The Perils of Excessively Relying on Medicine's Tradition of Standardization.

Abstract

Medicine has long relied on standardization to ensure safety, consistency, and efficiency. From evidence-based guidelines to competency-based curricula, standardized practices have shaped both clinical care and medical education. Yet, as social conditions evolve and clinical complexity increases, this commentary argues that rigid adherence to standardized protocols can become a liability. We explore how excessive standardization can constrain expert judgment, perpetuate inequities in education, and hinder responsiveness to emergent societal needs. Drawing on examples from admissions, assessment, and clinical practice, we show how the very structures meant to promote fairness and safety can inadvertently undermine equity and adaptability. We call for a shift toward "adaptive standardization"-an approach that balances consistency with contextual flexibility. Such a shift requires not only individual discernment but also systemic support for clinicians and educators to tailor decisions to specific circumstances. Ultimately, we argue that fostering adaptability alongside standardization is essential for medical systems to remain responsive, just, and resilient in a rapidly changing world.