Offshoring Radiology Services to India

The interpretation of medical images by Indian radiologists is often used to show how offshoring can threaten a high skilled U.S. occupation as easily as a call center operator. In reality, the example is false. Using interviews and field observation, we describe the Indian teleradiology industry and its client countries and we explain the institutional factors that currently preclude threats to U.S. radiologists. Radiology is an “extreme” professional service with extensive reliance of tacit rather than codified knowledge. The importance of tacit knowledge leads to long training periods, a limited global supply of radiologists and heavy government regulation, all of which are obstacles to a “flat world”. Computerization of low-end diagnostic radiology ultimately poses a bigger threat to the profession than offshoring. We argue that the obstacles to extensive trade in radiology services apply in various degrees to other professional services as well.