Apology offers salve for racial wound
Medical group apologizes for old policies of discrimination against black physicians

Elmeisha Sturdivant
Albany High School junior
Elmeisha Sturdivant, 16, says
she would be more comfortable
dealing with a black doctor.
(Paul Buckowski / Times Union)
Robert Baker

Union College professor Robert
B. Baker is co-author of a
recent study on racial
discrimination in the medical
(Michael P. Farrell / Times Union)
Sabrin Apermaul
Sabrina Permaul, left, with her
children Nyaira, 4, and Nianna,
7, talks Thursday, July 10,
about the AMA's apology for
more than a century of
discrimination against black
(Paul Buckowski / Times Union)

By Paul Grondahl

Albany, NY

July 11, 2008

ALBANY -- Sabrina Permaul, who is African-American, has never been treated by a black physician and neither has any of her four children.

That's the sad reality in a health care system in which just 3.5 percent of the nation's 921,904 physicians are black.

Such is the legacy of the past practice of racism and discrimination by the American Medical Association, the nation's oldest and largest medical group.

On Thursday, the AMA issued a historic apology for its long-held practices and policies that included barring black physicians from membership, thus tacitly contributing to what amounted to medical apartheid in America.

In a statement on its Web site, the AMA apologized "for its past history of racial inequality toward African-American physicians, and shares its current efforts to increase the ranks of minority physicians and their participation in the AMA."

"It's wrong and I'm glad they apologized," said Permaul, a single mother who had just left the Whitney M. Young Health Services office in Arbor Hill to catch a bus with her four children, ages 1, 2, 4 and 7.

Permaul, who is 26, said she hoped the AMA's apology would begin to reverse the discomfort she has felt since she was a child and went to the doctor's office or hospital and saw black faces only among the janitorial crew or secretarial pool.

"This is a wonderful thing the AMA has done with its apology," said Robert Baker, a bioethics expert and philosophy professor at Union College in Schenectady. He is the lead author of a groundbreaking study of the AMA's racial policies that will be published Wednesday in the Journal of the American Medical Association.

The study covers the years 1846 to 1968 and prompted the extraordinary apology from the AMA's immediate past president, Ronald Davis: "The medical profession, which is based on a boundless respect for human life, had an obligation to lead society away from disrespect of so many lives. The AMA failed to do so and has apologized for that failure."

Added Baker, "We hope this helps alleviate the distrust African-Americans have toward the medical profession."

Baker would not speculate on the timing of Thursday's apology by the AMA, which is a politically powerful organization headquartered in Chicago, and the fact that Illinois Sen. Barack Obama is the presumptive Democratic presidential nominee and leads in some election polls.

Baker and an independent group of researchers assembled in 2005 by the AMA were given access to the AMA's archives and told to find and report the truth. They documented "a pattern of exclusion of African-Americans" for nearly a century, until 1968.

For instance, physician directories in the early 1900s carried the designation "COL," for colored, next to the names of the few black doctors.

The country's black physicians, excluded from the lily-white AMA, formed their own organization, the National Medical Association -- the equivalent of the Negro Leagues in baseball.

While Jim Crow laws dominated the South, doctors in liberal northern states like New York and Massachusetts struggled to open doors for their black colleagues. "The Medical Society of the State of New York was a leader in trying to break down the barriers for African-American physicians," Baker said. But it had limited success because white doctors in the post-Civil War Deep South continued to argue that blacks were an inferior race.

The upshot in 2008 is that health care in America is still marked by a racial divide. Health care services for blacks are less accessible and of lower quality compared to what whites get, Baker said.

One holdover of the AMA's institutional racism is that blacks, who tend to distrust the medical establishment, are far less likely to fill out organ donor cards, Baker said.

On Thursday, Permaul praised the quality of care she and her kids received at Whitney Young, where there are two black doctors -- one of whom was hired last week -- among about 30 physicians on a staff that serves 18,000 patients, a large majority of whom are black.

"The AMA's apology is a courageous step that's long overdue," said Dr. Kallanna Manjunath, a pediatrician and chief medical officer at Whitney Young. He noted a critical shortage of primary care physicians across the U.S. and said he hopes the AMA's gesture encourages young blacks and Latinos to study medicine.

Manjunath said the small pool of black physicians means that recruiting and retaining black doctors in Albany is a challenge. He recently lost two black doctors to higher-paying jobs.

On Thursday afternoon, a group of black teenage girls who are counselors for an inner-city youth summer program weighed in on the AMA's apology while their campers played tennis at an Arbor Hill court. None of the girls had ever been treated by a black doctor.

"It's absurd they'd keep people out because of the color of their skin," said Shana Rogers, an Albany High School senior who hopes to become a registered nurse like her aunt.

"I'd be more comfortable with an African-American doctor," said Elmeisha Sturdivant, 16, a junior at the high school.

In the 1980s, black and Hispanic students made up about 5 percent of the enrollment at Albany Medical College, but current figures were not available.

Alice Green, executive director of the Center for Law and Justice in Albany, said whites can't fully appreciate how much blacks fear and distrust the predominantly white medical profession.

"I'm just delighted to hear the AMA is making this apology because apologies are important and this is an issue that runs deep," Green said.

"This is a good beginning," she said. "But I want to know what the AMA plans to do beyond its apology."

Paul Grondahl can be reached at 454-5623 or by e-mail at pgrondahl@timesunion.com.


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