Outsourcing of medicine

[coolness]

As many of you are aware, many jobs (accounting, IT, etc.) are being outsourced to India. Companies, as well as government, want to reduce cost. Also, they have a rich pool of educated and hard-working people in India. This has led to job loss in America and high levels of unemployment. Now I?m hearing that certain specialties in medicine are threatened as well (radiology, pathology). What are your opinions on this topic? Should all physicians or certain specialties feel threatened? Are there any specialties that you feel are safe (and not safe) from outsourcing?

On a side topic, I?ve read other posts that NPs are considered potential threats to primary care physicians, especially IM doctors. There are claims that NPs can perform almost every task that an IM doc can. They can also prescribe medicine as well. Also, the organization that looks over NPs is independent of organizations that look over MDs and DOs. So I have read that physician organizations cannot do anything. If this is the case, do you think IMs will be phased out by NPs, which earn lower salaries (hospitals can save money)?

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[Gleevec]

As many of you are aware, many jobs (accounting, IT, etc.) are being outsourced to India. Companies, as well as government, want to reduce cost. Also, they have a rich pool of educated and hard-working people in India. This has led to job loss in America and high levels of unemployment. Now I?m hearing that certain specialties in medicine are threatened as well (radiology, pathology). What are your opinions on this topic? Should all physicians or certain specialties feel threatened? Are there any specialties that you feel are safe (and not safe) from outsourcing?

On a side topic, I?ve read other posts that NPs are considered potential threats to primary care physicians, especially IM doctors. There are claims that NPs can perform almost every task that an IM doc can. They can also prescribe medicine as well. Also, the organization that looks over NPs is independent of organizations that look over MDs and DOs. So I have read that physician organizations cannot do anything. If this is the case, do you think IMs will be phased out by NPs, which earn lower salaries (hospitals can save money)?

I think the sky has been falling on every profession forever, but the fact is things are probably not going to be as bad as they seem. While its true that a few rads and paths might lose their jobs to Asia, most doctors want to interact face to face with the people they are working with on a diagnosis. Its likely that the only rads and paths to get outsourced are the ones that do little work, arent particularly team players, or are asking for too much. As is the case in any field, the better docs that are good team players and show up to work and work well with others wont have any problems. So if you want to do telerads on some yacht for 300k a year, you're probably going to get outsourced. But if you work well with other docs and patients, its unlikely that someone abroad would be able to offer what you are able to.

Basically the only specialties that are under threat from outsourcing as I understand it are rads and paths, but even then, there is little evidence that even this will continue into the future. Its not like software where code is hidden and its source is irrelevant to most consumers, people WANT to go to American doctors, so basically any field that interacts with patients is likely immune from outsorcing.

 

[southbelle]

Gleevec, you won't find too many community pathologists who do nothing but look at prepared slides one after the other all day. I see that as the only part of path that can be outsourced. Yes, that's a very significant billable source in pathology(the most significant in many practices), but what about immediate frozen sections and autopsies? Those certainly cannot be outsourced, and good luck finding a pathology group in the future to contract out with a hospital network that is outsourcing routine prepared slides but giving them all the autopsies and frozens.

And this doesn't even get into the CP part of path. Rads is a far more likely candidate for outsourcing than pathology.

 

[Zweihander]

I suspect that residency programs will start shutting down and specialties will begin to let fewer people in before existing doctors start losing their jobs.

 

[oldtimer]

Outsourcing rule of thumb: Can you job be done anywhere in the world? If all you need is a phone or computer monitor to do your job, then it is a prime candidate for outsourcing. The decision to outsource is more complicated than that and takes other factors into consideration but you get the picture. From what I have read, one of the major reasons why people go into rads is because it requires very little patient contact. So I do think that rads and path are the most likely medical fields to be outsourced. Even if your particular job is safe from outsourcing for now, remember that outsourcing affects your entire field. Outsourcing effectively increases the supply side because the global talent pool is being tapped, not just at the national level. Until global demand catches up, the supply/demand curve will be skewed in favor of lower wages and more difficulty in finding jobs in that field. This is what happened to manufacturing and blue-collar workers for the last few decades. It's finally having an effect on white-collar jobs. You see it happening now in IT. How big of an impact will outsourcing have on medicine? Nobody knows for sure. However, it behooves you to pay close attention to it though. To be safe, I'm going into a medical field where I know that the physician has to be physically present with the patient, ie, primary care, surgery, etc.

 

[fullefect1]

I have read a couple posts on this in the radiology board and they argue that insurance companies will most likely never let this happen, at least anytime in the near future. If you guys are really interested, go check out the radiology forum. There are a bunch of discussions about outsourcing in medicine in that forum.

 

[ewing]

Outsourcing just means subcontracting something out instead of doing it in-house. I think the term you mean is offshoring.

Of course a lot of people use the term 'outsourcing' the way you do, and it allows politicians to give sneaky answers to tough questions (like "outsourcing is only up 3% over the past year").

Incidentally, offshoring is already on the decline in the manufacturing sector--everyone has already built their factories in Mexico and China.

Sorry to be a nit-picking a--hole, but knowing the precise terminology enables one to do better research and thus be a more responsible voter, etc.

 

[flighterdoc]

I have read a couple posts on this in the radiology board and they argue that insurance companies will most likely never let this happen, at least anytime in the near future. If you guys are really interested, go check out the radiology forum. There are a bunch of discussions about outsourcing in medicine in that forum.

It's already happened to some degree. The question is if it will be allowed to continue.

There's an outfit in Australia called "Nighthaws" or something that will read films for your hospital/group, that is trying to get more business in the US.

 

[southbelle]

It's already happened to some degree. The question is if it will be allowed to continue.

There's an outfit in Australia called "Nighthaws" or something that will read films for your hospital/group, that is trying to get more business in the US.

arent those US board certified radiologists though? I don't think anyone is worried about that because there will only be so many US radiologists who won't want to live here, and the number of board certified radiologists wouldn't be affected.

What most people are worried about is indian radiologists who don't possess an american liscensereading and isn't that prohibited at this time by the federal government?

 

[SoulRFlare]

just wait until remote-controlled robotic surgery becomes widespread!!

 

[Gleevec]

just wait until remote-controlled robotic surgery becomes widespread!!

Remote controlled? Please, robots are superior to humans in every possible way. And I for one plan on welcoming our new overlords.

 

[greenwave34]

Just wait for the outsourcing/offshoring of OB/GYN's!!!...Oh wait, hmmmm.

 

[SoulRFlare]

Remote controlled? Please, robots are superior to humans in every possible way. And I for one plan on welcoming our new overlords.

...Resistance is futile...

 

[jeffsleepy]

With my degree in EECS, I am well equipped to join the enemy when the time comes and program computers to take over my old job.

 

[fullefect1]

It's already happened to some degree. The question is if it will be allowed to continue.

There's an outfit in Australia called "Nighthaws" or something that will read films for your hospital/group, that is trying to get more business in the US.

I believe this australian company is still paying like 500k a year, and ya they are U.S. board certificate radiologist. My impression is it is just like having american doctors taking a long vacation in another country.