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Threats: India, No; Computerization, Yes

December 7, 2010
Written by: , Filed in: Diagnostic Imaging, Practice Management
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Never fear, radiologists. Your job is not going to be outsourced to India. But you might want to keep a wary eye on your computer.

So say economist Frank Levy of the Massachusetts Institute of Technology and Kyoung Hee-Yu of the Australian School of Business. Their article in the December issue of the British Journal of Industrial Relations (also available here) says that radiologists don’t have to worry about the outsourcing of diagnostic radiology to India. Instead, the article says:

Computerization of low-end diagnostic radiology ultimately poses a bigger threat to the profession than offshoring.

The average Indian radiologist makes about $35,000 a year, theoretically raising the possibility of cost savings. However, the authors cite several reasons for their skepticism about the future of outsourcing to India:

  • Reading images requires judgment calls based on years of training and experience. It can’t be based on rules, as most successfully outsourced jobs are. The authors give the example of basic tax processing, which can be broken down to step-by-step following of the rules of tax law (the same process used with tax software). Radiology doesn’t work that way.
  • There aren’t a lot of Indian radiologists—only about 5,500, compared with about 27,000 in the United States.
  • At least a third of those 5,500 Indian radiologists have followed a lower-track training course that limits their qualifications to read images. Even on higher tracks, both training and work experience in India are more limited than in the United States. Indian radiologists often specialize in a particular scanning mode—ultrasound, for example, but not MRI, CT, etc.
  • U.S. regulations restrict most diagnostic reads to U.S.-trained and board-certified radiologists, of which India has relatively few. Hospitals that use radiologists who don’t meet those qualifications may risk losing malpractice insurance.

Still, the authors advise against complacency. “Today,” they say, “most medical images lie beyond computer recognition.” The same could be said 20 years ago about human speech. Now, some doctors use speech-recognition software for transcribing their dictated case notes. Similar advances in medical-image recognition appear inevitable.

“When computers become proficient in diagnosing simpler images,” the authors conclude, “the effects on the radiology profession are likely to be greater than anything from Bangalore.”

Related seminar: Radiology Review

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