|AMA should do more than just apologize|
|Written by Ardena L. Flippin, MD, MBA|
The AMA effectively barred African-American physicians from its membership until 1964, and news was made this month when the AMA issued an apology for its part in allowing professional segregation. When I graduated from medical school in 1978 (fourteen years after African-American physicians were “blessed” by the AMA), my African-American family physician gave me the gift of a paid membership to the National Medical Association. The National Medical Association is the professional organization of African-American physicians. If fourteen years wasn’t time enough to heal the hard feelings of intentional exclusion, will an apology forty-four years later be any more conciliatory?
The AMA apology expressed historical responsibility for African-American physicians’ hard feelings and, ultimately, for some measure of health disparities and I agree. The Sullivan Commission Report noted “schools of medicine, dentistry and nursing “have been among the last to integrate their classrooms…” (1) African-American physician and medical students represent a depressing 2.2% of the U.S. physicians.
In fact, I think that it’s impossible to determine the irreparable harm that was done if one considers that other organizations (dental and pharmacy) may very well have used the AMA-example to exclude African-Americans from their respective professional organizations. Fortunately the professional nurses’ organization was more progressive, as the National Association of Colored Graduate Nurses [NACGN] was dissolved in 1951, when its members voted to merge with the American Nurses Association. (2)
Ronald M. Davis, AMA President, wrote a commentary to the JAMA article, “African American Physicians and Organized Medicine, 1846-1968. Origins of a Racial Divide (JAMA, July 16, 2008). (3) In his commentary, Dr. Davis lists statements, policies and reports that the AMA will generate to track progress or the lack of progress in certain demographics. (4)
Well, that’s not enough.
In speaking to my African-American physician colleagues, their sense is that members of the AMA have received the various benefits of generations of membership in the organization while African-American physicians have paid the penalty for being excluded and this translates to differences in care to their patients. Maybe this could be the first example of an approach the issue of reparations. I don’t advocate giving individuals monetary contributions, and yet contributions could be made to the two remaining (predominantly) African-American medical schools Howard University and Meharry as a start.
I am aware that the AMA Institute for Ethics didn’t have to “invite(ed) a panel of experts to review and analyze the historical roots of the black-white divide in US medicine.” (5) My feeling is that while the AMA is being politically correct, they are not being accountable in any substantial sense.
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