The scientific rigor behind "implicit bias" has been questioned since at least 2009, when the Journal of Applied Psychology deemed the evidence "surprisingly weak" that the Harvard-designed implicit association test "predicts discriminatory behavior," despite the confident claims of psychologists and pop-science purveyors including Malcolm Gladwell.

"Sexy But Often Unreliable," Personality and Social Psychology Bulletin declared in 2011 in reviewing the "replicability of experimental findings with implicit measures."

Even liberal journalists at Vox and New York Magazine found the Harvard test unable to deliver consistent results, and a disclaimer provided in individual test results warns that they are "not a definitive assessment of your implicit preference."

Implicit bias training keeps showing up in professional mandates, however, prompting a liberty-minded public interest law firm to bring lawsuits on behalf of medical professionals against what they portray as ideological compulsion.

Grand Rapids dentist Kent Wildern sued Michigan's Department of Licensing and Regulatory Affairs last week for forcing him to submit to ongoing training or give up his license.

It's based on Democratic Michigan Gov. Gretchen Whitmer's executive order in July 2020 on "improving equity in the delivery of healthcare," as recommended by her Coronavirus Task Force on Racial Disparities, which also closely followed the riots set off by the killing of George Floyd in Minneapolis. 

Implicit bias training rules followed 11 months later, covering 400,000 healthcare professionals – but not veterinarians — in the Great Lakes State.

"LARA lacks any statutory authority to impose these sweeping, one-size-fits-all mandates" and "the rule’s ideological content bears no connection to the purposes of LARA’s authorizing statutes," Wildern said in the complaint filed by the Pacific Legal Foundation in the Michigan Court of Claims.

The state launched "at least 132" investigations against healthcare professionals as of September 2024 for refusal to take the training, with fines ranging from $125 to $2,500 and some losing their licenses while others proactively gave them up, he said.

A practicing dentist of 40 years, Wildern chose not to renew his license when his sought exemption based on "bona fide objections to the race-based trainings" as "illegal and immoral" was denied, and now wants his license back to keep practicing.

Even if it had "a legitimate government interest in requiring what amounts to no more than mandated indoctrination" in medicine and "regulating individuals’ subjective states of mind" as actual or would-be healthcare professionals, Michigan has "less-restrictive means" to mitigate negative outcomes from implicit bias, such as banning "discriminatory action."

Continuing medical education 'government speech'?

PLF is facing another uphill battle in California on behalf of ophthalmologist Azadeh Khatibi – also a plaintiff in a lawsuit that compelled the Golden State to abandon its medical misinformation law before it could be struck down – and medical advocacy group Do No Harm against California's statutory implicit bias training mandate, signed into law in 2019.

AB 241 was sponsored by then-Assemblywoman Sydney Kamlager-Dove, now a congresswoman being sued for defamation by Twitter Files journalist Matt Taibbi for repeating her claim from a hearing – where it's protected under the Constitution's speech and debate clause – that Taibbi is a "serial sexual harasser" on X, where it is not.

The bill has required all continuing medical education courses for physicians and surgeons since 2022 to "contain curriculum that includes specified instruction in the understanding of implicit bias in medical treatment," and course accreditors to develop compliance standards.

Khatibi and Do No Harm, representing "at least one member who teaches, has taught, and intends to teach CMEs in the future for credit in California" but doesn't want to include "divisive and discriminatory ideas" like implicit bias, lost at the district court on the grounds that CME training creators and presenters are engaged in "government speech." 

Their lawyers at PLF argued last month before the 9th U.S. Circuit Court of Appeals, warning that "the government can censor the content of such courses" if they are indeed government speech like license plates but not band names.

Apart from the Sophie's Choice of keeping a medical license or submitting to an alleged racial ideology, the fortunes of diversity, equity and inclusion in medicine continue falling even as some organizations rebrand DEI as "belonging."

Vanderbilt University Medical Center told WSMV on Wednesday it is "eliminating all DEI programs and is fully complying" with President Trump's executive orders on DEI, as reflected by "removing related content on internal and external websites to reflect the termination of these programs." The Mayo Clinic simply renamed its DEI office, however.

No legitimate interest in regulating 'subjective states of mind'

Whitmer's mandate requires Michigan healthcare professionals to take implicit bias "assessments" but also instruction in a related topic, including research on implicit bias, its historical basis and "importance," and "equitable access to healthcare," Wildern's suit says.

It is "imbued with ideological presuppositions" and lacks "any carve-out for specialized practices or differing professional contexts," yet is premised on LARA's statutory authority, "in cooperation with the professional boards," to promulgate standards to determine whether graduates "have the necessary knowledge and skills" for the professions those boards oversee.

That is a far cry from promulgating "one-size-fits-all continuing education requirements on all healthcare professions," and Whitmer's directive also inexplicably claimed authority from a LARA provision to set rules for "physician's assistants," the suit says.

"LARA’s rulemaking authority has been delegated in perpetuity with no sunset provision or conditions to trigger its rescission," usurping the Legislature, and the agency believes it can "impose any condition on any healthcare professional to attain or maintain a license to pursue their livelihood," Wildern said.

The rule infringes on freedom and thought and conscience by pressuring medical professionals to adopt a "particular viewpoint …  without constraint by legislative guidelines" or any "legitimate government interest" for what amounts to regulating "subjective states of mind."

The state cannot show any connection between the training and "improved competence" or healthcare outcomes, because "such programs are demonstrably counterproductive, increasing intergroup hostility and discord," the suit says.