June 1, 2021 – Howard Bauchner, MD, to step down as editor-in-chief of JAMA, the magazine of the American Medical Association – one of the most widely distributed medical journals in the world – following the aftermath of a February podcast and tweet about structural racism in medicine.
The announcement comes just days after a group of doctors wrote the AMA leadership criticizing a racial justice and justice plan that the AMA released last month.
“I am still deeply disappointed in myself at the failures that led to the publication of the tweet and podcast. Although I neither wrote nor saw the tweet or created the podcast, I am ultimately responsible as editor-in-chief, “said Bauchner in a statement. “I always share and support the AMA’s commitment to dismantling structural racism in American medical institutions, as evidenced by numerous JAMA publications on this and related topics, and I look forward to personally contributing to this work in the future. In order to promote justice in medicine, my contributions are best made in other places. “
FYI’s Florida and Louisiana Delegations are members of the Southeast Delegation, also known as authors of the resolution & letter currently in circulation, which underscores why a strategic equity plan is necessary in the first place.
PC: @cjstreed
5 / pic.twitter.com/5qRUUE6UQ9
– Luis Seija, md (@leseija) May 29, 2021
Bauchner was on administrative leave for several weeks while the incident was being investigated by an independent body, the AMA said.
The backlash began after a 16-minute JAMA podcast released on February 23, which was viewed as an attempt to discuss structural racism in the U.S. healthcare system.
“No doctor is racist, so how can there be structural racism in healthcare? An explanation of the idea from doctors for doctors in this easy-to-use podcast, ”JAMA wrote in a now-deleted tweet to promote the episode.
Subsequently, moderator Ed Livingston, MD, who was then associate editor for clinical evaluations and education at JAMA, and guest Mitchell Katz, MD, president and CEO of NYC Health + Hospitals and associate editor of JAMA Internal Medicine. On the podcast, Livingston, who said he “does not understand the concept” of structural racism, suggested that racism was made illegal in the 1960s and that the discussion of “structural racism” should move away from the term “racism” and focus held on socio-economic status.
Critics of the podcast described it as harmful and deaf and pointed to several discriminatory articles published in JAMA just last summer.
Livingston resigned as associate editor of the magazine on May 10.
After calling on several doctors of color to address the decades-long undercurrent of racism within the AMA, the association released outlines of a plan to combat racial and health injustice.
The aftermath reached new disputes last Friday when a letter from five doctors to the AMA leadership landed on Twitter. Carl G. Streed Jr., MD, a fellow in the Department of General Internal Medicine and Primary Care at Brigham and Women’s Hospital in Boston, tweeted the text of the letter in which the signatories may have described Livingston and Bauchner’s censorship as “steep.” an eyesore on freedom of expression and possibly an example of reverse discrimination too. “
Streed has since deleted the post.
The letter’s authors also criticized the AMA’s strategic plan to combat racism: “The language in the report uses terminology that is alien to most of us. This use of unknown polysyllabic terms often leads to misinterpretation and certainly slows down the reading of the report. Rewriting parts of the document would improve understanding, as would the educational modules suggested above. Think of health literacy! “
The letter goes on to say: “White males are characterized over and over again [in the AMA plan] as repressive and to some extent responsible for the injustices. This impressed many as an aggressively broad generalization and implies reverse discrimination against white men. “
Only one person who signed the letter, Claudette Dalton, MD, responded to a request for comment, saying that they had “been instructed to refer you to the AMA media work”.
The AMA issued a statement addressing neither the letter nor the “reverse discrimination” allegations by its authors.
We can’t even say racism in medicine.
We cannot recognize racism in our major medical journals.
When (thanks to Dr. Maybank) we make strategic plans to really get the top-level work done with the AMA, we get these bizarre arguments as to why no progress should be made.
– Stella Safo, MD MPH (@AmmahStarr) May 28, 2021
“The response to this important plan is diverse – some say it is going too far and others say not far enough,” said the statement by AMA President Gerald Harmon, MD. “But the social inequalities and their consequences for families, health care and the future of our country are far too great for AMA to be a passive spectator when our mission is to improve the health of the country. The existence of racism in medicine and society, both historically and today, is undisputed. The only question is how will we as doctors lead in addressing the health implications. “
Raymond Givens, MD, one of several black doctors who met with the AMA a few weeks ago, called the letter “word salad” and said it illustrated the depth of the problem.
“They’re doctors, I’m sure they’re pretty smart people,” said Givens, assistant professor of medicine at Columbia University Medical Center in New York City. “But something happens very often – that ability to really argue and think in complicated ways seems to break down completely when we talk about such subjects.”
Givens called for more doctors with color to join the debate, particularly from the National Medical Association, which advocates for doctors and patients of African descent. However, they have not responded to his contact and have not returned any emails from WebMD.
But there was a point on which the signatories of the letter and Givens agreed.
“Yes, I disagree with a lot of what I read, but I would appreciate an opportunity to speak to these people if there was the opportunity to go beyond sound bits and pre-made ideas,” he says. “They talked about wanting to debate and discuss in the [AMA] House of the Delegates. That sounds like a good idea. “
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American Medical Association: “AMA Announces JAMA Editorial Board Transition.”
Claudette Dalton, MD, Harrisonburg, VA.
Raymond Givens, Assistant Professor of Medicine, Columbia University Medical Center, New York City.
Twitter: @cjstreed, May 28, 2021 (deleted).
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