Medical Malpractice: Locality Rule

In a Medical Malpractice lawsuit it is incumbent upon the plaintiff to prove that the physician deviated from the necessary standard of care. However, that standard of care can be different depending on where the physician works. In many states, including Illinois, the “locality rule” reigns supreme. Originally designed to protect the physician working in rural areas, the locality rule compares a defendant physician’s conduct against the recognized practices and customs of that locality or similar localities. At the time, he impetus for the locality rule was the fact that a rural physician had less education and less access to proper equipment, etc. It was seen as unfair to compare their conduct to a physician practicing in urban areas.

In Illinois, experts are required to testify as to the standard of care that should have been applied in that particular case. In past Illinois decisions, courts held that the testifying expert had to be a physician who was aware of that locality’s specific standards. However, reflecting advancements in technology, communication, and transportation, Illinois, as well as many other states, has modified the applicability of the locality rule. Although the locality rule is still prevalent in Illinois, especially in situations where there is inequality between medical facilities, the testifying expert often does not need to be aware of that locality’s particular standards. Today in Illinois, an expert may testify as to national standards that form the baseline minimum standards related to certain diagnosis, treatments, and procedures. However, with the advancements in technology and education it must be noted that in many situations the minimum national standards will be aligned with the locality’s standards.

Although in some situations it is still seen as unfair to judge a rural physician by the standards of an urban physician, many states have rejected the locality rule althogether. Illinois has modified its applicability, but it is still a relevant consideration in many medical malpractice suits.