Who's Reading Your X-Ray?:
"SANJAY SAINI was not prepared for the hate mail. A radiologist at Massachusetts General Hospital, Dr. Saini thought he had found a clever way to relieve an acute shortage of specialists who could read X-rays and M.R.I. scans. The hospital would beam images electronically from some scans to India, to be worked on by radiologists there."

But the arrangement, made late last year with a company in India, has touched off a minor furor. It turns out that even American radiologists, with their years of training and annual salaries of $250,000 or more, worry about their jobs moving to countries with lower wages, in much the same way that garment knitters, blast-furnace operators and data-entry clerks do.

Since the news got out, Dr. Saini has received a flurry of angry e-mail messages, most of them anonymous, urging him to stop. The American College of Radiology, the professional group for the country's 30,000 radiologists, has set up a task force to look at the offshore transfer of radiology services. And the online discussion groups of AuntMinnie.com, a Web site for radiologists, have been buzzing with debate about the prospects for competition from "radiology sweatshops" abroad.

"This teleradiology thing is another nail in the coffin of the job market," wrote someone on the Web site who identified himself as a radiologist. "Who needs to pay us $350,000/yr if they can get a cheap Indian radiologist for $25,000/yr."

Daniel Courneya, a radiologist in Hibbing, Minn., fumed on the site that Massachusetts General, a Harvard teaching hospital known to its admirers as "Man's Greatest Hospital," should instead be called "Money Grubbing Hospital," another play on its initials.

On the surface, the controversy may seem a bit odd. Experts say that the number of X-rays from the United States now being read in India is minuscule and that regulatory restrictions are likely to keep it from growing rapidly. Moreover, most hospital jobs, unlike those in radiology, require close patient contact, so there is a limit to how much offshore outsourcing can be done.

Besides, employment in American health care has been growing. In the 12 months ended in August, the category added about 250,000 jobs while overall nonfarm payroll jobs shrank by nearly 500,000. Hospitals alone added about 70,000 jobs in that period.

Still, Dr. Saini's plan shows that even medical care, the most intimate and localized of services, is grappling with the globalization that has moved many jobs - first in manufacturing and more recently in white-collar work - across the ocean. And in health care, of course, there is more at stake than jobs. Dr. Courneya and other critics worry that radiologists outside the United States may not be trained properly, endangering patients' safety.…

http://www.nytimes.com/2003/11/16/business/yourmoney/16hosp.html