Kate Scannell: The AMA's apology to African American physicians
By Kate Scannell
Contra Coastal Times News
July 19, 2008
THIS WEEK, THE NATION'S largest organization of physicians — the American Medical Association, or AMA, — formally apologized for its history of racial transgressions against African-American physicians.
In its related publication in the July 16 issue of the Journal of the American Medical Association (JAMA), the AMA acknowledged its discrimination against black physicians well into the era of the Civil Rights movement in the 1960s. The association hopes that by "confronting the past we can embrace the future."
The association's transgressions against African-American doctors were severe. For example, the AMA had allowed its state and local subsidiaries to exclude black physicians from membership, effectively banning them from its politically powerful national group. As recently as 1954, it refused membership to a local medical society made up of black physicians in North Carolina.
In response to their exclusion from the AMA, black physicians formed a separate national medical society in 1895 — the National Medical Association, or NMA — which continues to exist with predominantly black membership.
It wasn't until 1939 that AMA discontinued its policy of listing African-American physicians as "colored" in its national physician directory. That same year, it adopted a policy discouraging racial discrimination in its subsidiary medical societies but, still, permitted that practice
to continue. When in 1944 the NMA asked to be allowed into the AMA as an "associate member" — a step-down from equal membership — the AMA refused. This followed on the heels of the NMA having to petition the Army and Navy during World War II to introduce African-American physicians to the U.S. armed forces.
Most of the reactions I've seen in the media acknowledge the AMA's apology as a long-overdue, welcomed and an appropriate gesture of "good will." Even the NMA "accepted the apology of the AMA for acknowledging its history of racial inequality that kept its doors closed to African-American physicians for more than a century."
But some media responses are not so conciliatory. A friend of mine who wishes to remain anonymous, said that the apology was "too little, too late" for him and the "thousands of my black patients who could have gotten better care if the AMA hadn't interfered and insisted on segregated and inferior care."
He was referring to the direct effects of the AMA's policies on the health and welfare of African-American patients and their families. Because the AMA was such a powerful influence in shaping national health policy, its refusal to force its subsidiary societies to include black physicians translated into less health care advocacy for African-American patients on the big stages of politics and media.
Indeed, the AMA declined to speak out against racial discrimination while the country and legislature debated the landmark Civil Rights Act of 1964. It refused to speak out against congressional considerations that allowed the construction of segregated hospitals that were built with federal funds. Consequently, separate black hospitals that admitted black patients had to be built.
Clearly, the racial discrimination infused by AMA politics threads through history and connects solidly with the current day. The NMA remains a separate medical association. In 2006, African-Americans made up 12.3 percent of the U.S. population, and only 2.2 percent of physicians and medical students — the same percentage as in 1910. No one can argue the fact that African-Americans suffer greater health care disparities than whites.
The AMA's apology will need to be tied to actions that visibly correct some of its transgressions if it is to gain credible traction in public sentiment and within the broader medical community. It will also have to acknowledge its historical discrimination against other groups of physicians, like women, if it hopes to present itself as a united association of doctors that believes that invidious discrimination against all classes of people is wrong.
What remains a little troubling, however, is that in articulating the role of the AMA in transgressions against black doctors and patients, the authors of the JAMA article reflect that "the history of race in the medical profession is rarely acknowledged..."
That's another way of claiming that "the" medical profession is the AMA. Because "the" segregated NMA and "the" separate National Women's Medical Association, and "the" doctors who declined membership in the AMA because of its divisive politics very much acknowledge the history of the association's discriminatory practices.
The AMA has been losing membership in recent years, and it continues to represent only about a third of all physicians in this country. Let's hope that this week's apology to African-American doctors and patients leads to further discussions at a wider table that embraces respect for all life, reaffirming an ideal that ought to thoroughly permeate the entirety of the medical profession.
Kate Scannell is an East Bay physician and syndicated columnist.