Why WON'T outsourcing diminish job market for American radiologists?

[AK_MD2BE]

To begin, I am not trying to stir up trouble. I am an MS2 here in the US who is really interested in radiology, but also hear about "outsourcing" and how there is the potential to have all of the radiographs sent to places like India as a way to save money. Therefore, I don't want to go through a five year residency, practice for five more years, and be out of a job. And I am relatively new to this forum, so if this topic has been beaten to death, could somebody please direct me to the correct thread? Or if this topic is up for debate...then what would keep hospitals from sending all of their images to foreign radiologists to do the interpretation or "reading" for a lot less money? Is there any legislation to prevent this from happening? Thank your for insight and knowledge.

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[dphoenix]

what you're talking about is commoditization of radiologic reads, which at least as long as radiologists are held accountable and are considered clinical interpreters, will not happen in the foreseeable future. Consider that a radiologist's job is to provide quality interpretations of images and clinical advice - i doubt that many international doctors really can provide the same quality of "product" given that their training is usually less rigorous than those standards in the US.

But even suppose that any doctor in some foreign land can provide good interpretations - our legal system will not allow foreign licensed physicians give official interpretations so there is a large barrier towards outsourcing offshore.

But perhaps the biggest reason that radiology CANNOT be offshored, is our litiginous society; if you offshore your reads, who is accountable? if an aortic dissection is missed, or an ischemic bowel, who will be responsible? some sweatshop radiologist in India? I can see the lawyers in the courtroom now interrogating the hospital CEO. . "so you decided to save money and let some sweatshop docs do your reading. . ." Radiologists are not just paid because they know how to interpret images (otherwise many other docs would gladly take the cash), they are paid to take the liability of the image. Thats why all hospital CXRs get an official radiology read, despite the fact that any medicine doc can easily spot whether there's a pneumonia or not.

 

[hans19]

To begin, I am not trying to stir up trouble. I am an MS2 here in the US who is really interested in radiology, but also hear about "outsourcing" and how there is the potential to have all of the radiographs sent to places like India as a way to save money. Therefore, I don't want to go through a five year residency, practice for five more years, and be out of a job. And I am relatively new to this forum, so if this topic has been beaten to death, could somebody please direct me to the correct thread? Or if this topic is up for debate...then what would keep hospitals from sending all of their images to foreign radiologists to do the interpretation or "reading" for a lot less money? Is there any legislation to prevent this from happening? Thank your for insight and knowledge.

As an MS2 if you know how to use medline, then you should be able to use the search function.

Here is a contemporary answer to your question, albeit at another web site.
http://www.auntminnie.com/forum/tm.aspx?m=131480

 

[AK_MD2BE]

Thank you for the knowledge gentlemen.

 

[Mariah246]

What I was told is that there are few US-certified rads living abroad.

In the IT field, you could find people with similar credentials to outsource to. That's not the case in radiology.

Unless the laws change and allow films to be read by non-US-certified personnel.

 

[Taurus]

I think imaging is just as important as H&P and labs.

If the foreign rad misses something, the patient can die or there may be delayed care which can cause severe injury and disability.

If you consider those things, there's no way that you can outsource rad to any meaningful level.

I used to be worried about outsourcing of rads too, but not anymore.

 

[CherokeeIndian]

To begin, I am not trying to stir up trouble. I am an MS2 here in the US who is really interested in radiology, but also hear about "outsourcing" and how there is the potential to have all of the radiographs sent to places like India as a way to save money. Therefore, I don't want to go through a five year residency, practice for five more years, and be out of a job. And I am relatively new to this forum, so if this topic has been beaten to death, could somebody please direct me to the correct thread? Or if this topic is up for debate...then what would keep hospitals from sending all of their images to foreign radiologists to do the interpretation or "reading" for a lot less money? Is there any legislation to prevent this from happening? Thank your for insight and knowledge.

If you look at the other things that have been outsourced (manufacuring jobs, computer programming, dell tech assistance,etc), most of the things are fairly simple jobs that require minimal if any college training. There are tons of people in other countries that have the training or can be trained to do those jobs. With radiology, this is not the case. It is not that easy to train someone to be a radiologist (like it is to train someone to follow computer prompts when customers call in with their problems or to put pieces together on an assembly line) and there are a limited number of people in the world who can read imaging films.

The second reason is it is currently illegal for a non_US boarded rad to read films for US patients. This law is unlikely to change for the reasons stated. The main point is that radiology is not going to be outsourced for a long, long time, if ever.

 

[AK_MD2BE]

Thanks for all of the reassurance. Rads...here I come!

 

[Taurus]

The biggest issue is rads is self-referrals by other specialties like cards wanting to do their own imaging interpretations and declining reimbursements.

 

[anotherhopeful]

The biggest issue is rads is self-referrals by other specialties like cards wanting to do their own imaging interpretations and declining reimbursements.

how much of a threat do you guys think this is? on one hand, this is an MD vs. MD competition, but on the other hand, it seems like most specialists already have their hands full with pts and procedures that very few would have time or want to read images. I guess this is sorta comparable to anesthesiologists vs. CRNAs except that that's a MD vs. RN issue.

 

[Lacuna]

I would think that the liability issue would dissuade many specialists from doing their own imaging. There is a law suit right now in which a cardiologist "subtracted" the lungs from a cardiac CT and missed a bronchogenic carcinoma. Plus I might venture to guess that MRI is too complex for non-radiologists to interpret. How will this pan out?

 

[Taurus]

I would think that the liability issue would dissuade many specialists from doing their own imaging. There is a law suit right now in which a cardiologist "subtracted" the lungs from a cardiac CT and missed a bronchogenic carcinoma. Plus I might venture to guess that MRI is too complex for non-radiologists to interpret. How will this pan out?

Or the cards may try to set it up so that the cards group reads the heart stuff and then have a rad do an overread for the rest of the chest. No rad should do this because they will be held liable for everything in the chest including the heart stuff.

 

[Lacuna]

Or the cards may try to set it up so that the cards group reads the heart stuff and then have a rad do an overread for the rest of the chest. No rad should do this because they will be held liable for everything in the chest including the heart stuff.

That would mean 2 reads for the same study, I don't think payors would go for that... Unless the cards split the fee with the rads, but isn't that is illegal?

 

[octaviopaz]

Hi lacuna,

do you have any specifics on the lawsuit you cite. i'm curious if its the same one i heard about.