There is a serious shortage of radiologists in the United States. One trade journal recently reported there is an average of four vacancies per radiology department at American academic centers over the past two years. In response to the nationwide shortage and to the demand for more sophisticated scans to diagnose illnesses, physicians at many small American hospitals are relying on companies that outsource diagnosis tasks to offshore radiologists.
Outsourcing is part of a growing telemedicine trend due to the relatively new ability to quickly transfer medical data over the Internet to any place where there is a compatible computer. Radiologists in countries such as Australia, India, Israel, and Lebanon are reading scans on American patients in order to take advantage of the time differences. This eliminates the problem of calling a local American radiologist to read a CT scan in the middle of the night. In a small hospital setting, it is likely that the same physician would have been required to work the next day, albeit in a groggy condition.
Proponents of outsourcing, which is often called “nighthawking,” claim that the use of teleradiology, including outsourcing, has improved on-call productivity and helped ease the radiology shortage. Advocates insist that the practice of nighthawking does not replace U.S. jobs with cheap unskilled labor. Instead, they insist that the foreign radiologists are almost all U.S. trained and licensed.
Despite these assurances, worries remain about the qualify of radiology services purchased from these offshore companies. A task force from the American College of Radiology expressed its concern about the implications of overseas radiology and its potential impact on patient care in the United States. The task force recommended that foreign radiologists should have liability insurance and a license to practice medicine in the states they serve as well as staff privileges at the hospitals where the scans are performed. The group focused its criticism on the inability to ensure the quality of the services provided when the radiologist is on the other side of the world.