Business

Radiologists weigh in on outsourcing of imaging work

The specialty group recommends that doctors working outside the country maintain the same licensing and credentialing standards as those within the United States.

By Tyler Chin — Posted June 14, 2004

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

The American College of Radiology has acted to protect patient safety by approving guidelines on the practice of "offshore" interpretation of radiological images.

Under the guidelines, which are voluntary, ACR recommends that radiologists outside of the United States who interpret images should meet, exceed or be held to the same standards as their U.S. counterparts.

Those standards call for offshore radiologists to be licensed in the state where the image was originally obtained; be credentialed and maintain privileges at the health care facility where the image was obtained; have appropriate liability insurance for the state where the exam was obtained; and be responsible for the quality of the images being interpreted.

"We feel there should be some significant qualifications for the person overseas who is receiving these images for interpretation," said E. Stephen Amis Jr., MD, a radiologist in New York who is chair of ACR's board of chancellors.

Radiologists who can meet the criteria would include those who are members of innovative practice groups that send their own physicians abroad to take advantage of the time difference when providing after-hours coverage to hospital emergency departments, Dr. Amis said.

Rather than have radiologists work what is essentially the graveyard shift in the United States, for example, those groups can set up a teleradiology operation somewhere in Europe so that their physicians can work during the day and enjoy the experience of living in a foreign country. In this case, it's not true outsourcing so much as a quality-of-life issue for U.S.-based physicians.

Quality is key

ACR does not oppose any form of offshore interpretation of images as long as those performing the interpretation meet its criteria, Dr. Amis said.

"What [ACR members] are concerned about is someone with unknown training sitting in a sweatshop in Bangladesh, for example, with perhaps one American-trained radiologist overseeing them and signing off on all reports, or simply issuing a preliminary report upon which treatment can be based."

ACR does not know the degree to which offshore interpretation is occurring, Dr. Amis said. He added that offshoring is a relatively new practice that the medical society began hearing about within the last two years.

"Perhaps some of this has been to fill the need, particularly during nights, weekend, holidays and ER coverage," Dr. Amis said. "If you have a short-staffing situation, the first thing that's going to suffer is the call because you don't have enough people to spread out."

Interpretation of images isn't being done by just foreign radiologists. Some American companies also employ American-trained, board-certified radiologists living abroad to provide "nighthawk" services, ACR said.

Physicians, hospitals and insurers also are offshoring billing, transcription, coding, claims review and adjudication, and nurse call centers to workers in English-speaking countries, observers say. Those countries, including India and Australia, offer cheaper labor and in some cases, a larger pool of qualified and available workers than America, they say.

Back to top


ADVERTISEMENT

ADVERTISE HERE


Featured
Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story


Read story

Goodbye

American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story


Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story


Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story


Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story


Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story


Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story


Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn