<p>I have been reading around the forums and some people are saying that there are jobs in the medical field that can be outsourced. I know it's possible for every job to be outsourced (for example if 1/3 people in America choose to become doctors), but which jobs are most likely to be outsourced?</p>
<p>I'm afraid I can't answer the question - I simply have no idea - but the econ major in me can't resist discussing it a little bit.</p>
<p>1.) Be sure to distinguish between outsourcing (one company contracting another company to do things for it) and offshoring (one company hiring employees to do work overseas). The two have some overlap, but as you can see, it's not complete. Dell opening up a new call center in Hyderabad is offshoring. Dell paying Tech-Support-Inc. (a fictional company) to manage its call centers is outsourcing. If TSI is in Hyderabad, then Dell is both outsourcing AND offshoring.</p>
<p>2.) It's unclear to me why you think a greater number of doctors here in the states would result in outsourcing or in offshoring - if anything, greater supply would drive down prices and make offshoring less profitable.</p>
<p>I would imagine about anything that can be put to the computer and sent via the internet would stand a good chance to be outsourced. However, there are many jobs that require face to face interaction. Job competition will come from people who earn their MDs abroad and then want to practice here.</p>
<p>I see, don't get the wrong idea, I don't think doctors will ever be outsourced, the example I was providing is an extremly unlikely scenario.</p>
<p>Bluedevilmike you were an econ major and not biology or did you double?</p>
<p>No, it's not that I think you're arguing they will be - I know you understand it's unlikely. It's just that the way you're framing the question leaves me unclear as to what you mean by "outsourcing" - whether you're confusing it with offshoring or whether you mean something else entirely, since neither of those should have to do with supply. (Besides which, the AAMC caps the number of doctors.)</p>
<p>And yes, econ only.</p>
<p>Good to know... I'm thinking about anthropology so it's good to know the just don't tell you, you can major in anything just to say it, and that it's actually true.</p>
<p>What I mean by outsourcing is that there will be either many people going into the field, more than needed, and competetion will arise causing the it to become difficult to land a job in that area. I also mean that they might find a way to make it so they will not need people to fill that position anymore, for example, having it done be electronic devices.</p>
<p>Oh, so you don't mean either offshoring or outsourcing - you just mean that it'll be hard to find a job - i.e. a glut of doctors.</p>
<p>Yeah, no, that's very clearly not going to be the case - in fact, there is predicted to be a dramatic shortage.</p>
<p>When should this predicted dramatic shortage be occuring?</p>
<p>BDM, I think you're last statement should come with some qualifiers...</p>
<p>The interest in certain specialties waxes and wanes in a very cyclical fashion. Anesthesia is pretty hot right now, but certainly wasn't 10 years ago. The late 80's on into the mid 90's (up to about '98) had such a push to develop primary care doctors, that the number of people hoping to be specialists was noticably lower than it is today - and right now the number of people hoping to be specialists is up. </p>
<p>So there are areas of medicine that develop a glut, but over time, the highs and lows cancel each other out.</p>
<p>The other thing that is important to consider is location. There are many areas in which OB/GYN's are very rare, and others where they are like Starbucks. The regional differences are largely due to malpractice climate and sometimes just simple desirability of location (Las Vegas vs rural Kansas). So it's also possible to areas in which is it is difficult to earn a living for certain specialties. Again, there is a cyclical nature to hot places to live and with the high interest in malpractice reform there is some alleviation on the way that may level the field.</p>
<p>Just some things to think about.</p>
<p>Well, you have to define shortage very carefully - the idea behind a "shortage" is that there are people who want doctors and are willing to pay a price that doctors would accept, except that doctors are simply too busy to take them as patients. By this standard, I would argue that a shortage currently exists, since some patients exist who would be willing to pay more for better care (i.e. appointments longer than 15 min) but cannot receive it in our current delivery system.</p>
<p>The shortage will only get worse over time, as HMO and government control tightens - particularly if Clinton-style health care is implemented, as I'm quite confident it will be within the next generation.</p>
<p>BRM is right that specialties wax and wane, but I think it's unlikely that any specialty in any area is currently experiencing a "glut" (doctors would be willing to practice at the market rate but cannot find patients), and I think the odds of such a glut will diminish considerably over time.</p>
<p>Slightly-less-invulnerable specialties might include diagnostic radiology, anesthesiology, and cardiothoracic surgery.</p>
<p>The predicted shortage also has alot to do with the aging baby boomers. A huge amount of people are getting older, and with age there is health problems. Currently there is a huge shortage of nurses and it is oly expected to get worse. So I do not see any problem landing a gob in health care.</p>
<p>
[quote]
have been reading around the forums and some people are saying that there are jobs in the medical field that can be outsourced. I know it's possible for every job to be outsourced (for example if 1/3 people in America choose to become doctors), but which jobs are most likely to be outsourced?
