COMMENTS AND RESPONSES The Value of Physician Assessment TO THE EDITOR: In response to Lipner and colleagues ’ research (1),

I would like to point out that approximately 6000 first-time candi-dates annually participate in the American Board of Internal Medi-cine (ABIM) certification process at about $1000 per candidate; cu-riously, about half as many candidates enroll in the Board’s Maintenance of Certification process. Revenues are nearly $9 million annually (2), and review and exam preparation materials provide additional in-come for the ABIM and other organizations. Studies about ABIM processes, which are often funded by the ABIM, have been con-ducted for decades. Consequently, evidence for the ABIM’s processes should be clear and widely understood, especially in academia (3). The rate-limiting step of ABIM certification is the written ex-amination. As an idea born of academia, the examination would ideally be valued in academia. However, my survey of 1 academic group of general internists revealed that the use of the ABIM exam-ination as a measure of clinical quality is far from universally en-dorsed (Table); some internists expressed sentiments that were sim-ilar to those reported by Lipner and colleagues (1). It remains to be shown whether other academic groups perceive the examination sim-ilarly. Without concrete evidence, many employers and payers often mandate ABIM certification as a marker of high clinical quality. In an era of evidence-based medicine, such a policy is clearly unwarranted