Outsourcing of Path

[Molly Maquire]

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Hi,

There is an article in today's New York Times about the outsourcing of medical services overseas. You guys probably know that this has been an ongoing controversy in radiology (the chairman of Rads at MGH has tried to send images to India).

The article also states that other specialties are affected as well. Apparently, Path images can be digitized and sent anywhere. This works two ways, however: According to the article, the University of Arizona plans to market its pathology services overseas.

Anyone know of any other hospitals that are sending path images out of house?

 

[Sertraline]

hi mm,

I also read that article.

What scared me is the possibility of large volume of US trained/board ceritified pathologists abroad(Perhaps I am wrong but I assumed this because historically many pathology spots have been filled by FMGs) willing to work for less from their own countries.

I know of a pathology group in ME that has been working with NH/VT community hospital pathologist via teleconference. This hasn't worked only because of poor infrastructure(poor resolution of slides for most part) but once the technology catches up(and it always does), it will be difficult to predict what can happen to the market.

 

[governaitor]

For one thing Hosptials don't pay pathologists. Insurance Cos. Medicare and the patients do. So why would a hospital do this? Moreover, if a hospital started doing this, then all the pathologists have to do to put a stop to it is to refuse to provide any services for the hospital unless they get to provide all the services for which they are trained.

 

[Doctor B.]

I haven't heard of any path departments sending images out of house (of course, this doesn't mean much as I've only had exposure to a few path departments). I don't think it's a good idea, however. Pathology as a service requires the establishment of a good relationship with clinical faculty. In order to have optimal patient care, the clinicians must have a trusting relationship with the pathologists. Being able to look at a slide with a pathologist and talking over the case with them is an essential component of our practice. Outsourcing material loses this interaction and I think that is not a good thing. If I were a clinician, I would rather see a diagnosis rendered by my own in house pathologists and be able to go talk to them about the case rather than simply getting a report from some far reaches of the world. Of course, outsourcing is necessary for some hospitals with small surgical volume who cannot justify having in house pathology. But for larger hospitals, I think keeping pathology services in house is essential for good patient care.