May 13, 2021 – The American Medical Association has released a 3-year strategic plan to address long-standing health inequalities that harm marginalized communities and improve the AMA’s performance in these areas.
The 82-page report, produced by the association’s Center for Health Equity, advocates both internal changes at the AMA and changes in the way the association addresses racial inequalities in general.
The report was released just two months after WebMD reported that a podcast hosted by AMA’s Top Journal was classified as racist and non-contact. On the podcast titled “Structural Racism for Doctors – What is it?”, A JAMA editor argued that there is no such thing as structural racism. He eventually resigned and the magazine’s chief editor was put on administrative leave.
The strategic framework of the new AMA report is based on the immense need for justice-based solutions to address the damage caused by systemic racism and other forms of oppression for blacks, Latinx, indigenous people, Asians and other people of color, as well as for people who do so That causes you to identify yourself as LGBTQ + and people with disabilities, “the AMA said in a press release. “Its urgency is underscored by the ongoing circumstances, including the exacerbated inequalities from the COVID-19 pandemic, ongoing police brutality and hate crimes against Asian, black and brown communities.”
This @AmericanMedicalAssn Strategic Plan contains a plan to help move medicine toward racial justice and health justice. The work remains, but that’s great.
👏🏽 🙏🏽 to @DrAlethaMaybank, AMA colleagues & lawyers!
I’m honored to have helped with the #upstream elements. @ HealthBegins
– Rishi Manchanda, MD MPH (@RishiManchanda) May 12, 2021
The plan includes five main approaches to addressing inequalities in health care and AMA:
- Implement anti-racist equity strategies through AMA practices, programming, guidelines and culture.
- Build alliances with marginalized physicians and other stakeholders to enhance the experiences and ideas of historically marginalized leaders and minority health leaders.
- Strengthening, empowering and equipping doctors with the knowledge and instruments to reduce structural and social health inequalities.
- Guarantee fair innovation opportunities.
- Promote truth, racial healing, reconciliation, and transformation for the AMA’s past by considering how policies and processes exclude, discriminate, and harm communities.
As the report confirms, the AMA has a long history of exclusion and discrimination against black doctors, for which the association publicly apologized in 2008. Over the past year, the AMA reaffirmed its commitment to addressing this legacy and being proactive for health equity.
Among other things, the association has described racism as a public health crisis, stated that race has nothing to do with biology, that police brutality is a product of structural racism, and called on the federal government to collect and release COVID-19 race. Ethnicity data. Because of his contribution to explicit racist practices, the name of AMA founder Nathan Davis, MD, has also been removed from an annual award and exhibition.
Stock-based solutions
In 2019, the AMA started its center for health justice with the task of “embedding health justice in the entire company”. Aletha Maybank, MD, has been named AMA’s Chief Health Equity Officer to lead the center.
In the report Maybank co-wrote, the AMA discusses the consequences of individual and systemic injustice against minorities. These consequences, the report says, include “segregated and unequal health systems”.
The “equity-centric solutions” listed in the report include:
- End segregated healthcare.
- Establish national standards for health equity and racial justice.
- End the use of race-based clinical decision models.
- Eliminate all forms of discrimination, exclusion, and repression in the education, training, recruitment, and promotion of doctors and health professionals.
- Avoid exclusion and ensure equal representation of blacks, indigenous peoples and Latinos when entering medical schools, as well as in leadership positions in medical schools and hospitals
- Ensure equity in innovation, including design, development, implementation and support for equitable innovation opportunities and entrepreneurship.
- Strengthening the links and coordination between health care and public health.
- Detect and repair past damage done by institutions.
Change medical education
In an exclusive interview with WebMD, Dr. med. Gerald E. Harmon, President-elect of the AMA, highlighted medical education as an area ripe for change. “One of the most threatened phenotypes on the planet is the black male doctor,” he said. “The number of applicants for medical schools continues to decline. We have more and more women in medical schools – over 50% of students are women – and more black women are entering medical school, but black men in medical schools are facing extinction.
This @AmericanMedicalAssn Strategic Plan contains a plan to help move medicine toward racial justice and health justice. The work remains, but that’s great.
👏🏽 🙏🏽 to @DrAlethaMaybank, AMA colleagues & lawyers!
I’m honored to have helped with the #upstream elements. @ HealthBegins
– Rishi Manchanda, MD MPH (@RishiManchanda) May 12, 2021
“We’re trying to make the doctor’s staff look like the patient’s staff.”
Harmon cited Atlanta’s Morehouse School of Medicine “Pipeline Program” and the AMA’s AMA “Doctors Back to School” program as examples of efforts to attract minority students to careers in health care. Much more needs to be done, he added. “We need to bring equity and representation to our medical workforce so that we can provide better quality and more reliable care to underrepresented patients.”
Put the AMA’s house in order
In its report, the AMA also makes recommendations on how to improve equity within its own organization. In the next 3 years among other things tThe association plans to improve leadership diversity at AMA and its JAMA magazine. Training of all employees in relation to capital requirements; and develop a plan to recruit more racial and ethnic minorities, LGBTQ + people and people with disabilities.
Maybank, the AMA’s chief health equity officer, told WebMD that she would not label these efforts as positive action. “This goes beyond positive action. It is about deliberate activities and actions to ensure equity and justice within the AMA. “
The AMA needs to thoroughly examine its own processes and determine “how inequality shows up on a daily basis,” she said. “Whether through hiring, innovating, publishing or communicating, everyone needs to know how inequality manifests itself and how their own mental models can exacerbate inequalities. People need tools to challenge themselves and ask critical questions about racism in their processes and what they can do to mitigate it. “
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