The Business of Testing Physicians

If you want to understand the world of professional board certification, it is important to understand the business and politics of testing professionals. Such testing is big business. So big in fact, that huge international media and education companies that trade on the New York Stock Exchange have been created to service this need. According to one article on Reuters from 2012, "the entire education sector, including college and mid-career training, represents nearly 9 percent of U.S. gross domestic product, more than the energy or technology sectors."

Part of the expense of "maintaining" one's professional board certification goes for fees for the testing center where the computerized testing occurs.  Because cardiac electrophysiologists must hold two board certificates (Cardiac EP and Cardiology), we must pay for two rounds of test-taking fees: the first is included with our cardiology maintenance of certification (MOC), then we must pay a second $750 testing fee for the second EP test.  (Each test contained 180 questions - $4.17 per question).  I am assuming almost all of this goes to the company that administered my test: Pearson VUE.

ABIM holds a contract with Pearson VUE, a professional testing subsidiary of Pearson Education, the North American subsidiary of Pearson, PLC (NYSE: PSO) - an 9 billion dollar British corporation that claims it is the largest commercial testing company and education publisher in the world. It boasts Penguin Random House publishing and the Financial Times Group as some of its other far-reaching subsidiaries. Mr. John Fallon is the 52 year-old Chief Executive Officer of Pearson, PLC and earns a cool $2.55 million dollars annually while holding 282,147 shares of Pearson stock and plently of stock options.  He is joined by Mr. William T. Ethridge, age 62, who serves as "advisor" currently, but was previously responsible for the North American Educational Division of Pearson.  According to one source, William Ethridge was once chief executive of Pearson's North American Education division in 2008. According to Forbes, his total compensation in 2011 was $1,390,000 and he held a half million shares of Pearson stock at that time.

Pearson VUE states it "is built on a foundation of experience in electronic testing."  My experience with Pearson VUE was parodied in an earlier blog post. As I reflect, it seemed that Peason VUE was more concerned about storing my biometric palm scans and a digital photograph as much as they wanted to assure a fair testing environment. While the ABIM discloses this process on their website, doctors unaccustomed to such paranoid security measures are caught off-guard by these tactics and should be concerned about how this information is stored and used. Are previously-certified doctors really this sketchy?

Pearson VUE earns a pretty penny from its professional testing and its physician testing in particular. According to Pearson's most recent SEC filing:

"Professional testing continued to see good revenue and profit with growth test volumes at Pearson VUE up 25% on 2012 to almost 12 million [pounds] ($19.9 million). Key contract renewals included tests for the American Board of Internal Medicine, the Association of Social Work Boards and the Pharmacy Technician Certification Board. "

But profitting from physician education is a politically hot topic, too. Not surprisingly, Pearson Education seems quite active in this space spending $2,100,000 to lobby Washington during the last presidential election cycle in 2011 and 2012, contributing 7:1 to the Democratic side of the political aisle. Also, 6 of the eight current Pearson lobbyists have previously held government jobs.

Doctors should understand how and where their money and personal information are being used in the ABIM's MOC testing process, since much of those funds seem to support the corporations and political aspirations of those who are doing the testing rather than the needs of patients that the ABIM is pretending to protect.

-Wes