… these sorts of obscenely greedy non-profit people/institutions are a perennial source of amusement at University Diaries, passionate as we are here about hypocrisy at its most pious. And it doesn’t get any more pious than the non-profit world, where it’s all for Art, for God, for Enlightenment… for Humanity, dammit!

But chauffeur-driven Berlowitz and the astoundingly overcompensated trustees of Bremmer are teeny weeny greed/hypocrisy tales… Their organizations are too runty to make much of a ruckus when local reporters force open the books and expose everyone. There’s a pleasure in the revelations, to be sure; but it’s a modest pleasure, like drawing on a Cuban cigar while standing on a fine-sand beach on a clear night… Happy-making, but circumscribed…

And then there’s the ABIM.

Let us take a trip mise en ABIM – into the abyss of the American Board of Internal Medicine, as it buys multimillion dollar apartments which offer owners chauffeur driven late model BMWs because American medicine will never obtain optimal patient care unless the ABIM trustees can stay in this apartment when they’re passing through Philadelphia…

The ABIM has figured out over the years that its monopoly on the recertification of doctors means they’ve got the men by the balls and the women by whatever you get the women by. You wanna practice, you gotta stay certified. So…

1. charge tens of thousands of dollars for the test and for test prep materials; and

2. constantly increase the number of tests that have to be taken.

Through these clever expediencies, this non-profit has accumulated tens of millions of dollars for itself! We’re talking tens of thousands of doctors after all! There’s nothing runty about it! And you can’t argue with the results:

[I]n 2001—just as the earliest round of new-test standard was kicking in—the ABIM brought in $16 million in revenue. Its total compensation for all of its top officers and directors was $1.3 million. The highest paid officer received about $230,000 a year. Two others made about $200,000, and the starting salary below that was less than $150,000. Printing was its largest contractor expense. That was followed by legal fees of $106,000.

Twelve years later? ABIM is showering cash on its top executives—including some officers earning more than $400,000 a year. In the tax period ending June 2013—the latest data available—ABIM brought in $55 million in revenue. Its highest paid officer made more than $800,000 a year from ABIM and related ventures. The total pay for ABIM’s top officers quadrupled. Its largest contractor expense went to the same law firm it was using a decade earlier, but the amounts charged were 20 times more.

But then it turns out that you can’t just keep increasing your salary and your tests and your real estate portfolio forever. A tipping point will eventually be reached, and here the tipping point is named Paul S. Teirstein. Teirstein points out that

The ABIM is a private, self-appointed certifying organization. Although it has made important contributions to patient care, it has also grown into a $55-million-per-year business, unfettered by competition, selling proprietary, copyrighted products.

So Teirstein has introduced competition, starting his own certifying organization:

The group’s fees are much, much lower than those charged by the ABIM. And its board and management—all top names in medicine—work for free.