ABSTRACT
In addition to Maine and Florida, other states have developed programmes that allow physicians to use CPGs in some form as a legal defence in a malpractice case.14 In 1993, Maryland, for example, created an Advisory Committee on Practice Parameters in order to study the development of practice parameters for medical specialties and to provide information for and make … recommendations on the adoption and use of practice parameters. The Committee was to propose practice parameters that ‘are consistent with the appropriate standards of care … and are designed to discourage inappropriate utilisation’. Thus, like Maine, Maryland embraced a two-fold approach that sought to improve quality and contain costs. It also incorporated a risk management approach in that the Committee was required to develop practice parameters for ‘individual procedures or diseases that are subject to a significant amount of medical malpractice litigation’. However, any such practice parameters were, by statute, precluded from being admissible as evidence in any legal proceedings in Maryland as evidence of the standard of acceptable care.15
