Peter - regarding checklists: I am absolutely a proponent of using checklists in medicine. I'm a doctor now, but I was an engineer first. When using humans to perform a task, you improve performance by putting in systems to minimize variation. Intel was great at this; whenever someone made a mistake, our first question was "is this something that could have been prevented by a systems improvement?" This did add sometimes cumbersome layers to a task, but results at Intel are phenomenal.
Back to medicine, this applies directly to Radiology. It can be crucial to have a pre-determined way to approach any given examination. We frequently fall victim to the "satisfaction of search," where a prominent positive finding prevents us from noticing the more subtle abnormalities in a study. Time after time in our M&M conferences, a missed diagnosis comes down to "I guess I just failed to look for _____." I believe that in reviewing a given type of radiology study, the radiologist should take precisely the same steps. I read recently about a hospital (Michigan) who improved radiology reporting by having pre-determined templates for all reports -- basically a checklist of "I checked this, and is was normal, I checked this, and it was abnormal." Many radiologists prefer to dictate their own personalized report, but the standardized report ensures that everything is looked at and reported.
Alvin - Regarding "Death Panels": Actually Becky is the one who came up with this recommendation. A good place to start would be requiring individuals to generate their living will and health care power of attorney documents in order to enroll in Medicare. This would have no effect on many patients, but does take the burden of decision off of the families who find themselves extending care because they don't know what's best for mom or dad, and don't want the burden of having "pulled the plug." And we do see living wills that say "any and all care" on them. Those are fine, too.
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