Commentary
California State Board of Pharmacy Mandates ‘Cultural Competency’ DEI Training for License Renewal
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The California State Board of Pharmacy says it “shall not renew a pharmacist license” unless the license holder has successfully completed a course in “cultural competency and humility” that focuses on Critical Race Theory-inspired ideology.
An anonymous tip obtained by Do No Harm shows the state board is now requiring pharmacists and pharmacy technicians to complete the diversity, equity, and inclusion (DEI) training. “Pursuant to Business and Professions Code (BPC) sections 4202 and 4231, pharmacy technicians, pharmacists and advance practice pharmacists renewing their license after January 1, 2024 will be required to complete at least one hour of CE regarding cultural competency,” the board states under its section on “Mandatory CE Courses.”
“The Board will not be providing a course and cannot recommend or endorse a specific course,” the directive continues, but adds the board requires the DEI training “adheres to the following guidelines”:
- The course focuses on patients who identify as lesbian, gay, bisexual, transgender, gender nonconforming, or queer, or who question their sexual orientation or gender identity and expression.
- The course is approved from an accreditation agency approved by the board.
- The course covers recognized health disparities faced by “Black, Indigenous, and people of color.“
- The course contains elements demonstrating how sexual identity is directly impacted through intersectionality.
License holders must submit to the board “proof satisfactory” which “may include specifying completion of the required CE on the renewal application provided by the Board,” says the email sent by the anonymous source.
In August, Pacific Legal Foundation filed a lawsuit on behalf of Dr. Azadeh Khatibi, Dr. Marilyn Singleton, and Do No Harm, that challenges California’s mandatory Critical Race Theory-inspired implicit bias training for physicians, asserting such mandates are unconstitutional. Now, these mandates are clearly being extended to other healthcare fields.
Khatibi v. Lawson, filed in the U.S. District Court for the Northern District of California, argues:
Rather than respect the freedom and judgment of continuing medical education instructors to choose which topics to teach, California law now requires the Medical Board of California to enforce the mandate that all continuing medical education courses include discussion of implicit bias. Under the First Amendment to the United States Constitution, the government cannot compel speakers to engage in discussions on subjects they prefer to remain silent about. Likewise, the government cannot condition a speaker’s ability to offer courses for credit on the requirement that she espouse the government’s favored view on a controversial topic. This case seeks to vindicate those important constitutional rights.
“Physicians should base medical care on each patient’s individual situation and condition,” Caleb Trotter, an attorney at Pacific Legal Foundation, said in a press statement about the case. “Implicit bias training does the opposite, telling doctors they should be concerned about a patient’s immutable characteristics like race, gender, and sexual orientation, regardless of the characteristics’ relevance to the patient’s treatment.”
Singleton, a California anesthesiologist who teaches continuing medical education courses in the state, and also serves as a visiting fellow at Do No Harm, said the mandatory implicit bias training “promotes the inaccurate belief that white individuals are naturally racist.”
“This message can be detrimental to medical professionals and their patients as it creates an atmosphere of suspicion and animosity, which goes against the fundamental principle of doing no harm,” she continued.
Do No Harm Chairman Dr. Stanley Goldfarb emphasized that physicians are not merely agents of the state.
“Physicians have free will and act in the best interest of their patients,” he said in the press statement.
“The idea of unconscious bias states that one acts on those biases, and there’s no evidence of this happening in the medical community,” Goldfarb added. “Medical professionals take the Hippocratic oath to do no harm, and do not need lawmakers or medical organizations to tell them what they should think when providing medical advice to patients.”
Goldfarb’s words readily apply across healthcare disciplines, including the field of pharmacy.
The August meeting minutes of the California State Board of Pharmacy show that, in July 2022, board staff attended training “on building an inclusive regulatory community.” In July 2023, the state board reported that 20 “executive level, senior management and management staff” completed a day-long DEI training that included:
- Introduction to Cultural Intelligence
- Understanding Implicit Bias Through the Lens of Cultural Intelligence
- Managing Conflict Through the Lens of Equity
- How to Create Sustainable Change
Also in July, the minutes indicate board staff completed additional training courses that included “How to Decode Our Unconscious Bias.”
Despite these clear references to DEI training in the board’s meeting minutes, there is no mention of mandatory DEI training for license renewal in the state pharmacy board’s “Strategic Plan” for 2022-2026.
