Although medical specialty boards — as nonprofit organizations funded by physicians —have been entrusted to match revenue and expenditures, most boards exhibited revenues that significantly exceeded their expenditures in 2013, according to a research letter that recently appeared in JAMA.

“The process of board certification has a central role in the self-regulation of physician quality standards,” Brian C. Drolet, MD, of the department of plastic surgery, Vanderbilt University and Vickram J. Tandon, MD, of the department of plastic surgery, University of Michigan, wrote. “However, many physicians have objected to programs by the American Board of Medical Specialties, particularly maintenance of certification, citing a lack of clinical relevance and evidence to support efficacy as well as high fees to participants.”