Recently I have heard about the following business plan from the dermpath director at my place, which (according to him) is already up and running somewhere on the West Coast. The system works a little bit like cytology setup. Dermpath cases get shipped to India via telepathology, where they are triaged. Anything simple (BCCs, most of squamous lesions) get diagnosed, anything complex gets flagged and is shipped back for review. Dermpath attending in the US then cosigns the simple cases, and diagnoses the complex ones. I do not want to raise the specter of the telepathology-outsourcing boogeyman, because this topic has been beaten to death. However, I would like to discuss the viability and legality of this practice, and the effect that tele-technologies will have on the practice of pathology. I think that if this becomes more prevalent model, some sort of quality control should be imposed, similar to what cytology has. Does it mean that the pathologists in the US will compete with their offshore brethrens for work? In the era of healthcare cost-savings measures, it would be every healthcare administrator's dream.