| Abstract | Low-cost labor, time zone differences, and telecommunication advances have "flattened" the world of business and services1; however, health care has been relatively insulated from these world-flattening forces until recently. In particular, the fundamental physicality of medicine — the need to examine a patient or look at a chart or radiograph — prohibited the remote outsourcing that was possible in manufacturing or call centers.2 However, digitized health care now permits the outsourcing of a range of medical services, from clinical diagnostics to direct care.
Although outsourcing of any type triggers predictable worries,3 outsourcing of health care raises special issues. Health . . . |