Gov. Gretchen Whitmer has ordered state officials to create rules requiring implicit bias training for Michigan health professionals as they seek licensure, registration and renewals as a way to ensure equity in health care access.
The training is among recommendations from the state’s Coronavirus Task Force on Racial Disparities being led by Lt. Gov. Garlin Gilchrist, and comes amid data that show communities of color — particularly African Americans — are disproportionately affected by the pandemic in both cases and deaths. Black Michigan residents comprise 40 percent of COVID-19 deaths but represent 14 percent of the population.
Whitmer also called for implicit bias training for health and medical professionals earlier this year during her State of the State address. Gilchrist said COVID-19 has underscored the need for more widespread training.
“We must do something right now because more and more lives are still being lost here and across the country,” Gilchrist said today.
Whitmer’s executive order announced at a press conference today directs the Department of Licensing and Regulatory Affairs to undergo a formal rulemaking process, which could take six to 12 months, officials said.
Reports have shown white patients tend to receive a higher quality of care compared to people of color, who also report they are generally less satisfied with their interactions with health care providers.
Dr. Joneigh Khaldun, the state’s chief medical executive, said implicit bias surfaces in offering different treatment plans to patients, dismissing complaints and “not being sensitive” to cultural differences.
“Implicit biases absolutely show up in medical interactions and can lead to negative health outcomes,” she said.
Dr. David Spahlinger, president of University of Michigan Health System, said his organization has trained 14,000 of 28,000 faculty and staff in implicit bias, while another 4,000 have gone through intervention training.
“It’s an educational tool designed around the fact that the unconscious mind is a powerful and intrinsic force that shapes behavior,” he said.
Last month, Grand Rapids-based Spectrum Health announced it will commit at least $100 million over the next decade to address racial and ethnic disparities and improve equity in health care.
Blue Cross Blue Shield of Michigan President and CEO Daniel J. Loepp issued a statement agreeing that implicit bias “does show in various ways” in the health system.
“It benefits all medical professionals to spend time working to recognize where implicit bias may be present in the delivery of care and developing approaches to address it to the benefit of patients everywhere,” Loepp said in support of Whitmer’s order. “Raising awareness of implicit bias through training and education is critical if Michigan is to have equitable systems of care for all, regardless of race or cultural background.”
COVID cases rising
Whitmer announced the order a day after Michigan saw its highest spike in COVID-19 cases since late May. Grand Rapids is now leading the state with 45 cases per million people per day and has shown three weeks of increasing rates of cases, Khaldun said.
The Upper Peninsula — which has maintained relatively few cases since mid-March — is now seeing its highest rate of increased cases throughout the pandemic.
Khaldun said the recent increase in cases has been linked to food processing plants, bars, a casino, congregate care facilities and religious gatherings, “but there is also evidence of general community spread,” she said. Although hospitalizations and death rates have not increased, those tend to follow “several weeks after cases are identified.”
Testing also is increasing across the state, but the percentage of cases coming back positive has slowly grown from 2 to 3 percent, Khaldun said. The state is also “making great strides” with contact tracing once the virus is identified, but local health departments are still struggling with contacting people who may have been in contact with COVID-19 patients.
Overall, the state is not yet ready to officially scale back phases of the state’s reopening plan, but officials say it still remains an option. Khaldun and Whitmer reiterated today that wearing masks in indoor public settings remains the most effective way to reduce the chances of spreading COVID-19.
“Michigan is in a different place than we were a few weeks ago,” Khaldun said. “Cases are rising but there is still time for us to keep this curve down and not see the resurgence we’re seeing in so many other parts of the country.”