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Study examines high costs of maintaining medical certification

stethoscope-448614_1280After you've got an MD and passed your board exams, you're all set, right?

Well, not quite. Physicians must meet new requirements for maintaining medical board certifications - and doing so can be costly. A new study from a team at Stanford and University of California-San Francisco explored the costs of the American Board of Internal Medicine (ABIM) requirements, as described in a UCSF article:

The researchers developed a mathematical simulation model of the entire ABIM-certified workforce of internists, hospitalists and internal medicine subspecialists in the United States and estimated total societal costs over 10 years – including ABIM fees and the monetary value of physician time spent on fulfilling [maintenance-of-certification (MOC)] requirements. They calculated that costs to individual physicians would average $23,607 over 10 years, with costs in some subspecialties exceeding $40,000. Subspecialists face higher costs than general internists in the program, primarily because they take additional certification examinations that generate more fees and a greater time outlay.

“We found that 9 out of every 10 dollars in MOC costs were related to the program’s demands on physician time,” said Alexander Sandhu, MD, the lead author of the study and the Veterans Affairs Health Services Research and Development fellow at the Center for Health Policy/Center for Primary Care and Outcomes Research at Stanford University, and a clinical instructor for the Department of Medicine...

The study comes after the ABIM increased its requirements and fees in 2014. Following protest, the ABIM revised the requirements earlier this year but retained the fees and number of modules required. The February changes are "a step in the right direction," the authors write, but further examination is needed:

Whether the costs of MOC ultimately will be borne by physicians or will be passed on to employers, payers, or patients is uncertain. Furthermore, unless balanced by improved efficiency downstream, the increased demand on physician time in a period of anticipated physician workforce shortfalls may have a deleterious effect on access to care, particularly elective care.

Dhruv Kazi, MD, an assistant professor of medicine at UCSF, was senior author of the study.

Previously: Clinical informatics gains recognition as new medical sub-speciality, A call for extended bedside-manner training and The next challenge for biodesign: constraining health-care costs 
Photo by HolgersFotografie

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