I know what racial progress looks like. I was one of the first Black students to attend Stanford University and the University of California San Francisco medical school. When I received my medical degree 50 years ago, in 1973, society was far from just. Yet it seemed that California was leading the nation toward a future of equal treatment, free of the racist belief that skin color defines who we are as human beings.
What happened to that forward-looking California? My state is now going backward – to the point of enshrining racism in law. Since the start of 2022, lawmakers have mandated that all continuing medical education courses offered by state-based organizations include a focus on so-called “implicit bias.”
Physicians are required to take at least 50 hours of such coursework every two years. For me, this is a double whammy. Like all physicians, I have to renew my license, and I frequently teach continuing education courses.
The concept of “implicit bias” is racist. It assumes that a person’s skin color determines how they treat individuals of different races – that our melanin dictates our interactions with them. The California law takes this claim as fact, stating that “implicit bias… exists” and includes the “attitudes or internalized stereotypes that affect our perceptions, actions, and decisions.” It further states that such bias “contributes to unequal treatment of people based on race,” and that implicit bias “affect[s] the behavior of physicians and surgeons, nurses, physician assistants, and other healing arts licensees.”
While the law doesn’t say it, the accusation is clear: White people are oppressors and Black people are oppressed. Nationwide, implicit-bias trainings for medical professionals routinely discuss systemic racism, White supremacy, and other race-based attacks on classes of people.
I don’t care that I’m not the target. This still represents the kind of racist thinking that was starting to fade 50 years ago. I don’t want to be taught this evil, nor do I want to teach it to others.
The law’s authors and advocates think the new racism is justified by health disparities between White and Black patients. These things are real, yet blaming bias for health disparities is the easy way out, since it ignores the host of cultural, economic and other factors that influence patient health.
Besides, if implicit bias were real, you’d think I would have seen it in 50 years of medical practice. I haven’t, neither in how my peers have treated me nor in how they’ve treated patients of different races. I certainly have never seen a White colleague provide worse care to a Black patient.
The very idea of discriminating against patients runs counter to everything we’re trained to do. Physicians work tirelessly to understand the unique medical needs of the person in front of us, regardless of what they look like. The relentless focus on the individual is the defining characteristic of our profession – a point I make when I teach continuing education.
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Accusing physicians of implicit bias adds nothing to our ongoing learning, and in fact, it detracts from this critical process. Continual medical education is designed to keep physicians up to date on the newest research and treatment methods. Every minute that’s spent on “implicit bias” is time that could have been spent on real science and improved standards of care.
The law also requires courses to discuss “strategies” to mitigate bias, which means fixating more on people’s skin color, not less. Having taught courses on such topics as eugenics, medical practice models, and the tension between public health and individualized care, I can say with confidence that dwelling on race is dangerous.
My license is up for renewal at the end of this year, the first time since the mandate went into effect. I refuse to take any courses that include implicit bias. I am also routinely asked to teach continuing medical education courses, so I’ll be declining all requests from California-based organizations. But I hope the opportunity will return.
On August 1, an Iranian American colleague and I filed suit against the state of California with the help of the Pacific Legal Foundation. The First Amendment protects me from being forced to teach the state’s preferred narrative on such a divisive topic. Medical professionals should teach medicine, not the party line.
I hope this lawsuit helps reverse California’s moral decline. My state was once at the forefront of America’s progress, briskly moving toward equal treatment regardless of race. Now we’re regressing, though our leaders still think it’s progress because a different race is in the crosshairs. Nothing good will come of the new racism, no matter what it’s called or who it targets.
