The future of Radiology...

[nycpremed]

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So I just read an article that states that recently, some hospitals in the country have started outsourcing radiological images to other countries like India, for a lesser cost than here in the states. I became worried about this being a huge factor and also a bit concerned seeing that something like this might have the potential to affect the salaries of so many radiologists in the future. What is your take on this and do you think that this might drastically reduce the earnings of radiologists or even worse, eliminate jobs altogether?

 

[asmallchild]

I'll answer your question with a question: How do you sue someone in India for a misread?

 

[Neuronix]

So I just read an article

Source please.

BTW, this topic comes up about every month. Why not search previous posts before posting? The technology and financial motivation to do this have been available for at least 10 years, yet Radiology will never be significantly "outsourced" for a lot of reasons. I for one am very glad there are prelim read services to cut down on call...

 

[penguin24]

Yeah, if what you say goes through, it would be the end of radiology as the best field of medicine. However, most likely it won't go through, so you might as well bet on a winning team than to go into another field b/c of some 'article' speculation.

If worst comes to worst and this nightmare goes through, then I will just go to another field, that's tough, but hey in the real world nobody cares about you or me, it's all about maximizing profits & minimizing overhead. But there is only, say, a 5% chance, so if I go into Rads I have a 95% of being in the best field of medicine.

 

[powerade]

i'll answer your question with a question: How do you sue someone in india for a misread?

+1

 

[Green Grass]

What about the danger of other med specialties just reading their own images and not requiring a radiologist to read it? Is this a legit danger?

 

[MossPoh]

What about the danger of other med specialties just reading their own images and not requiring a radiologist to read it? Is this a legit danger?

To the patient.

The expertise acquired after immersing yourself for years in something is hard to replicate with a tiny fraction of the practice.

 

[Amxcvbcv]

What about the danger of other med specialties just reading their own images and not requiring a radiologist to read it? Is this a legit danger?

They can "read" studies all they want, but until their signature is on the bottom of the report it's not really their responsibility.

The problem is that specialists only want to comment on their area and not the whole image. If it's on the study, it's your responsibility to find it.

An ER doc can send a patient home after he rules out a pneumothorax, consolidating pneumonia, or airway foreign body, but it'll be the radiologists finding after comparing it to a prior study that says he needs to have this new subtle lung nodule investigated.

Pick the image and specialist and there are any number of permutations that all fall, ultimately, under the purview of an imaging specialist.

 

[Lacuna]

Medicare will only reimburse reads that are done on US soil. At the hospital I work in there is a US trained radiologist that does the PRELIM reads overnight (from 11-7am), and in the morning the radiology group does the FINAL read. This makes call oh-so-nice for the local radiologists because they don't need to be called in the middle of the night. Between 5-11pm they can read films from home, too, with home PACS. Since most hospital/ER pts are medicare, I don't anticipate full outsourcing of diagnostic radiology any time soon. Anyway, what are you going to say on the witness stand, that you missed a tumor because you outsourced your imaging to save some $?

 

[colbgw02]

Medicare will only reimburse reads that are done on US soil. At the hospital I work in there is a US trained radiologist that does the PRELIM reads overnight (from 11-7am), and in the morning the radiology group does the FINAL read. This makes call oh-so-nice for the local radiologists because they don't need to be called in the middle of the night. Between 5-11pm they can read films from home, too, with home PACS. Since most hospital/ER pts are medicare, I don't anticipate full outsourcing of diagnostic radiology any time soon. Anyway, what are you going to say on the witness stand, that you missed a tumor because you outsourced your imaging to save some $?

Expect this practice to decrease, if not go away completely. With reimbursement cuts, it will make less and less sense for practices to pay a percentage of their professional fee to an overseas radiologist when they essentially have to duplicate the work once the sun comes up. My gut feeling is that more and more overnight teleradiology will be happening on U.S. soil.

Your point is well taken though, and I think it's even more important than the litigation angle. Medicare is already the 800-pound gorilla in the reimbursement room, and the federal government's role in reimbursemnt will - at best - remain the same in the coming years. It's unlikely that the government will suddenly allow its reimbursements to go directly to radiologists abroad. I think that, more than anything else, will keep the fear of outsourcing exactly where it belongs - in the imaginations of underinformed pre-meds and med students.