A recent study reveals that diagnostic radiologists in the United States will collectively spend nearly $984 million on board certification over their careers. This total consists of approximately $208.5 million for initial board certification and around $775.3 million for maintaining this certification over a span of 35 years. These findings were highlighted in an analysis published by the American Journal of Medicine on November 19.
The research also examined the financial implications for all members of the American Board of Medical Specialties (ABMS), noting that about 90% of U.S. physicians are currently board certified. The overall cost for initial certification among affected physicians could reach nearly $3 billion, while the ongoing maintenance of certification (MOC) may amount to $9 billion throughout their professional lives. Currently, ABMS member boards hold a net surplus of $839 million, a figure that has seen a 31% growth since 2014.
In their analysis, co-author Alan H. Daniels, MD, suggests the growing number of board-certified physicians will likely lead to increasing costs. He emphasizes the significant time and effort physicians invest in fulfilling both initial and continuing certification requirements, which contribute to a $12 billion burden on the healthcare system. Daniels calls for further research to assess the effectiveness of board certification as an indicator of professional competence and its impact on patient outcomes.
The study looked at data from ABMS reports and noted a 14% increase in the number of physicians maintaining active certification and a 33% rise in continuing certification from 2016 to 2023. The certification tests across various specialties typically consist of lengthy exams with an average of 300 questions and a high pass rate. Specifically, for diagnostic radiology, the initial written exams are notably rigorous and expensive, with a total cost of $3,200, a high pass rate, and extensive question coverage.
According to the 2022 financial report, the certification process generated a surplus of about $47 million and resulted in a total net balance of approximately $839 million across all ABMS member boards. The American Board of Radiology (ABR), which serves the diagnostic imaging field, recorded total revenues of approximately $18.4 million, predominantly from fees.
Despite substantial costs, some physicians have questioned the benefits of maintaining certification, arguing that the expenses are excessive and lack scientific backing. Previous legal challenges against the ABR regarding the value of its requirements have arisen but have been dismissed in court.
Daniels and his co-authors argue that there is a necessity for ongoing scrutiny of the certification process to determine whether it effectively monitors physician qualifications and promotes high-quality care. They propose that the funds currently allocated to the certification process could be better directed towards improving self-regulation among physicians, fostering evidence-based care, enhancing the work environment, and promoting overall physician wellness.
This analysis underscores the importance of evaluating both the costs associated with medical certification and their impact on healthcare delivery. By rethinking the certification process and financial allocations, there is potential for positive reforms that could benefit not only physicians but also patient care outcomes in the long run.