The question to ask is, how is it that pilots made the switch from "cowboy style" to more reliance on machines and protocols? The answer is probably cultural.

Which brings me to another thing that occurred to me: Is medicine ready for "5 whys?" Checklists aren't going to work until the culture of the medical profession is ready for it. I get the impression that doctors are treated as "functionally infallible" (so long as they consult with other doctors when they need to) and mistakes are treated as flukes and aberrations. (If not entirely swept under the rug.) It's pretty clear that medicine's capacity for self improvement is not entirely mature from the performance of infection control. There are still hospitals that spread infections. (http://www.ehso.com/ehshome/washing_hands.htm)