How does outsourcing radiology impact the US workforce and economy?

[OhioChick]

Source: American College of Radiology
Date: 28 July 2008
Improved efficiency, lower costs and enhanced quality are some of the reasons industries like manufacturing have made outsourcing work overseas common practice. Health care providers have been slower to adopt; however, the practice is gaining momentum with advances in information technology, which permit some services to be provided remotely, according to an article in the August issue of the Journal of the American College of Radiology.

'Outsourcing: A Primer for Radiologists', by Daniel J. Altman, M.D., and Richard B. Gunderman, M.D., Ph.D., MPH, examines the nature of outsourcing in medicine with a special focus on benefits and costs. A 2003 US Department of Labor Survey estimated that 13,000 US workers were laid off between 1999 and 2003 due to outsourcing. While this practice may lead to lower overall costs, patients may not choose reduced prices in place of higher quality health care. On the other hand, the practice of medical tourism is increasingly gaining attention, as individuals travel overseas to undergo procedures at more affordable rates. According to the study's authors, an angioplasty in the United States would cost a patient $57,262-$82,711. The same procedure in India runs $11,000. For radiology especially, the risk of outsourcing is high, but the authors advise health care organizations to continue providing innovative, quality services at lower costs to remain competitive with this emergent trend.

'Hospital-Owned and Operated Imaging Centers: Strategies for Success', by Giles W. L. Boland, M.D., highlights the differences between the operating and business strategies of hospitals and hospital-owned outpatient imaging centers. Most importantly, hospital-owned OPICs must assess the competition, location, services offered and workflow procedures in order to achieve the financial success that can come with offering high-tech imaging services such as computed tomography and magnetic resonance imaging. Choosing to open an OPIC as a joint venture with radiologists or to have sole ownership is also discussed, along with the importance of effective customer service and marketing strategies. Boland points out that unlike hospital-based scanners, physicians can refer patients to whichever imaging center they choose, so patient satisfaction of services must not be overlooked.

For radiologists practicing in a digital radiology environment, repetitive stress symptoms were found to be common, according to Phillip M. Boiselle, M.D., et al., authors of 'Repetitive Stress Symptoms in Radiology: Prevalence and Response to Ergonomic Interventions'. According to the survey respondents of faculty members, residents, and fellows, 68 per cent reported working more than eight hours per day, with 38 per cent reporting a prior diagnosis of repetitive stress symptoms.

Because musculoskeletal complaints can be attributed to workstation setup and chair design, ergonomic chairs, workstations, and training were provided to the respondents to evaluate improvement options. Users rated their experience with the ergonomic alternatives; improvements were noted in 70 per cent in those who received ergonomic chairs, 80 per cent in those who received ergonomic workstations, and 70 per cent in those who underwent training administered by a physical therapist.

In 'The Reasons That Many Radiology Practices Don't Use Off-Hours Services', by Scott Kennedy, et al., 300 US hospitals with diagnostic radiology practices were randomly selected and surveyed on their decisions to use external or internal off-hours services or none at all. Radiology practices using internal off-hours services were significantly larger with 19.9 radiologists on staff than both those using external off-hours services, at 8.2 radiologists, and those using no off-hours services, with 10.7 radiologists. The most common reasons radiology practices did not use any external off-hours services were that they had sufficient overnight coverage and the cost to implement the service was at too high a cost.

http://www.medicexchange.com/news.aspx/14682/How-does-outsourcing-radiology-impact-the-US-workforce-and-economy-

[tavalon]

1. We've been using an Australian service for overnight for a number of years

At least I enjoy the accent when they tell me I can't have my report.

[Skittles]

2. Aussies are indeed fun to hear

whenever we get their calls we all end up trying to talk like them and of course end up sounding ridiculous :D

[peacebird]

3. "Improved efficiency, lower costs and enhanced quality" - try lower cost and lower quality. Look at

those wonderful childrens toys from China last year.

In my industry the management is crazy about outsourcing, after all - it isn't only salaries that are lower, it is work regulations, and no need to pay for retirement plans or health care. Still - the quality of the work they are getting from overseas is substandard and they know it. They say they are "developing future potential" by shifting white collar jobs to India.

But the "rising tide will lift all boats" crap that the Big Dawg sold us is bogus, the truth is that our middle class is sinking down faster than theirs is rising up. I actually heard some rightwing talking head all a-twitter about our job opportunities in this new environment - and touting the SERVICE INDUSTRY as a growth area for our people to "aspire" to. Not a good manufacturing jog, or programming, IT, engineering.... service industry. And when Wal*Mart is the biggest employer then you know we're screwed.

[Igel]

4. I'm agnostic.

Let's say I'm having a CT scan done at 3:30 am. The local folk's biological rhythms are ordering them to be asleep and their cognitive abilities are at their nadir. I'm wisely relying on their attention to detail and ability to recall and apply a wide range of memories and learning.

Or they send the data overseas, where it's anywhere from 1:30 pm to 6:30 pm.

Are the people overseas less qualified? Dunno. Some overseas medical schools are quite good. And some overseas folk train in the US and Europe. This, however, is a manageable issue.

Are they less cognitively impaired? Almost certainly. But it depends on how overworked they are: If they're really swamped and overworked, they may be as bad as the local staffers.

Are they beyond the range of lawsuits? There's a question.

Will they no be as conscientious because they don't see me face to face? Dunno. Didn't see the folk who did my CT scan analysis in March, did that matter?