Letters |
1 Consultant ENT Surgeon, St John's Hospital, Chelmsford CM2 9BG, England,
UK
2 Department of ENT, St John's Hospital, Chelmsford CM2 9BG, England, UK
E-mail: docvivek{at}gmail.com
Drs Dodani and LaPorte in their article on brain drain (November 2005 JRSM1) alluded to telemedicine as a tool for doctors in developed countries to work with patients in developing countries, and establish educational cooperation with centres there.
Clinical process outsourcing (CPO) is a new phenomenon that can potentially reverse the brain drain. Like the booming business process outsourcing sector, CPO involves a specific procedure being transferred out of a developed country to be performed at a significantly lower cost elsewhere without compromising quality. An excellent example is tele-radiology, wherein X-rays, computerized tomography scans or magnetic resonance images are emailed from a hospital in a developed country. This allows a USA/UK board-certified radiologist living in a developing country to view and report the films. The hospital receives accurate advice around the clock, with a consequent increase in productivity. Currently more than 600 USA hospitals utilize services provided by an Australian radiology company.2
In addition to cutting the burgeoning healthcare costs in the West, this situation enhances efficiency, reduces waiting times and may be worth considering in the NHS. The need for foreign-trained doctors living in developing countries is bound to grow, helping them reduce the wage differential between the countries of their training and origin.
This is an option worth considering for doctors wishing to return home after training abroad. However, time will tell whether this trend can be extended to the entire spectrum of medical services.
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