Sunday, November 16, 2003
Outsourcing Radiology
Andrew Pollack writes in the NYT about the next wave of techonology that will probably be outsourced to India -- medical technology (beyond mere transcription etc). In this case, radiology -- the hospital would beam images electronically from some scans to India, to be worked on by radiologists there..
Radiology is not the only medical service that may someday be performed for Americans by people in other countries. Other candidates are the analysis of tissue samples, the reading of electrocardiograms, the monitoring of intensive care units and even robotic surgery. Back-office medical work has been moving offshore for several years now, particularly to India, which has a large number of educated English-speaking people. Though the number of affected jobs is only a small fraction of the total, many experts say the share is growing as hospitals face pressure to cut costs.
Radiology may be just the start of patient care performed overseas. Next may be pathology. It is now possible to transmit images of tissue samples for remote diagnosis. There are also robotic microscopes that can be operated remotely, allowing a doctor at a different site to move a slide and focus the image. As technology improves, "it would be possible for a small hospital in the United States to digitize an image, put in on their server and have a pathologist anywhere in the world, such as in India, provide a diagnosis," said Ronald S. Weinstein, professor and head of pathology at the University of Arizona College of Medicine in Tucson and director of the Arizona Telemedicine Program.
Medical care, the most intimate and localized of services, is grappling with the globalization that has moved many jobs - first in manufacturing and more recently in white-collar work - across the ocean. And in health care, of course, there is more at stake than jobs. Dr. Courneya and other critics worry that radiologists outside the United States may not be trained properly, endangering patients' safety.
The movement of back-office jobs offshore has raised some concerns about privacy, in that foreign workers could not be easily prosecuted under American laws governing confidentiality of American records. But the outsourcing of radiology overseas raises more issues. Unlike back-office functions, radiology is performed by doctors and is directly related to patient care. A mistake could conceivably cost a patient his or her life.
Much ado about nothing?
On the surface, the controversy may seem a bit odd. Experts say that the number of X-rays from the United States now being read in India is minuscule and that regulatory restrictions are likely to keep it from growing rapidly. Moreover, most hospital jobs, unlike those in radiology, require close patient contact, so there is a limit to how much offshore outsourcing can be done. Besides, employment in American health care has been growing. In the 12 months ended in August, the category added about 250,000 jobs while overall nonfarm payroll jobs shrank by nearly 500,000. Hospitals alone added about 70,000 jobs in that period.
Radiology is not the only medical service that may someday be performed for Americans by people in other countries. Other candidates are the analysis of tissue samples, the reading of electrocardiograms, the monitoring of intensive care units and even robotic surgery. Back-office medical work has been moving offshore for several years now, particularly to India, which has a large number of educated English-speaking people. Though the number of affected jobs is only a small fraction of the total, many experts say the share is growing as hospitals face pressure to cut costs.
Radiology may be just the start of patient care performed overseas. Next may be pathology. It is now possible to transmit images of tissue samples for remote diagnosis. There are also robotic microscopes that can be operated remotely, allowing a doctor at a different site to move a slide and focus the image. As technology improves, "it would be possible for a small hospital in the United States to digitize an image, put in on their server and have a pathologist anywhere in the world, such as in India, provide a diagnosis," said Ronald S. Weinstein, professor and head of pathology at the University of Arizona College of Medicine in Tucson and director of the Arizona Telemedicine Program.
Medical care, the most intimate and localized of services, is grappling with the globalization that has moved many jobs - first in manufacturing and more recently in white-collar work - across the ocean. And in health care, of course, there is more at stake than jobs. Dr. Courneya and other critics worry that radiologists outside the United States may not be trained properly, endangering patients' safety.
The movement of back-office jobs offshore has raised some concerns about privacy, in that foreign workers could not be easily prosecuted under American laws governing confidentiality of American records. But the outsourcing of radiology overseas raises more issues. Unlike back-office functions, radiology is performed by doctors and is directly related to patient care. A mistake could conceivably cost a patient his or her life.
Much ado about nothing?
On the surface, the controversy may seem a bit odd. Experts say that the number of X-rays from the United States now being read in India is minuscule and that regulatory restrictions are likely to keep it from growing rapidly. Moreover, most hospital jobs, unlike those in radiology, require close patient contact, so there is a limit to how much offshore outsourcing can be done. Besides, employment in American health care has been growing. In the 12 months ended in August, the category added about 250,000 jobs while overall nonfarm payroll jobs shrank by nearly 500,000. Hospitals alone added about 70,000 jobs in that period.
