Being an economist, you don’t want me to play medical doctor in order to save you money.  Likewise, when doctors write an economic cost study that concludes that doctors do not need to keep up with the latest medical research, I can’t help but think of the potential for intellectual malpractice.

There has been a growing controversy about what is known as Maintenance of Certification, a program offered by 24 specialty boards that regularly tests physicians on their clinical knowledge. Many boards are requiring increased engagement by doctors, given the speed with which science and medicine are changing in today’s world.

While I have no opinion on whether certification requirements should be increased or decreased, as a patient, I do want my physician to be very qualified and highly attuned to the latest research and medical techniques.  Board certification provides the public some assurance that their doctors know their stuff, including the latest advancements in medicine and medical techniques.

Recently, a group of doctors wrote an economic cost study in the Annals of Internal Medicine, and unfortunately the study has been cited as gospel by a variety of medical websites.  That study measured the 10-year certification costs to be “considerable” and that reform in the certification program is needed to lessen the time doctors require to meet the programs requirements.  Putting aside the flaws in the study that erroneously double physician labor costs and accepting their 10-year estimates as accurate, when expressed in current annual dollars, the study’s 2015 average costs for the program was $1,308.  For general internists, using the study’s figures, the 2015 annual average costs for the program was only $927.  Are those costs so prohibitive?  Maybe, but try paying for an MRI.

The major objection that some physicians have to certification is that brushing up and learning new techniques and practices takes away some free time.  While some patients may appreciate it, some doctors don’t want to be bothered with certification or maybe they just believe that they know it all.

In fact, the study did find that physicians’ time (they assume a base case of 12.5 hours per year) accounts for 90% of all certification costs.  In other words, it’s not the direct expenses of the certification program itself that is costly, but that learning takes time. Of course, by that logic, there could be considerable cost savings by having physicians (and possibly economists) skip medical school altogether.  However, saving on training and education produces tradeoffs that will have negative consequences on patient outcomes.  The study does not measure that.

The reality is that education is an investment in human capital as economists, like Nobel Prize recipient Gary Becker, have long pointed out.  Like most good investments, they tend to generate positive returns, often in the form of increased economic output and earnings.

Does investing in medical certification increase physicians’ earnings?  Data show that certified physicians to earn $100,000 more per year than uncertified physicians.  It may be that certified physicians work harder or are smarter and better educated than their uncertified counterparts.  It may be that patients prefer certified physicians over others physicians.  In any case, if we look at the higher wage as a measure of marginal productivity, then board-certified doctors would appear to make $100,000 more a year than their uncertified counterparts, but they incur $1,308 more in costs.  Not a bad return on investment.

The point is that the cost is not that high, provided that there is an offsetting benefit.  Therein lies the problem with those that oppose broad certification altogether – the call for reform cannot be influenced solely based on costs.  If entrepreneurs only measured costs, we would never have a successful business case.  If the FDA only focused on costs, we would not have prescriptions on the market. There are benefits to consider.

If anyone should know this, doctors should.  A basic approach to decision-making, whether that is in economic policy or medical efficacy, is the use of cost/benefit analyses.  If there is any confusion on this point, then maybe remedial courses are, in fact, necessary.

Again, I don’t know if certification requirements should be decreased or increased.  However, as an economist, it is intellectually unsophisticated for some opponents to rely on “time” as a main reason against certifying that physicians are up to date on the latest science and medical practices.  It may be that this opposition is driven by academic arrogance or just plain laziness or other reasons, but the earnings differential from certification clearly suggests that the benefits of certification do outweigh its costs, at least on average.

In any case, let physicians skip board certification if they feel it is too costly or of no benefit, but let consumers know who they are.  Knowing whether or not physicians are certified can provide consumers with better information when choosing their doctors.

This piece was published in FORBES.