May 13, 2021 – The American Medical Association has published a three-year period strategic plan to combat long-standing health inequalities that harm marginalized communities and improve WADA’s own performance in this regard.
The 82-page report, created by the association’s Center for Health Equity, advocates both internal changes in the WADA and changes in the way the association addresses inequalities based on race in general.
The report was published just 2 months ago after WebMD reported that a podcast organized by the main AMA newspaper was criticized as racist and out of touch. In the podcast, entitled “Structural Racism for Doctors: What Is It?”, One JAMA the editor argued that structural racism does not exist. Eventually, he resigned and the magazine’s top editor was put on administrative leave.
The strategic framework of the new AMA report “is driven by the immense need for equity-focused solutions to address the harms caused by systemic racism and other forms of oppression for people of black, Latin, indigenous, Asian and others, as well as for people who identify as LGBTQ + and people with disabilities, ”the WADA said in a press release. “Its urgency is underlined by the current circumstances, including the inequalities aggravated by COVID-19 pandemic, ongoing police brutality and hate crimes against Asian, black and brown communities. “
The plan includes five main approaches to addressing inequalities in health care and WADA:
- Implement anti-racist equity strategies through AMA practices, programming, policies and culture.
- Build alliances with marginalized physicians and other stakeholders to elevate the experiences and ideas of historically marginalized and minorities health care leaders.
- Strengthen, empower and equip doctors with the knowledge and tools to dismantle structural and social inequalities in health.
- Ensure equitable opportunities in innovation.
- Foster the truth, racial healing, reconciliation, and transformation of AMA’s past, keeping in mind how policies and processes excluded, discriminated against, and harmed communities.
As the report acknowledges, the WADA has a long history of exclusion and discrimination against black physicians, so the association publicly apologized in 2008. Over the past year, the WADA has reaffirmed its commitment to addressing this legacy and to being proactive in health equity.
Among other things, the association has described racism as a public health crisis, said race has nothing to do with biology, said police brutality is a product of structural racism, and called on the federal government to collect and release the COVID-19 race / ethnicity data. He also removed the name of WADA founder Nathan Davis, MD, from an annual award and exhibition because of his contribution to explicit racist practices.
WADA launched its Center for Health Equity in 2019 with the mandate to “incorporate health equity throughout the organization”. Aletha Maybank, MD, was appointed WADA’s director of health equity to lead the center.
In the report Maybank helped write, the WADA discusses the consequences of individual and systemic injustice toward minorities. Among those consequences, according to the report, are “segregated and inequitable health systems.”
The “equity-focused solutions” in the report include:
- End segregated health care.
- Establish national standards of health equity and racial justice.
- End the use of race-based clinical decision models.
- Eliminate all forms of discrimination, exclusion and oppression in the education, training, recruitment and promotion of doctors.
- Prevent exclusion and ensure equitable representation of blacks, Indians and Latinos in admissions to medical schools, as well as in the leadership ranks of medical and hospital faculties
- Ensure equity in innovation, including design, development, implementation and support for equitable innovation and entrepreneurship opportunities.
- Solidify the connections and coordination between health care and public health.
- Recognize and repair past damage done by institutions.
Change in medical education
In an exclusive interview with WebMD, Gerald E. Harmon, MD, president-elect of the AMA, highlighted medical education as an area of change. “One of the most endangered phenotypes on the planet is the black doctor,” he said. “The number of applicants for medical schools continues to fall. We have a growing number of women in medical schools (more than 50% of students are women) and there are more black women entering medical school, but black men in medical school are a species in endangered.
“We’re trying to make the staff of doctors look like the patient’s workforce.”
Harmon cited the “pipeline program” at Atlanta’s Morehouse School of Medicine and the WADA’s “back-to-school doctors” program as examples of efforts to attract minority high school students to careers. of health. Much more needs to be added, he added. “We need to put equity and representation in our medical staff so that we can provide more reliable and quality care and more quality to underrepresented patients.”
Put the house of the AMA in order
In its report, the WADA also makes recommendations on how it can improve equity within its own organization. For the next 3 years, among other things, tthe association plans to improve the diversity of leadership of the AMA and its magazine, JAMA; train all staff on equity requirements; and develop a plan to recruit more racial and ethnic minorities, LGBTQ + people and people with disabilities.
Maybank, the head of WADA’s health equity, told WebMD that he would not describe these efforts as affirmative action. “It simply came to our notice then. These are activities and actions intended to guarantee equity and justice in the AMA ”.
The WADA must thoroughly examine its own processes and determine “how inequality appears on a day-to-day basis,” he said. “Whether it’s hiring, innovation, publications or communications, everyone needs to know how inequality is shown and how their own mental models can exacerbate inequalities. People need tools to challenge themselves and ask themselves critical questions about racism in their processes and what they can do to mitigate them. “