Here is what happens to those who advocate outsourcing, take this prestigious radiologist who
was a professor at Harvard Medical School.
This is when he first advocated outsourcing:
MGH examines India for X-ray reading help
Hospital may use radiologists there
By Martin Desmarais
Published: 10/15/2002
Jo-Anne O. Shepard, M.D., director of thoracic radiology at Massachusetts General Hospital, examines X-rays. A shortage of radiologists is causing officials to consider outsourcing diagnostics to other countries.
BOSTON Hospitals have a problem finding radiologists, whose salaries are skyrocketing, said Dr. Sanjay Saini. He believes India has the solution.
Since most X-rays are now digital and can be sent in electronic files, Saini said it is feasible that radiologists in other countries can examine X-rays over the Internet.
Saini is an associate professor of radiology at Harvard Medical School and on staff in the radiology department in Bostons Massachusetts General Hospital.
He said several radiology centers are already examining X-rays over the Web. These include the School of Medicine at Case Western Reserve University, which works with radiologists in Australia, and The University of Medicine and Dentistry of New Jersey, which works with radiologists in Israel.
For Mass General, Saini has enlisted the help of the Bangalore-based Wipro Ltd., a software provider with over 9,500 software engineers and offices in 27 locations around the world. Wipro would set up the technological infrastructure that will allow Mass General to work with radiologists in India.
Mass General and Wipro are currently working to put an initial system in place to see how it works.
In the last few years, the number of radiologists graduating from colleges across the country has decreased significantly, leaving hospitals such as Mass General scrambling for staff, Saini said.
At the same time, he added, the expanded use of radiology from traditional diagnostics for bone injuries to preventive measures for detecting cancer or coronary diseases has increased the need for radiologists.
The problem we are trying to solve is a mismatch of demand for services and radiology specialists, he said.
Further complicating the matter, Saini added, is that because the demand for radiologists has increased, professionals in the field have begun to demand higher salaries and better working hours.
While hospitals need a radiologist available 24 hours a day, seven days a week, many radiologists are looking to work fewer hours and avoid weekends altogether. Its an arrangement some hospitals are willing to make because they need staff so badly, Saini said.
As a result, hospitals such as Mass General are losing staff, he said. For example, the University of Massachusetts Medical Center has lost half its radiology staff in the last seven months, he said.
With a six-year college-training curve for radiologists, the problem shows no signs of getting better.
Saini said there are three possible solutions: computer-aided diagnostics that could interpret X-rays; physicians assistants to replace radiologists in some cases; and outsourcing diagnostics to other countries, where there is less of a demand for radiologists.
However, since computer-aided diagnostics are not available yet and physicians assistants are not certified to diagnose X-rays, outsourcing is the most viable and immediately available option.
According to Saini, the plan is to find doctors here in the United States who are willing to go back to India and work, on the one hand; and on the other, to bring doctors from India, train them here and then send them back.
He said India is a good country to work with on such a program because there is no shortage of radiologists and their salaries are much lower.
In the United States, he continued, radiologists make between $300,000 and $500,000, whereas in India they make the equivalent of between $10,000 and $25,000.
Even if we pay a radiologist $100,000 in India, it is still more cost-effective, Saini said.
More importantly, he stressed, if Mass General can set up an effective program with radiologists in India it will be a model to use across the United States in combating the radiologist shortage.
Saini said he believes Mass General will have something in place soon to test the system.
The focus, he added, will be to ensure that the quality of work remains the same and that Mass General has the highest confidence in the offshore radiologists.
We are certainly not going to send our stuff to the unknown, Saini said. From a hospitals perspective, as long as we maintain the quality
(we dont) care where the work is being done.
There are some licensing and insurances issues that arise concerning such arrangements, Saini said. But, most of these can be overcome by getting licenses in India and setting up a check-list system so that all diagnostics from India are co-signed by Mass General staff, he said.
Look at where he is now: (read at the bottom)
http://msnbc.msn.com/id/6621014/
words of advice: your reputation as a physician is the most important thing you have. Lose the respect of your peers and your patients and you have nothing...
