Recent research reveals that the diagnostic radiologist workforce will collectively invest nearly $984 million into certification over their careers. This significant figure encompasses around $208.5 million for initial board certification and approximately $775.3 million for maintaining that certification throughout a typical 35-year career. The findings were published on November 19 in the American Journal of Medicine.
The analysis included data on other members of the American Board of Medical Specialties (ABMS), indicating that around 90% of U.S. physicians are currently board certified. Overall, board certification expenses for physicians in the United States could reach nearly $3 billion for initial certification and $9 billion for Maintenance of Certification (MOC) across their careers. The member boards of ABMS currently maintain a net surplus of $839 million, a 31% increase since 2014.
Co-author Alan H. Daniels, MD, from Brown University’s Department of Orthopedics, notes that the rising number of board-certified physicians hints at even greater costs in the future. He emphasizes the need for further research into the board certification process, questioning its effectiveness in reflecting professional competence and its direct correlation with patient outcomes. The study highlighted that from 2016 to 2023, the count of certified physicians grew by 14%, while those maintaining certification surged by 33%.
For initial certification examinations across various specialties, the average consists of 300 questions administered over six hours, with an 89% pass rate and an examination fee of $2,942. In diagnostic radiology specifically, the initial examinations cost about $3,200. Candidates face a comprehensive first exam featuring 615 questions over 11.5 hours and a second examination consisting of 298 questions spread over 5.7 hours. The first exam records a high pass rate of 95%, while the latter shows an 86% pass rate.
Continuing certification tests, which apply to all specialties, average 49 questions and have a pass rate of 93%. In diagnostic radiology, the MOC examination includes 260 questions over 13 hours, and radiologists must fulfill specific requirements every five years, such as earning CME credits and paying an annual certification maintenance fee.
The certification process generated around $47 million in surplus for the 2022 tax year, contributing to the substantial net balance across the ABMS boards. In the realm of diagnostic imaging, the American Board of Radiology (ABR) garnered about $18.4 million in total revenue, primarily through fees. However, expenses also totaled $18.4 million, with a significant portion directed towards employee compensation.
Despite the financial aspects, many physicians have raised concerns regarding the value of certification. Critics argue it is costly and lacks scientifically demonstrated benefits. A notable lawsuit by a Tennessee physician against the ABR for perceived injustices in required payments was dismissed in 2021.
Daniels and his co-authors called for continued scrutiny of the certification process, suggesting there should be a reassessment of its role in vetting qualified physicians and enhancing ongoing education, which is crucial for sustaining high-quality patient care. They proposed that financial resources could be better allocated toward self-regulation among physicians, improving their work environment, or enhancing overall wellness and performance.
Overall, the findings present an opportunity for the medical community to delve deeper into the efficacy and economic implications of certification processes, ultimately aiming to ensure both physician well-being and patient care quality are prioritized.
In summary, while the current system demands significant financial and time investments from physicians, it also opens doors for innovative discussions on certification necessity and potential reforms that could benefit both practitioners and patients alike.