Radiology Board Claim They Are Unable To Reduce Exam Fees

The American Board of Radiology revealed recently that it has experienced “persistent barriers” in preventing them from reducing exam fees following its transition to a virtual test-taking model.

The board is making the switch away from in-person certification in 2021 after radiologists demanded alternatives for their safety amid the COVID-19 pandemic. One of the “perceived potential benefits” of the change was a reduction in costs and user fees, making the test more available to low-income students. However, leaders with the Tucson, Arizona, doctor-certification group said insecurity amidst the pandemic is preventing them from changing pricing.

“There are persistent barriers to fee abatement at the time of this writing,” Executive Director Brent Wagner, MD, MBA, and American Board of Radiology’s President, Vincent Mathews, wrote in the latest issue of the Beam. Those include the new exam structure’s unproven track record, a lack of dependable forecasting, long-term financial commitments for in-person exam centers, and unpredictable costs tied to the virtual exam software.

However, both Wagner and Mathews said their organization is committed to managing costs and optimistic that reduction will be achievable in the future.

“Despite these obstacles, the board members view themselves as responsible stewards of ABR resources, both financial and otherwise,” they concluded. “In this vein, they consistently challenge each other, and the ABR staff, to reduce costs and, subsequently, fees, to the extent possible.”

ABR has been under criticism from the American College of Radiology in recent years over its finances, alleged secrecy and “power imbalance” over members of the specialty. A report from ACR’s Task Force on Certification estimated the average rad spends $14,680 during their career to maintain accreditation—one of the highest totals among medical specialties. A Tennessee radiologist twice attempted to sue ABR over its program, but a judge tossed the claim in January.

The report said high fees are one of the chief complaints from radiologists. Residents and fellows pay about $640 a year for ABR’s services, on top of high student debt loads, while the board has tens of millions in assets and annual revenue of $14 million in 2018.

A Texas neuroradiologist, blogger and outspoken ABR critic, Ben White, questioned the board’s reasoning in a post shared Tuesday.

“Does any stakeholder believe that ~$50 million in cash reserves isn’t enough to deal with ‘a lack of dependable forecasts of the future steady-state expense structure,’” White wrote Feb. 23. “Transparency, transparency, transparency. Anything less is just self-love,” he added later.