Friday, April 04, 2014

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.



W.O.R.M. said...

Until physicians, one person at a time, REFUSE to kneel before the false god of re-certification, nothing will change.
It's past time to take off our blinders, acknowledge the outrage and recognize the ABMS and its subsidiaries for what they are. Well funded and powerful autocratic organizations that quite literally threaten our very livelihoods with their proprietary brand of extortion.

Art Fougner MD said...

Nothing to see here...Move along,

Anonymous said...

They also earn additional $$ by selling our information (ABMS Directory of Board Certified Medical Specialists).

Single concurrent user - $849.00
IP Recognition - 5 concurrent users; single location $949.00

professional information provided includes Birth Place and DOB, total invasion of privacy.

Jeffmedic said...

I do not know this for a fact but I would bet that most of the money generated by the test goes to ABIM. Exams at this level are very expensive to prepare due to all of the psychometric standards that must be met. I am basing this observation on the NREMT exam which I took and have helped write questions for. I think most, if not all, major certification and licensing exams are developed similarly.

SteveofCaley said...

Even more than WORM stated, we have bought into the nonsense of standardized testing - the fig leaf of education that blends from the "credible" to the IQ tests and the "lie detector." We pretend that a person who knows the answers to ACLS is useful at a code. Personally, I know a lot of ACLS, and I'm damn useful at a code - but I haven't memorized the new algorithms. Other than saving lives, I can't speak much for myself and my resuscitative techniques.

Anonymous said...

Off topic--your Medicare number for 2012 was $163,185. Michelle Obama made $350k with no nights, weekends, call, malpractice, etc.

Roy M. Poses MD said...

Given the former ABIM President's history of undisclosed conflict of interest, and the weakness of the ABIM policies on conflicts of interest, (see: it might be worth trying to find out if there are other financial ties between Pearson and ABIM or ABIM leadership.

Unknown said...

Those of you who see MOC for the scam that it is should join up with like minded docs via this website:
Reach out and get in touch! Let us know who you are; strength in numbers!