Growing competition in physician credentialing is drawing renewed attention to the financial and administrative burden associated with maintaining traditional board certifications, according to a recent Medscape report.
- Traditional Board Certification Has Long Been Dominated by ABMS
Most physician certifications in the U.S. have historically been managed through one of 24 specialty boards under the American Board of Medical Specialties (ABMS). - Certification Maintenance Can Be Costly
A 2025 analysis published in the American Journal of Medicine estimated physicians may spend more than $12 billion collectively over their careers on maintenance of certification requirements, including exam fees, continuing education, and related expenses. - An Alternative Certification Option Is Expanding
The National Board of Physicians and Surgeons (NBPAS), which received formal recognition from The Joint Commission in 2022, now represents more than 15,000 physicians and is accepted by approximately 250 hospitals, health systems, and insurers nationwide. - Lower Costs and Flexible Requirements Are Driving Interest
NBPAS certification requires physicians to maintain an active medical license, complete continuing education requirements, and previously hold certification through an ABMS or American Osteopathic Association board. The organization’s lower-cost model has become a major point of interest for physicians seeking alternatives. - Hospitals and States Still Control Acceptance Policies
Individual health systems determine whether NBPAS certifications meet credentialing standards through their own bylaws and policies. Some state regulations also limit how physicians may advertise board certification status, leading some clinicians to maintain both traditional and alternative certifications. - Legal and Legislative Pressure Is Increasing
The NBPAS has publicly advocated against what it describes as anti-competitive certification practices within the current system. These concerns have also appeared in court, including a 2018 antitrust lawsuit against the American Board of Internal Medicine alleging unfair ties between initial certification and ongoing maintenance requirements. - Additional Specialty Boards Could Follow
Other physician groups are exploring independent certification pathways as well. Cardiologists recently attempted to establish the American Board of Cardiovascular Medicine as a new certifying body, though the application was reportedly denied by ABMS, leaving the current certification structure unchanged for now.
Resource: Emerging competition in physician credentialing, explained