"Services" is where the IT business is going. And yes, there are outsourcing companies in the USA and various other non-India, non-China nations. Skilled, flexible talent is very valuable to a services company. And it's satisfying work because you're not stuck with one environment all the time -- you get to play with lots of different customer environments, picking up new skills along the way.
Basically, what I'm saying here is, quit whining. Ma
Many hospitals are contracting with large national companies to provide physicians services that were traditionally provided "in house." This is most easily done for things like Radiology, where films can be digitized and shipped anywhere in the world to be read by a room full of radiologists. It's also being done (and has been for years) with Pathology services... send your slides and tissue specimens to a big lab to be examined rather than the employing a bunch of local pathologists. Admittedly, there are some economies of scale that enter into the picture... "sending out" can be more efficient.
This is also a big deal in my own specialty (emergency medicine); competition is brutal. There are large national "contract management" ER groups that are constantly approaching hospital administrators with sales people, brochures, and a pitch about their high-quality, lower-cost emergency medicine care. Contracts change hands in ER all the time, which is why a lot of ER docs live like gypsies... if your hospital outsources their ER services, you get fired, and have to find another job (if you live in a smaller area with only one or two hospitals, you can be SOL... time to uproot the family and move.)
How do I/we fight it? Relationships and service. We make ourselves available to the administration to address concerns and problems. We build relationships with the community physicians, so that they KNOW who's taking care of their patients in the ER, and KNOW they can trust us to take care of the critically-ill. We integrate ourselves into hospital committees, and get involved in the community. We implement Quality Assurance and Peer Review to ensure that we're practicing up to the standard of care. It can be a lot of work trying to keep your job (never thought you'd hear a doctor say that, did you?).
In ER, losing your contract/job or not usually has nothing to do with bad medicine... it's failure to "play the game" that sinks you. There may be a parallel here for the infosec geek that was fired... If there's one area where the prototypical "geek" personality probably hurts the most, it's in the eschewing of those critical relationships. It's great to have m4d 5ki11z in the server room... but a little face time with the powers that be could make the difference between paycheck and pink slip...
There's no guarantees, however... even with all my efforts, I can still get sold out if my hospital administrator gets a wild hair, or just plain doesn't like me.
It's business reality for lots of folks, not just IT.
My wife works in HR in a hospital and the stories I hear are really freaky about some hospitals work. All the doctors are contractors and all the nurses are in the union. If someone gets killed no one gets in trouble because the company doesn't employ the doctors and the nurses are protected by the union contracts.
Easy solution (Score:5, Interesting)
Get a job working with an outsourcer. Duh.
"Services" is where the IT business is going. And yes, there are outsourcing companies in the USA and various other non-India, non-China nations. Skilled, flexible talent is very valuable to a services company. And it's satisfying work because you're not stuck with one environment all the time -- you get to play with lots of different customer environments, picking up new skills along the way.
Basically, what I'm saying here is, quit whining. Ma
Not just in IT (Score:5, Interesting)
Many hospitals are contracting with large national companies to provide physicians services that were traditionally provided "in house." This is most easily done for things like Radiology, where films can be digitized and shipped anywhere in the world to be read by a room full of radiologists. It's also being done (and has been for years) with Pathology services... send your slides and tissue specimens to a big lab to be examined rather than the employing a bunch of local pathologists. Admittedly, there are some economies of scale that enter into the picture... "sending out" can be more efficient.
This is also a big deal in my own specialty (emergency medicine); competition is brutal. There are large national "contract management" ER groups that are constantly approaching hospital administrators with sales people, brochures, and a pitch about their high-quality, lower-cost emergency medicine care. Contracts change hands in ER all the time, which is why a lot of ER docs live like gypsies... if your hospital outsources their ER services, you get fired, and have to find another job (if you live in a smaller area with only one or two hospitals, you can be SOL... time to uproot the family and move.)
How do I/we fight it? Relationships and service. We make ourselves available to the administration to address concerns and problems. We build relationships with the community physicians, so that they KNOW who's taking care of their patients in the ER, and KNOW they can trust us to take care of the critically-ill. We integrate ourselves into hospital committees, and get involved in the community. We implement Quality Assurance and Peer Review to ensure that we're practicing up to the standard of care. It can be a lot of work trying to keep your job (never thought you'd hear a doctor say that, did you?).
In ER, losing your contract/job or not usually has nothing to do with bad medicine... it's failure to "play the game" that sinks you. There may be a parallel here for the infosec geek that was fired... If there's one area where the prototypical "geek" personality probably hurts the most, it's in the eschewing of those critical relationships. It's great to have m4d 5ki11z in the server room... but a little face time with the powers that be could make the difference between paycheck and pink slip...
There's no guarantees, however... even with all my efforts, I can still get sold out if my hospital administrator gets a wild hair, or just plain doesn't like me.
It's business reality for lots of folks, not just IT.
Re:Not just in IT (Score:2)
Re:Not just in IT (Score:2)
Folks IT was hit first, the medical and accounting industry are next.
What is going to stop this trend and save everyone from working at Walmart?