"A radiology group in Bangalore, India, has promised it can
study X-rays and send a diagnosis within 30 minutes, Health
Minister Khaw Boon Wan said yesterday. And it can do it cheaper
too.
Mr Khaw said he saw no reason why Singapore should not pass on
routine radiology work to cheaper places and concentrate on
high-end work instead."
(Straits Times 8 Sep:
http://straitstimes.asia1.com.sg/sub/singapore/story/0,5562,339446,00.html?)
Is this the way forward? Outsourcing diagnostics can certainly be
cheaper and achieve better turnaround time. However, whilst labs in
Singapore are accreditated by international bodies (Singapore was
blowing its trumpet just few days ago about acquiring College of
American Pathologists accreditation), the same cannot be said of
low-cost diagnostic centres in India.
The Minister's idea is for the X-rays (and probably other lab tests
in future) of Singaporeans who want a cheap service to be
outsourced to India. Paying and foreign patients who are willing to
pay for higher quality will have their tests done in Singapore at a
higher price. Subsidized patients with difficult conditions will
continue to be handled locally at higher cost, but with time more
of these can be outsourced as the quality of Indian labs rapidly
improve.
From the experience of others who have gone down this route, one
implication is that hospitals will not want to train younger
radiologists who do the bulk of the simpler cases. In any case, the
easy cases have all gone to India anyway, so hospitals will just
hire qualified radiologists to handle the complex cases. Secondly,
in time, India and China will have so many cases that they will
train increasingly more radiologists whilst we will lose them, as
increasingly complex cases can be outsourced. Eventually, all of
diagnostics will be outsouced (it has happened in the US).
The writing is on the wall: if you are a young doctor considering
specialisation, there is no future in diagnostic radiology unless
you are prepared to accept a lower pay or work in India, where the
cost of living is lower. This will eventually happen to other
disciplines that can be easily outsourced, such as telepathology
for diagnostic pathology services.
