June 1 marked the start of a new era for Michigan’s more than 400,000 healthcare professionals, who are now required by the state to complete implicit bias training, through the Licensing Department. and Michigan Regulatory Affairs.

“New applicants for licensure or registration will be required to complete at least 2 hours of training, and renewal applicants will be required to complete at least 1 hour of training each year,” read the announcement on the LARA website. “The annual training program can cover a variety of topics related to implicit bias, but must incorporate strategies to reduce disparities, including the administration of self-assessments.”

The new requirement was not welcomed in all circles.

Abigail Nobel, a registered nurse in West Michigan since 1989 and the 2018 founder of Michigan Healthcare Freedom, views implicit bias training as the state that imposes a particular worldview on an entire profession. She fears this will push back those with other points of view.

“People shouldn’t have to wade through a swamp of state nonsense to care for patients,” Nobel said. “Dealing with patient health care, I’m here to tell you, is hard enough. You have to follow the science. You track your team members and their abilities. You track your patients and what they need.

“It’s more than a full-time job,” Nobel told Michigan Capitol Confidential. “You do what it takes to take care of your patients. It’s hard work, it’s a lot of work, and putting more obstacles in front of it is immoral.

The state’s leading hospital trade group, on the other hand, agrees with the new requirements.

Under normal circumstances, the Michigan Health and Hospital Association, an industry group representing some 130 hospitals in the state, would prefer reforms to be industry-led and not come to Lansing through laws or regulations, said said CEO Brian Peters.

But for the implied bias requirement, the association worked alongside the state to craft it, Peters told Michigan Capitol Confidential.

Most of the hospitals in the association were already running training sessions on implicit bias or planning to offer them, Peters said, adding, “We can do better.”

By comparison, Peters credits a 2000 National Institutes of Health study, “To Err is Human: Building a Safer Health System,” with changing the way people think about medical errors. The study estimated that medical errors kill 98,000 people a year. Within the association and in the field, hospitals, doctors and nurses have started thinking about how they can reduce these numbers.

“To Err is Human” argued that “the problem isn’t bad people in healthcare – it’s that good people are working in bad systems that need to be made safer”.

Peters says the systems still have a long way to go, 22 years later.

After the study, the association noted the high rates of catheter-related bloodstream infections in its intensive care units. According to a 2006 study published in the New England Journal of Medicine, “an evidence-based intervention resulted in a large and sustained reduction (up to 66%) in rates of catheter-related bloodstream infection that was maintained throughout the 18-month study period.”

Peters estimates that thousands of lives have since been saved because that lesson has been passed on to others. He sees similar potential with implicit bias training and thinks it will teach healthcare professionals to better listen and treat their patients as individuals, addressing their unique needs.

“That’s why we use the term implicit or unintended bias,” he said. “I don’t think anyone goes out of their way to treat someone differently or provide substandard care or to not listen to their concerns. I think the goal of this training and this goal is to make sure that clinicians understand that you may want to treat everyone the same, which is a laudable goal, but not everyone gets there in the clinical setting with the same set of circumstances in their lives. everyday life. »

The hospital association recommends the implicit bias training offered by the Michigan Health Council to any organization that needs a program.

Peters acknowledged that the requirement for implicit bias training is another demand on healthcare professionals’ time. In addition to working long hours, doctors and nurses have annual continuing education requirements. Workplaces may have additional requirements. And since June 1, they face another state requirement for even more training.

Peters thinks the benefits of the new training requirement will outweigh the time commitment.

“Yes, we might need time for our clinicians or employees to go through this training,” Peters said. “But if we avoid re-hospitalizations, if we avoid complications that require an extended hospital stay, we’re going to save them time with better outcomes.”

But Nobel argues that training is not just about professionals being trained to do better.

“It’s the state that interferes with people’s worldview,” Nobel said. “He has nothing to do with that. It has nothing to do with the quality of care. It has everything to do with politics.

Over the past year, Nobel has refocused its efforts. Her job at Michigan Healthcare Freedom has become a job in itself. But she’s still a nurse and fears that requirements like implicit bias training could drain talent from the field, or drive it away.

“And who does that leave to take care of you?” Nobel asks.