4 min read

The Revenue Powering Medical Boards

A 2017 JAMA article estimated that the American Board of Medical Specialties ("ABMS") makes $313 per ABMS Board certified physician. Today, the ABMS makes $378 per ABMS Board certified physician.

With 915,000 physicians, that's an overall revenue of $345,000,000 per year.

These boards exist to ensure a high standard of professionalism for physicians and to support physicians' professional development. And in they released a response to the JAMA paper that the $313/physician number is totally reasonable.

The American Board of Internal Medicine ("ABIM") has been under scrutiny (for many years) regarding excessive Maintenance of Certification ("MOC") fees. The IM community has started to rally with a petition, with over 20,000 signatures, to eliminate MOC.

Let's take a peek at the ABIM finances compared to other medical boards and see:

  • how money flows to medical boards like the ABIM
  • how other medical boards compare to the ABIM
  • why many other boards should get more scrutiny than the ABIM

ABIM...

...charges fees to maintain MOC (literally a certificate), and an exam fee taken every 10 years. Here's a quick snippet of the fees that all IM physicians (or if they're lucky, their employers) end up paying:

And this is only a glimpse of the entire picture. A family member just passed their ABIM board exam. It cost $1,430 just to take the initial exam. Next up is their subspecialty exam, which will cost a pretty $2,325.

Combine all these fees IM physicians are forced to pay, and the ABIM's revenue for MOC and exam fees look like this:

And the ABIM's total revenue?

In 2022, $71,400,000 out of $72,100,000 (99%) of the ABIM's revenue came from two overarching services: MOC and Certification of Exam Fees.

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$71,400,000 out of $72,100,000 (99%) of the ABIM's revenue came from two overarching services: MOC and Certification of Exam Fees.

However, the high fees of the ABIM are not unique to the ABIM. Some other medical boards make more per physician.

Revenues of All Medical Boards

ABIM has the highest revenue of any medical board. And it isn't even close. It is followed by the American Board of Family Medicine ("ABFM") and the American Board of Pediatrics ("ABP").

Revenue Breakdown

These are outstanding businesses that pull in a substantial amount of recurring revenue. But where does the money come from?

Each medical board reports their program service revenue along with their overall revenue. After analysis, the main components come from these major categories:

  • certification fees
  • examination fees
  • annual fees
  • application fees

It's not surprising these are the main sources of revenue. After all, they are boards and have to mandate a certain level of quality for their certification to have any value.

Per Member Metrics

Okay, so boards make money off of fees, certifications, and continuing education. So what?

The ABMS posted the number of diplomates in the 2021-2022 year. The PDF is available here (archived).

And with this, we can see how much each board makes off of fees, certifications, and continuing education per diplomate. A "diplomate" is a physician who has a certification from said medical board (just trying to be consistent with the medical board terminology!).

The ABIM actually pulls in less money per physician than 16 other medical boards. While their movement towards eliminating MOC fees is one I fully support, shouldn't other specialties also fighting to eradicate exorbant fees?

I don't have full knowledge of everything inside a medical board, but I do see that there is a lot of revenue created by having a certification monopoly (the American Board of Medical Specialties is truly a money-making machine). I hope the IM community's voice will not go unheard and pave the way for other specialties to also lower massive fees mandated by their respective medical boards.

Look more into medical boards' finances with the White Coat Salary Nonprofit Explorer. Check it out if you're interested in looking at executive compensation, increasing revenue, and much more!

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