The Impact of Medical Liability Standards on Regional Variations in Physician Behavior: Evidence from the Adoption of National-Standard Rules

FOR ONLINE PUBLICATION The traditional "locality rule" contained both a substantive and a procedural component. The substantive component simply provided that physicians must follow the practices of local physicians. The procedural restrictions of the traditional rule required that plaintiffs use local physicians to testify as to the local practices, implicating concerns regarding plaintiffs' abilities to find physicians willing to testify against their peers. Many states amended their malpractice laws by the 1970’s to alleviate this concern, either by permitting the use of outside experts familiar with local practices or by adopting modified locality rules that based standards on the practices of physicians in the same locality or in a similar locality. While relaxing certain evidentiary burdens,