Oh, I'm sorry. I need to brush up on my geography. I totally forgot that the world has only two countries - India and the US.
Tongue-in-cheek aside, it all depends on legislation, which is influenced by countless variables. The current medico-legal system of the US health care system maintains the role of American radiologists. If that were to change for whatever reason, it would simply depend on the principles of free trade. It doesn't really matter if there are shortages of radiologists in India, China, Brazil, etc. As long as the currency exchange and overall price/cost work in favor of outsourcing, it will happen. Let's not forget that there are many examples in history where countries with famines were net food exporters.
It's not just India. There is a limited global supply of radiologists. The same principle badasshairday mentions still applies.
"We discuss teleradiology and medical image reconstruction from the
perspectives of both India and its client countries. Radiology is an "extreme" professional service with extensive usage of tacit rather than codified knowledge. The importance of tacit knowledge leads to long training periods, a limited global supply of radiologists and heavy government regulation, all of which are obstacles to a "flat world". Computerization of low-end diagnostic radiology ultimately poses a bigger threat to the profession than offshoring.
http://web.mit.edu/flevy/www/indian_rad.pdf : The conclusion sums things up nicely:
"Most of the answer lies in supply and demand. "The world is flat" is a story about
large numbers of developing country workers who can do industrialized country jobs at
much lower wages. 44 In today's economy, there are three reasons why this story has
particular force for back-office services and manufacturing jobs:
•Much of the work in these jobs involves rules-based tasks that can be easily
taught. This makes the assumption about large numbers of developing country
workers realistic.
•The rules-based nature of the work makes output quality easy to determine and so
markets for back office services and manufactured goods are typically lightly
regulated. The lack of regulation eliminates a possible barrier to offshoring the
work."
•Because much of the work is rules-based, workers in both developed and
developing countries face competition from computerized work. Domestic and
offshore workers are competing with each other in a declining market for labor. 45
For the moment, diagnostic radiology satisfies none of these conditions. Because the
work rests on pattern recognition and extensive tacit knowledge, it requires expensive,
multi-year training in every country. As a result, relatively few people world-wide are
capable of doing the work and the supply is not increasing very fast. Because tacit
knowledge (i.e. unarticulated rules) is so important, radiologists currently face no
computer substitution and, in fact, the opposite is true: radiologists are an indispensable
complement to computerized medical imaging, and rapid advances in imaging expand
demand for radiologists' services. The result is a tight labor market for radiologists –
expanding demand and restricted supply – that is the mirror image of the global labor
market for factory and back office workers.
Within this tight labor market, wages do differ significantly across countries. Because
most radiologists are concentrated in high wage countries and supplies in any country can
change only slowly,
an unregulated global radiology market would increase Indian wages
more than it would lower U.S. and E.U. wages. But full convergence is purely
hypothetical since, again unlike factory or back office work, the radiology market is
heavily regulated. The regulations have a public purpose – a way for consumers to
determine professional competence when the cost of incompetence is high. But the
regulations also serve to restrict competition within and across countries. Because
radiologists provide healthcare, a politically charged product, teleradiology can stimulate
public opposition as well. In client countries, patients may protest the use of foreign-
trained doctors. In a sending country like India, people may object if the limited number
of Indian radiologists serves foreign markets rather than medical needs at home."
...
"But even in the Singapore case, market disruption from offshoring [radiology] will not
be very large – the limited world supply of radiologists ensures that."
