lowest level of care or the least a doctor could do when caring for a patient. Prior to this time, I had thought “standard of care” meant the best care a doctor or nurse can give a patient; however, the name is misleading and is meant to protect doctors from lawsuits and to defend doctors working in indigent and rural areas where they have very few tools and tests to use to diagnose and treat patients. Needless to say, that day I changed how I used the term “the standard of care!”, and how I viewed the care I gave to my patients.

When planning a procedure or a treatment, If your doctor tells you he is following the standard of care you should let her know that you understand that that is the minimum she can do, and that you want the best care possible for your problem, if it is available the most accurate testing and treatment possible.  By letting them know, that you KNOW, you understand the lingo they are using and that you want to receive the best care, you are likely to have a much better outcome than if the bare minimum is done for you.

An example is often seen in the emergency room when a female patient comes in with urinary symptoms: painful urination, trouble passing urine, and back pain. The standard of care is to get a urine specimen and if there is blood in the urine, and white blood cells the standard of care would be to send the urine off for culture and treat the patient with antibiotics.  However, these symptoms are often the sign of a kidney stone, or a renal tumor.  A simple Xray can usually find kidney stones, or an ultrasound of the kidneys can diagnose dilation of the kidneys that would indicate an obstruction of the ureters like a stone or a tumor. Positive tests would lead to more diagnostic procedures and negative would solidify the diagnosis of a urinary tract infection.  The Xray and or Ultrasound would be above the standard of care, but not all hospitals have a radiologist on call to do these tests outside of normal business hours.  Another test that is above the standard of care is a culture of the cervix for chlamydia, a sexually transmitted disease that can scar fallopian tubes and cause infertility.  An above minimal care test would be to also culture the cervix for chlamydia so that the patient could be made aware of an STD so her partner can be treated as well as receive appropriate treatment for Chlamydia.  The chlamydia test would be above the standard of care but is also a necessary test in sexually active women to prevent infertility and should be done!