Critiquing and Expanding on the Concept of ‘Standard of Care’ in Health and Healthcare

By Jon Warner

April 2025

The term ‘Standard of Care’ (SOC) is pervasive in health systems and medical literature, but its meaning and implications are worth examining more closely. On the surface, SOC implies an evidence-based, universally agreed-upon standard for treating a given medical condition. However, a deeper analysis reveals SOC is a less rigorous concept than is commonly assumed.

SOC Often Reflects Local Norms, Not Best Practices

In practice, SOC frequently refers more accurately to the approach “most often used here and now” rather than a true standard. The care deemed standard in one locale may differ significantly from another region even within the same country.

For example, rates of cesarean section deliveries vary widely between US hospitals, from 18% to 69% of births, despite little evidence that some locations achieve better outcomes. This suggests local norms and practice styles influence SOC more than clinical evidence. If the standard was truly evidence-based, we would expect greater uniformity.

Likewise, standards in one nation may bear little resemblance to other countries. For instance, Japan’s SOC for breast cancer involves less aggressive treatment than the US, with similar survival rates. International variation implies the potential for improvement remains when solely relying on present norms as the benchmark.

Medical Knowledge Evolves While SOC Risks Stagnation

What constitutes best practice is constantly evolving as research advances our understanding of disease etiology, genetics, and new treatment modalities emerge. Yet SOC terminology implies a fixed standard that risks stagnating progress.

By definition, SOC represents the status quo rather than the forefront of innovation (and therefore should be the focus of entrepreneurs or intrapreneurs). An inherently conservative concept, SOC therefore provides little incentive to explore alternatives that could transform standards. This dynamic maintains the current approach rather than optimizing care.

For example, SOC long discouraged genetic testing for cancer susceptibility. As the clinical utility of genomics became clear, rigid views of SOC slowed the adoption of this breakthrough. A dynamic, evidence-based perspective is needed to drive continual quality improvement rather than passive acceptance of present norms.

One-Size-Fits-All Standards Limit Personalized Care

No two patients are alike, yet SOC implies a uniform protocol. Individual circumstances like comorbidities, disease severity, patient values and preferences, and biological factors vary widely. A standardized approach may be inappropriate or suboptimal for some cases.

Personalized and precision medicine aim to match treatments to individual characteristics and needs. But the concept of SOC, emphasizing conformity over customization, runs counter to this patient-centered philosophy. A more flexible framework is required to enable personalized solutions rather than a one-size-fits-all mindset.

Emerging Technologies Challenge Traditional Standards

Rapid technological advances especially call for an open and enabling perspective rather than rigid views of SOC as an immutable benchmark. Virtual care, digital health solutions, medical devices, and other innovations promise to transform standards of practice.

For instance, remote patient monitoring enables early intervention for worsening conditions instead of waiting for deterioration requiring hospitalization. Yet entrenched SOC may impede coverage and adoption of such advances despite potential to improve outcomes and experiences of care.

A dynamic view embracing continuous quality improvement, rather than passive deference to present norms, creates space for innovation to evolve standards rather than facing resistance as deviations from the status quo. This mindset maximizes opportunities to advance care through emerging technologies.

Toward a Constructive Reframing

Given these limitations, a more constructive reframing is needed. Rather than an immutable standard, SOC could be understood as the “most often used current approach” — a starting point rather than an endpoint. Focus shifts from rigid compliance to achieving best available outcomes in each unique case.

Terms like “standard therapeutic options” acknowledge variability in patient populations and medical progress over changing times. Continuous quality improvement replaces passive acceptance of present protocols. And an open, evidence-based perspective welcomes innovation to transform rather than disrupt standards.

This dynamic view better enables personalized, precision, and technology-driven approaches shown to improve experiences and outcomes of care. Ultimately, the goal is not adherence to present norms but continually raising the bar on quality through an enabling framework receptive to new ideas.

This article was written by Jon Warner, Executive Chair of Citizen Health Strategies (CHS). Citizen Health Strategies (CHS) specializes in building innovative products and solutions where and when health citizens need them - eliminating care gaps and bottlenecks to create operational efficiencies and outcome effectiveness.