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"Experts estimate that as many as 98,000 people die in any given year from medical errors that occur in hospitals. That's more than die from motor vehicle accidents, breast cancer, or AIDS--three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems."

From the blurb (I'm not going to buy the report), IOM seems to lump everything that occurs anywhere in the hospital together, from the doctor who errs, to the nurse who administers the wrong medication, to the lab tech who reports out incorrect lab result.

That's NOT the same as "Accidental deaths caused by physicians total 120,000 per year".

It's entirely reasonable to have a system that compensates for bad outcomes (why are all the "bad doctors" in just a few specialties: Obstetrics, Orthopedic Surgery and Neurosurgery?) but there are more efficient ways to do it than to allocate 2/3 of the money to the plaintiff's and defense attorneys.

The study is flawed in more ways than that. There are many assumptions made that are uncorroborated. You criticism is extremely valid, in that ANYTHING that goes wrong in a hospital is attributed to the doctor. This is the "captain of the ship" principle used by the malpractice lawyers [also known as the "deep pockets" principle: "he didn't actually do anything wrong, but he should have known the floor would be mopped and would still be wet after it was mopped, and that doctor has all that malpractice insurance after all, so HE is the one we will sue because that hospital patient fell, even though that doctor was in his office at the time"].

So if a nurse gives a wrong medication, and the patient dies, it is the doctors' fault. If a lab technician gives a wrong result, and the doctor acts on that result to protect the patient, and the patient thereby is harmed, it is the doctors' fault. There are liberal elements in the medical profession [ the AMA is full of them, I might add] that delight in self-castigation. This is the same liberal mindset that is responsible for the "blame America" attitude in the MSM. A lot of them are in the IOM as well. These people aren't taking care of patients; they are instead doing "studies"; thats how they get paid.

I read the IOM study when it first came out. From what I recall, all medical errors were lumped together and no effort was made to try to assess whether there was medical malpractice in the legal sense. The methodology of the study tended to under estimate the rate of error and has withstood challenge.

Some medical specialties invite litigation because they involve high stakes and difficult judgment calls. Brain surgery, Ob-Gyn, and orthopedic surgey all frequently require decisions with the potential to cripple or kill that is lacking in specialties such as dermatology or family practice.

Doctors often fantasize about a no fault compensation scheme for "bad outcomes." But such a mechanism is implausible because it would soon become like workmen's comp with high premiums, frequent but paltry awards, and its own burdens of administrative and legal costs. Since the number of prospective claimants would be far more numerous than doctors, they will tend to win the political battles that shape any such system.

Actually, the medical profession seems to be moving toward more vigorous efforts to reduce or eliminate errors and to be more forthcoming with patients. Anesthesiologists were nearly put out of business by high malpractice premiums but eventually revised their equipment and procedures so as to eliminate many sources of error. Consequently, they now have one of the best malpractice records and low insurance premiums to match.

The combination of high malpractice premiums, evidence based medicine, cost control, and quality measurement will bear fruit over time. The best course for the medical profession is to pursue such reforms rather than to try to tilt the legal system in their favor. When the chips are down, the public fears being the victim of medical malpractice more than they fear death or sympathize with doctors over high malpractice premiums. Doctors almost always lose when malpractice issues get to the ballot box.