Interview with Dr. Robert Wachter on the outsourcing of medical services. (07:22)Download Imagine two patients arriving in the emergency department of a Maine hospital at midnight. The first has a presentation consistent with pulmonary embolism; the second, appendicitis. A decade ago, the first patient might have been started on heparin therapy and scheduled for an early-morning ventilation–perfusion scan. The second patient would have been seen by a surgeon, who would have made a judgment call regarding the diagnosis of appendicitis and the need for surgery.Today, both of these patients and hundreds of others like them would receive middle-of-the-night CT scans, taxing the hospital's radiologists. But midnight in Bangor, Maine, is 10:30 . . .
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Robert M. Wachter (2006) studied this question.