The study and practice of medicine is constantly changing. Hospitals and specialty societies develop protocols and standards of care based on what is thought to be the best evidence and science at the time. Over the years, these things change or even go in cycles: leaches for bloodletting, tourniquets for limb salvage at the scene of trauma, and crystalloid versus colloid for resuscitation. What we can ALL do is recognize that the standards of care, that we not only embrace, but also insist upon, are not considered standards of care everywhere. In fact, in many places what we consider “standards of care” either don’t exist at all or are rare and when present might actually be disruptive technologies.

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