Two physicians are suing multiple members of the Medical Board of California to halt regulation that requires continuing medical education courses in the state to include discussion of implicit bias, according to court documents.

The doctors, Dr. Azadeh Khatibi and Dr. Marilyn M. Singleton, as well as Virginia-based nonprofit, Do No Harm, filed the lawsuit against the board that enforces the law in the US District Court in the Central District of California on Aug. 1. The lawsuit argues that AB 241, which went into effect in January 2022, violates their First Amendment rights.

Azadeh Khatibi(left) and Marilyn Singleton(right) claim that the implicit bias training requirement violates their first amendment rights. (Instagram/@drazadehkhatibi/Screenshot) (Twitter/@MSingletonMDJD/Screenshot)

“There is inconsistent evidence that implicit bias in healthcare is prevalent and results in disparate treatment outcomes,” the lawsuit states. “Even assuming sufficient evidence exists that implicit bias in healthcare is prevalent and results in disparate treatment outcomes, there is no evidence-based consensus that trainings intended to reduce implicit bias are effective.”

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According to reports, physicians are mandated to review the topic when taking 50 hours of continuing medical education courses. They must complete the courses when renewing their license every two years.

Both Khatibi, an ophthalmologist, and Singleton, an anesthesiologist, have taught and organized medical education courses in the state, according to the complaint. They said they want to continue teaching classes but avoid inserting the topic of implicit bias when it’s irrelevant to their respective subjects.

The lawsuit says if they both opted out of the discussion, their course would not “qualify for continuing medical education credit.” This could result in physicians choosing not to take their course.

“Imagine I’m talking about muscle relaxants, pancuronium versus rocuronium. Where does implicit bias fit in there?” Singleton told MedPageToday. “I am certainly not naive. I grew up in a Black neighborhood and have been Black all my life. And I have not had any of my complaints as a patient or my advice as a doctor discounted because of my race.”

Do No Harm, an organization made up of physicians, healthcare professionals, and other individuals that focus on protecting “healthcare from a radical, divisive, and discriminatory ideology,” is also included in the lawsuit.

Per the lawsuit, at least one of its members does not want to conduct the training citing that it has not been “shown to successfully reduce barriers to healthcare, and instead risk infecting healthcare decisions with divisive and discriminatory ideas.”

Incurrences of medical racism, whether through health disparities or experimentation, have been documented throughout history. The American Medical Association, the nation’s largest professional association of physicians, has created a strategic plan for racial justice and health equity.

“I’m sure there are outliers,” she continued. “But the problem with doing something for the masses is you insult the masses just to get to the outliers. And guess what? We all know the outliers aren’t going to change. Taking some dippy course is not going to change a hardened racist.”

Per the lawsuit, the plaintiffs request an injunction to keep the board from enforcing the requirement. In addition, they are also seeking legal-related fees and other relief deemed necessary by the court.

Khatibi said in an Instagram post that other physicians told her “they’re afraid to speak,” and the situation is ‘bizarre’ and ‘dangerous.'”

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