I remember how frightening M&M conferences were when I was in residency. They were led by the 5th year general surgery resident from Yale and I and my two fellow first year podiatry colleagues at the West Haven VA would be sitting there, prepared to present whatever cases we had been assigned from our general surgery rotation. It meant some patient had had a severe complication: a pulmonary embolism, an overdose of a medication, a wrong-sided surgery or - Lord help us all - had died!

That 5th-year Yalie was forbidding enough but how about this for a judge and jury - how about if you had Uncle Sam running your M&M conference. In the New York Times this morning on the Op Ed Section, Jim Hall, former chairman of the National Transportation Safety Board (NTSB) floats the idea of a National Medical Safety Board.

While the NTSB investigates all plane, ship and rail disasters, it can only make recommendations. It has no regulatory powers, Hall says, adding "...its recommendations are viewed by the industry and the public as unbiased and therefore credible, and federal regulators usually act with haste to address them."

Hall points out the need to act on trends not Dr. X's case that went bad. For instance, he thinks that the MRSA cases that seem to be unchecked in hospitals, running medical expenses into the stratosphere, would be one instance where the proposed NMSB would come into play.

We are all duking it out over whether or not to have a national health care plan. Some podiatrists are arguing that the healthcare in America is the very best there is while others point to the data coming out of the WHO, telling us via evidence based medicine that that is not necessarily the case given mortality rates.

The NTSB has never "killed" anybody. In fact, evidence has shown us that it has saved many people.

Hmmm, maybe the National Medical Safety Board could do the same. Maybe Uncle Sam should be allowed to head up our M&M Conference. What do you think?