[/quote]
</p>
<p>As was said by somebody else, any job that can be computerized can be outsourced fairly easily. Radiology immediately comes to mine - as Xrays can be shipped over the Internet and read by any doctor anywhere in the world. </p>
<p>Another major area would be elective surgery, particularly cosmetic surgery. These are procedures that you don't really need, that can be delayed, and that insurance won't pay for, which provides a strong incentive for consumers to shop around. Why get a boob job or liposuction or LASIK in the US if you can fly to a foreign country and get it there at a discount? </p>
<p>However, I think what is not gaining enough press lately is the rise of telemedicine. The fact is, many patients don't really need to have a live doctor in the room. With the rise of cheap Internet videoconferencing, many patients can do perfectly fine with a linked videoconference with a doctor, perhaps helped by an in-room nurse. Combine this with tele-instruments (where a doctor can obtain instrument readings from you from a distance). With the aid of robotics, researchers are even coming up with ways to do remote surgery. </p>
<p><a href="http://en.wikipedia.org/wiki/Telemedicine%5B/url%5D">http://en.wikipedia.org/wiki/Telemedicine</a>
<a href="http://en.wikipedia.org/wiki/Telehealth%5B/url%5D">http://en.wikipedia.org/wiki/Telehealth</a>
<a href="http://en.wikipedia.org/wiki/Remote_surgery%5B/url%5D">http://en.wikipedia.org/wiki/Remote_surgery</a></p>
<p>I think that colonoscopies are something that could be easily converted to telemedicine.</p>
<p>Reading colonoscopies certainly could be tele-outsourced, but performing colonoscopies cannot. Routine colonoscopies performed by a skilled endoscopist in a well-prepped patient with straight forward anatomy appear deceivingly simple. Much of the important decision making occurs during the study itself. Since biopsies, removal of appropriate lesions, and electrosurgical coagulation of bleeders are all potentially part of routine colonoscopy, this procedure must be performed by physicians, not technicians. Because some finesse, body english, dynamic patient positioning and, occasionally, force are required to manipulate the scope (without perforating the GI tract), remote or robot-assisted endoscopy remains impractical.</p>
<p>By contrast, many ultrasound studies such as transthoracic echocardiograms and "routine" pre-natal ultrasounds are performed by technicians and then later read by onsite or offsite radiologists. Of note, "high risk" pre-natal ultrasounds typically are performed and read by neonatologists in real time.</p>
<p>
In 1995, an ASA commissioned study concluded that there was and would be a substantial surplus of anesthesiologists. Practices delayed hiring and individual physicians postponed retirement in preparation for the anticipated slowdown. Residents finishing training in 1995 were greeted by a March 17 Wall Street Journal article entitled "Once hot specialty, anesthesiology cools as insurers scale back." Many residents put off entry into the job market by taking a fellowship, some accepted marginal positions, and a few took salaried CRNA-type positions.
[quote]
The dilemma posed by declining opportunities for anesthesiologists and the implications for current graduating residents have generated both concern and discussion. This discussion has effectively operated to discourage recruitment at the resident level and probably explains the trends reported here. Reduction was regarded as desirable in the light of the reduced need for our services anticipated in the Abt Associates Inc. report, "Estimation of Work Force Requirements in Anesthesiology." The magnitude of this reduction, however, and its implications demand careful evaluation.
[/quote]
<a href="http://www.asahq.org/Newsletters/1996/05_96/article1.htm%5B/url%5D">http://www.asahq.org/Newsletters/1996/05_96/article1.htm</a></p>
<p>Most strikingly, more than 50% of available anesthesia training positions went unfilled via the 1996 match process as US students chose other specialties. (Positions went unfilled or were filled by FMG's). See the dramatic graph at
<a href="http://www.asahq.org/Newsletters/2005/05-05/grogono05_05.html%5B/url%5D">http://www.asahq.org/Newsletters/2005/05-05/grogono05_05.html</a></p>
<p>The anticipated surplus never materialized and AMG residents finishing training in 1998 to 2004 found themselves in great demand. Current demand for AMG board certified anesthesiologists remains high.</p>
<p>My two cents...I say colonoscopies and upper endoscopies b/c I've been doing the ****ing things every other day for the past week and a half...sereiously I've done in that time probably 16 or 17, and most have been with my preceptor out talking to other patients or dictating progress notes. Upper scopes are even easier than colonoscopies. I'm not saying I'm an expert but they really aren't that hard (playing a lot of video games as kid helped I think.)</p>
<p>Yes, there are certain conditions, pathologies, and abnormal anatomies that cause problems, but the overall procedure is pretty straightforward. With appropriate support staff on site (which are usually in greater numbers than MDs...even in small communities) I really think that remote scoping by a good MD (my preceptor is a general surgeon in a small town) is completely plausible. The only situation in which telecolonoscopies would be problematic would be in extreme emergencies, where an MD's knowledge is vital. But that's probably inherent in all types of telemedicine.</p>