Skip to content

Locality Rule in Tennessee: Medical Malpractice Law, Getting an Expert To Trial


I.       The Supreme Court of Tennessee looks disfavorably upon the locality rule for standard of care regarding physicians in the State, opining that it should be “relegated to the ash heap of history” and replaced by the national standard.  However, as the rule is statutorily created by the Tennessee legislature, the Court is averse to doing away with it.  Instead, the Court has lowered the bar, allowing a relaxed more forgiving interpretation, which allows a greater number of out of state physicians to be admitted as experts in medical malpractice cases.

     The Supreme Court, Sharon G. Lee, J., held that: a medical expert in a medical malpractice case must demonstrate “a modicum” of familiarity with the medical community in which the defendant practices or a similar community; (emphasis mine) Shipley v. Williams, 350 S.W.3d 527, 552-53 (Tenn. 2011).  Furthermore, a proffered medical expert is not required to demonstrate firsthand and direct knowledge of a medical community and the appropriate standard of medical care there in order to qualify as competent to testify in a medical malpractice case, rejecting Eckler v. Allen, 231 S.W.3d 379, and Allen v. Methodist Healthcare Memphis Hosps., 237 S.W.3d 293.

There is substantial Tennessee precedent that permits experts to become qualified by educating themselves by various means on the characteristics of a Tennessee medical community. See Stovall, 113 S.W.3d at 723; Searle, 713 S.W.2d at 64–65; Taylor, 231 S.W.3d at 368–71; Pullum v. Robinette, 174 S.W.3d 124, 132–33 (Tenn.Ct.App.2004); Bravo, 148 S.W.3d at 360–61; Ledford, 742 S.W.2d at 648.  “A profferedexpert may educate himself or herself on the characteristics of a medical community in order to provide competent testimony in a variety of ways, including but not limited to reading reference materials on pertinent statistical information such as community and/or hospital size and the number and type of medical facilities in the area, conversing with other medical providers in the pertinent community or a neighboring or similar one, visiting the community or hospital where the defendant practices, or other means. We expressly reject the “personal, firsthand, direct knowledge” standard formulated by the Court of Appeals in Eckler and Allen.”  Shipley v. Williams, 350 S.W.3d 527, 552-53 (Tenn. 2011).