Medical care providers in Michigan will be required to take part in regular implicit bias training beginning in June of next year.
The new requirement,announced by Gov. Gretchen Whitmer earlier this month is meant to prevent unconscious bias from influencing a patient’s medical care.
Implicit bias refers to attitudes or prejudices that are unconscious but still influence people’s thoughts and actions.
“There is a lot of evidence in the literature which says that bias, prejudice, and uncertainty on the part of the health care provider often contribute to the inequities in healthcare,” said Dr. Debalina Bandyopadhyay, who serves as the administrative director for the Michigan State University College of Osteopathic Medicine's Detroit Medical Center site.
“It has been shown with a lot of data that minorities, people who belong to a minority race, ethnicity or sexual orientation, receive lower-quality care than non-minorities,” she said.
Lt. Gov. Garlin Gilchrist II said state officials were already studying racial disparities well before the COVID-19 pandemic hit, but the deep disparities revealed by the pandemic were alarming.
“Very quickly we saw that there were indeed disparities in tax rates and deaths from COVID-19. To put it in perspective, Black Michiganders makeup 30.6 percent of the population, but, in the first two months of the pandemic, we accounted for more than 40 percent of the people who died,” Gilchrist said. “That disparity was something that was too alarming for us to ignore.”
The Department of Licensing and Regulatory Affairs, which oversees health professional licensing, will begin requiring the implicit bias training next summer. New applicants will be required to complete at least a two-hour training and those applying for license renewal will be required to take a one-hour course each year.
“I think that we have a tremendous amount of agency to optimize for better outcomes,” Gilchrist said. “So when we have the chance to find a way to make better choices to be more responsive to people, particularly people who are dealing with unique challenges we need to embrace that.”
Many hospitals and medical care facilities already have implicit bias training in place.
"Sparrow has provided implicit bias training for all physicians and caregivers for four years," Sparrow Health spokesperson John Foren said in a statement. "Sparrow’s mission is to improve the health of the people in our communities by providing quality, compassionate care to everyone, every time, and understanding how implicit bias impacts the delivery of care is an important step to address health disparities.”
Gilchrist said he still expects the requirement and the inclusion of a wide variety of perspectives to help improve care outcomes across the state.
"I don't think that this is being interpreted as redundant at all. In fact, I think this will help to improve the practice of medical professions in the state of Michigan is going to help us be a leader in this space. And so we're very proud of that," he said.
Implicit bias isn’t unique to race, said Stef Schuster, a MSU sociology professor. Schuster uses they/them pronouns.
Schuster described their own experience with implicit bias going into a hospital for a medical procedure. A nurse made an assumption about Schuster’s gender that simply would not have worked for Schuster’s body.
“I'm like, but you've never even asked me what my gender is and so you might not know that I'm a trans person who is assigned female at birth,” they said. “So it's like those tiny interactions when all of those belief systems about like snap judgments are playing out that it can cause real harm.”
Schuster said implicit bias has a real impact on treating different genders.
“I think another classic example is, for a long time, women were underdiagnosed with heart attacks because the symptoms list was built on the symptoms that men had experienced,” they said. “So when women go into the hospital and they're experiencing a heart attack, it might be cast-off as something else.”
Bandyopadhyay said one training on its own won’t necessarily bring about major changes.
“I say, at the end of every lecture I give, one training is not going to change the disparities or the inequities that exist in health care. But it's a first step,” she said.
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