Knowledge and ability refer to all aspects of the physician-patient relationship, especially diagnosis and treatment 5 . Courts once held rural doctors to a different standard of care than city doctors because of differences in access to information and technology 6 . This is changing because information routes now spread from the physician's immediate geographic locality into cyberspace. The quantity of information continues to expand into the Internet with medical journals on line, searchable databases and e-mail discussion lists for physicians. Courts determine what practice information common to other physicians a defendant-physician should know 7 .
Some courts weigh the community standard as only one factor amongst many in evidence.
There are jurisdictions that do not apply the locality rule at all, but use a general professional standard instead 8 . Expert physician testimony as to standard of care is common in malpractice trials. It is one type of evidence to help a judge or jury determine the standard of knowledge and skill to impose upon the defendant-physician. To encompass different schools of thought in a field, courts have allowed a physician following a minority-view school to be judged against tenets of that school 9 . However, as medical practices become more standardized, this is diminishing as an acceptable legal approach.