Standard of care refers to treatment modalities of specific diseases that are widely accepted by the majority of physicians, insurance companies and certain health care related organizations. Such standard treatments have evolved over the years as a result of clinical experience, basic science research, clinical research and technical innovation with the goal of leading to uniformly acceptable outcomes. Some of the outcomes are unsatisfactory to many physicians and researchers, but never the less these outcomes are accepted because they are the best that can be achieved given available knowledge and expertise. The vast majority of physicians practice in very similar ways on most of the well-known and long established conditions and diseases. Of course, this is to be expected, and it is a paradigm that holds true not only for medicine but also for all human endeavors where evolution is the key to progress, and where the “minority” is always the catalyst for change.