What Is the “Two Schools of Thought” Doctrine in a Medical Malpractice Case?

It is a malpractice defense, stated by the Supreme Court of Pennsylvania in Jones v. Chidester (1992), that a physician is not negligent for choosing one accepted treatment when qualified medical opinion is divided. The doctrine is not part of Georgia’s statutes, and the name comes from Pennsylvania law; in a Georgia case, the same question is answered through Georgia’s own standard of care in O.C.G.A. § 51-1-27 and the expert evidence each side offers.

The doctrine where it was named

In Jones v. Chidester, a patient suffered nerve injury after orthopedic leg surgery in which the surgeon used a tourniquet. The Supreme Court of Pennsylvania stated the rule this way: “Where competent medical authority is divided, a physician will not be held responsible if in the exercise of his judgment he followed a course of treatment advocated by a considerable number of recognized and respected professionals in his given area of expertise”. Three features of that formulation decide how it works:

• It applies only to real alternatives. The court said the doctrine “is applicable only where there is more than one method of accepted treatment or procedure”.
• The supporting group must be both reputable and substantial. The court combined two earlier tests, requiring “a considerable number” of “recognized and respected” professionals, without setting a number.
• The defendant carries the burden. “The burden of proving that there are two schools of thought falls to the defendant”, using expert testimony.

How the same question is decided in Georgia

Georgia measures a physician’s conduct by the statutory standard: a person practicing medicine “must bring to the exercise of his profession a reasonable degree of care and skill” (§ 51-1-27). When a defendant argues that the chosen treatment was one of several accepted approaches, that argument is an argument that the care met the reasonable-care standard, and it is presented through qualified experts under § 24-7-702.

That has three practical consequences in a Georgia case:

1. The choice is tested against the standard, not against the outcome. A bad result from an accepted approach is not, by itself, a breach; see the standard of care in a Georgia malpractice case.
2. Competing experts create a jury question. When qualified experts disagree about whether a method was acceptable, the conflict is resolved at trial; in Nguyen v. Southwestern Emergency Physicians (2015), the Supreme Court of Georgia quoted a concurring opinion explaining that, on summary judgment, a trial court must assume the jury could believe a qualified plaintiff’s expert even against a larger array of defense experts.
3. Execution is separate from selection. Choosing an accepted method does not answer whether it was performed with reasonable care and skill.

What the doctrine does not cover

• Informed consent. Whether a patient was told of the risks of the chosen procedure is a separate question under Georgia’s disclosure statute; see when lack of informed consent supports a malpractice claim.
• Emergency care. In an emergency department or obstetrical unit, the plaintiff must prove gross negligence by clear and convincing evidence (§ 51-1-29.5), a separate standard from any “school of thought” argument.

Questions to put to the experts

1. Was there more than one method the relevant specialty accepted at the time of treatment?
2. Who uses the method the defendant chose, and how is that use documented in the field?
3. Even if the method was acceptable, was it carried out with reasonable care and skill?
4. Is the expert qualified under § 24-7-702 in the same profession and area of practice?

Sources

• O.C.G.A. §§ 24-7-702, 51-1-27, 51-1-29.5.
• Jones v. Chidester, 531 Pa. 31 (1992)
• Nguyen v. Southwestern Emergency Physicians, P.C., 298 Ga. 75 (2015)

General information about Georgia law as of October 2026. It is not legal advice, and reading it does not create an attorney-client relationship.