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Medicolegally, which guidelines am I supposed to follow?


MedP111
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Hey everyone. A few months into IM residency and this is still not very clear to me at all. I always struggle to know which guidelines I'm supposed to be following for the various cases I'm dealing with. I study mostly with American resources so know those the best, but I'm wondering if from a medicolegal point of view, if ever an American guideline differs from its Canadian counterpart and I follow the American one, could I get burned? Malpractice occurs when one fails to provide the "standard of care", but it's not clear to me what exactly the "standard of care" is when there are often multiple guidelines to look at for the same topic. Am I better off always studying Canadian guidelines first and only turning to American resources if the former are lacking? Thanks!

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When it comes to possible cases of malpractice, you are compared to what most of your similarly-trained peers would have done in the same situation. 

It is unlikely that American guidelines deviate significantly from what would be considered reasonable by a Canadian physician. If you can show that your actions are grounded in evidence based practices (as opposed to nothing), that would also be a strong point in your favor.

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18 hours ago, MedP111 said:

Hey everyone. A few months into IM residency and this is still not very clear to me at all. I always struggle to know which guidelines I'm supposed to be following for the various cases I'm dealing with. I study mostly with American resources so know those the best, but I'm wondering if from a medicolegal point of view, if ever an American guideline differs from its Canadian counterpart and I follow the American one, could I get burned? Malpractice occurs when one fails to provide the "standard of care", but it's not clear to me what exactly the "standard of care" is when there are often multiple guidelines to look at for the same topic. Am I better off always studying Canadian guidelines first and only turning to American resources if the former are lacking? Thanks!

As Intrepid86 said. Also, I'd add guidelines aren't perfect, there are plenty of guidelines that are not updated with the latest evidence, and some that are controversial and somewhat biased. Guidelines ultimately serve as a summary and are written by one committee, so even deviating from guidelines is safe as long as it is reasonable with what similarly trained peers would have done. 

 

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On a day-to-day basis you probably want to use the Canadian guidelines within your specialty because that is probably what your peers are doing. However; you are not judged by physicians in court: it will be judge/jury (i.e. educated layperson or completely lay people). Many areas in medicine are not clear cut (conflicting guidelines, vague guidelines, etc.) and they can probably find someone willing to testify as an expert against you.

As said above, at the end of the day you just have to use your best judgement on what guidelines to follow and if they apply to the patient in front of you.

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