Radiology in India is commoditised

Radiology in India is commoditised. I say that as a radiologist, not as a critic. There is no denial about it, and the reasons are a post of their own.

By commoditised I mean that, for most buyers, a scan and its report have become interchangeable. A CT here or a CT there, a report from this radiologist or that one: the decision is made mostly on price and convenience. That is how commodities are bought. I wrote the post this page is based on in July 2026, and I have kept it as I wrote it, with a few explanations for readers outside medicine and some practical questions for centre owners at the end.

When any service or product becomes a commodity, a few things happen.

Some good, some not.

The good

1. Affordability. A scan for as little as Rs 3,000, about 30 dollars, in a country of a billion people across every income level. A boon, plainly.

2. Availability. Imaging in India is among the easiest to access anywhere in the world. Walk in today, scan today, report the same day, often on self-referral.

3. Speed. Rapid diagnosis is possible, whether it's an ACL tear on MRI or a renal stone on CT KUB. For most patients that means less pain and less waiting. For the stroke and the bleed, it means being alive.

For readers outside medicine: an ACL is the anterior cruciate ligament in the knee, a common sports injury. CT KUB is a CT of the kidneys, ureters and bladder, the standard scan when a patient arrives with the pain of a kidney stone. Self-referral means the patient walks in without a doctor's prescription for the scan.

The flip side

1. Quality erosion. With scan prices this low, the margin per report is thin, and the only way to earn is volume. No radiologist wants to read a hundred scans a day. The economics leave many with little choice, and errors follow. Some minor. Some not.

2. Disparity. Easy access means those with paying capacity extract the most from the system. Pay and get what you want.

3. Devalued expertise. This one I feel personally. Over a decade of training, and the market prices a signature at less than the auto fare to the centre. I have made peace with the economics, but I see what it does to the profession's ambition. Research careers take a back seat when depth does not pay.

4. Razor-thin margins. Companies across this space survive on volume.

It is worth noticing that the good and the bad come from the same place. The low price that makes a scan affordable is the same low price that pushes a radiologist to read too many of them, and the same speed that saves the stroke patient becomes, in teleradiology, a promise of minutes that leaves no room for a careful read (I wrote about that side of it in Teleradiology in India is structurally broken). You cannot keep one half and simply remove the other.

The questions I have to live inside

Is this the right direction? There is no clean answer. But the technology under this system is shifting, and I have to live inside the answers:

These are not abstract questions for me. I report scans, and I build software for radiologists. Both jobs sit inside the same economics, and in both of them the radiologist's attention is the thing that runs out first.

What this means for a centre

If you run a centre, you already live with these trade-offs. The questions above translate into practical ones you can ask of any technology you bring in:

1. Does it make the radiologist's day easier? Fewer clicks, faster priors, less copying between systems. A worklist that can be driven by voice, as we described in Talking to the worklist, is one example of taking small frictions out of a long list.

2. Does it support the quality of the read? For example, by helping with triage, measurements, a structured template or a second look, while the radiologist remains responsible for the report. Structured reporting is one of the plainer ways to make reports more consistent without slowing anyone down.

3. Does it protect the price of the scan? The point is to raise quality without making imaging less affordable or less available. A tool that only works by raising what the patient pays has missed the question.

4. Does it take cost out of running the centre? When registration, scheduling, billing, acquisition, reporting and report delivery run on one platform instead of several, the front desk stops retyping details and the radiologist stops logging in twice, and those savings do not have to be passed on to the patient.

I wrote that change also needs regulators and hospital systems to recognise the pitfalls and adopt better protocols. Software alone does not do that. But serious software is part of it.

Could India have a UPI moment in healthcare?

I am optimistic. If Indian regulators and hospital systems recognise the pitfalls, adopt better protocols, and bring serious software into their operations, Indian healthcare may well have its UPI moment.

UPI, the Unified Payments Interface, is how India moved to instant digital payments, from street vendors to large businesses.

The case study the rest of the world ends up copying.

I would like radiology to be the chapter where it started.

Related reading

• Teleradiology in India is structurally broken — what price-only competition has done to remote reporting.
• The worklist doesn't care — what volume does to the distance between radiologist and patient.
• Talking to the worklist — a voice-controlled worklist, and what it saves on a long list.

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