Clinical judgment and best evidence: will I be sued if I do not follow the guidelines?

Optometrists are increasing their roles into the field of clinical management. Making management decisions and treating patients increases the risk of litigation. Guidelines have been developed to assist in the clinical care of patients and are being increasingly used in litigation cases to assist in the decision making process. This article outlines the status of litigation as it relates to current optometric and ophthalmic practice, and discusses clinical management in the context of guidelines. In some countries, including the UK, optometrists are becoming the principal providers of primary eye care in the community, with their role expanding beyond traditional refractive practice into the realm of the treatment of medical conditions. The delivery of health care in the modern era is becoming increasingly challenging as a result of improving patient knowledge via the Internet, and a commensurate rise in patient expectations. In addition, close scrutiny by the media and those in the legal profession has appeared to drive an increase in claims against practitioners. Practitioners are vulnerable to litigation when patients consider that their care has fallen below acceptable standards. This article discusses the current status of guidelines with respect to potential litigation in the context of clinical care as it relates to expanding roles within optometric practice.