Am I a closet racist? After 30-plus years of providing conscientious care to diverse patients in the Washington, D.C. area, I would have thought the answer was a self-evident "no." Yet Maryland now requires me to take training that accuses me of ingrained racial bias toward non-white patients.
This isn’t just inaccurate. It’s deeply insulting, and it will injure our state’s medical system and those who depend on it.
Such an initiative in Maryland is unprecedented. Since April of last year, every physician and nurse in the state has been required to take an "implicit bias" training course as a condition of license renewal.
Although I recently retired, I keep my license current so that I can participate in volunteer activities such as the Maryland Medical Reserve Corps and COVID-19 vaccine drives. I therefore signed up for the required training at the start of this year.
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The assumption of this training was clear from the start: as a White man, I have implicit, unconscious biases that "significantly contribute to disparities in healthcare services."
There is a powerful, malign accusation in these words: Namely, that I would treat Black and brown patients differently, resulting in worse health outcomes.
Sure enough, the training directly states that "implicit bias leads to a decreased likelihood of receiving life-saving emergency medical treatment." Such sweeping statements demand indisputable proof, yet throughout the training none was provided.
These proclamations also fly in the face of my own experience. At least half my patients over the years have been minorities, especially as the area where I practice has become increasingly diverse.
I always strive to treat each patient – regardless of skin color, ability, or sexual orientation – with care and humanity. I even became fluent in medical Spanish so I could better serve my county’s rapidly growing Hispanic communities.
In 30-plus years of medical practice, and a further 10 years providing medical training, I have never met a physician, nurse, or any health care professional who demonstrated bias or racial animus.
To the contrary, I have seen every single one of my colleagues strive tirelessly to help patients, no matter what they look like or where they come from.
Physicians take an oath to first "Do No Harm." It’s a pledge we uphold with conviction.
The required training attempted to disprove my decades of clinical experience. It assumes an unconscious racial bias, taking the position that while I think I’m not racist, I inherently am.
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That’s a convenient argument, but it’s not scientific, as it is impossible to prove or disprove. It also misdirects attention from the real and complicated causes of racial health disparities, which must be accurately identified and assessed if we have any hope of addressing them.
Simply pinning the blame on purported bias is unacceptable. In fact, attempts to demonstrate the reality of implicit bias have been repeatedly debunked in medical journals. And the creators of the implicit-association test – the foundational tool in the implicit-bias movement – have openly admitted it can’t predict individual behavior.
Yet the training I took both recommended that test and said it would predict how I would act. Maryland is forcing physicians to take training that is without scientific basis or factual support.
Medical care must always be grounded in truth, for the sake of improving patient health outcomes. Instead, Maryland is inserting a faddish agenda into the heart of health care.
What’s worse, this is the path to sowing distrust in the medical profession, since it tells patients their physician may not have their best interests at heart. That’s a surefire way to worsen health outcomes, even as Maryland hopes to improve them.
As a physician, I can’t imagine a more disheartening turn of events. If Maryland is truly concerned about empowering physicians to provide the highest standards of care to patients of all colors and backgrounds, it should foster training on cultural differences and bridging divides based on language, heritage, and worldview. Instead, Maryland is baselessly insulting physicians and nurses, while putting politicized ideas ahead of medical excellence.
Accusing physicians of bias and racism helps no one, but it will harm many.
