- Sen. Ray Miller
COLUMBUS, Ohio — Nurses, physicians, pharmacists and most other health-care professionals would be required to take cultural competency training under new legislation introduced recently in the Ohio Senate.
This is the third attempt in about five years to get state-required cultural competency training. The difference — in the big picture, at least — is that some states have started passing similar laws. California, New Jersey and Washington are among the states who have approved such measures in recent years.
Most states still reject these bills, however, and the leading physicians group in the Ohio opposes legislation for mandated education. Plus, it may be even harder to pass such legislation in the midst of a federal health-care debate. In some states, opponents of cultural competency training link the proposals to providing health care for illegal immigrants.
The Ohio legislation, Senate Bill 158, sponsored by Columbus Democratic Sen. Ray Miller, would require a certain amount of cultural competency training to be licensed in the state, and would require continuing education classes to retain a license. The classes are meant to help narrow race and gender-based disparities in health care.
“It’s one of those things that makes sense: if you understand more about the cultural or ethnic or racial background of patients, you’ll provide better care to them,” said Ash Sehgal, director of the Center for Reducing Health Disparities at Case Western Reserve University. However, Sehgal noted, there has yet to be a clinical trial that shows cultural competence on behalf of a provider leads to better outcomes. In fact, a 2006 study published in BMC Medical Education reported no measurable impact.
The Ohio State Medical Association opposes the legislation because it’s against what it calls “content-specific continuing medical education requirements.” Tim Maglione, the OSMA’s senior director of governmental relations, said medical associations and health-care organizations already offer cultural training programs.
“We think that opportunities already exist to get this information and if it fits within their practice mix doctors will get it,” Maglione said.
But there is more than enough evidence (pdf) to show cultural competency helps patients, said Tawara D. Goode, director of the National Center for Cultural Competence at Georgetown University. She points out that some sectors of health care, such as American medical schools, are increasing cultural competency education.
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The center is hopes to take the lessons from states like New Jersey, California and Washington and work with other states and legislators to create passable bills, Goode said. A new study through the Robert Wood Johnson Foundation will be out soon analyzing legislative efforts to create cultural competency requirements. One example of a bill that’s been more palatable to physicians groups: receiving credit for cultural competency when such training is included within another continuing medical education course.
[Front-page photo courtesy of the National Center for Research Resources]
