Making medicine more diverse

For a century, the American Medical Association failed to live up to the ideals of medicine in its treatment of African-American physicians. In the first decades of the 20th century, the Association identified black doctors as "colored" in its national directory. Through the late 1960s, it did not act against state and local medical associations that excluded black doctors from their ranks, which in effect barred them from the AMA.

This blemish on the Association's history cannot be erased, but it can serve as a tool for this generation and others. AMA Immediate Past President Ron Davis, MD, perhaps summed it up best when he said "By confronting the past, we can embrace the future."

Today's AMA is making a concerted effort to do both. In July, the Association publicly apologized for its history of racial inequality against black physicians. The apology was spurred by the results of three years of work by an AMA-convened independent panel that examined the racial divide in organized medicine. Its findings were published in the July 16 Journal of the American Medical Association, along with a commentary from Dr. Davis.

The statement is part of an ongoing effort by the Association. In recent years, the AMA has created several programs to boost diversity in medicine, build stronger relationships with minority organizations and end racial disparity in health care delivery.

For example, in 2002, the AMA created a program to help doctors implement strategies to eliminate ethnic and racial disparities across the health care system. The initiative helps physicians form collaborations with national specialty organizations, state medical societies and other groups to address this issue.

Also in 2002, the AMA launched the Doctors Back to School program to raise awareness about the need for minority doctors and to get minority students interested in medicine. Statistics show the need for such a program. Blacks, Hispanics and American Indians make up about 25% of the nation's population but only 7% of doctors.

In Doctors Back to School, physicians and medical students share their personal stories and talk to students about careers in medicine, helping them realize they can become doctors, too. So far, more than 100 schools have been visited, reaching about 13,000 students nationwide. In May, seven physicians and medical students visited about 270 schoolchildren at the Ted Lenart Regional Gifted Center in Chicago, hoping to spark children's curiosity by letting them wear surgical outfits and listen to heartbeats with stethoscopes.

In 2004, the AMA, National Medical Assn. and National Hispanic Medical Assn. teamed up to establish the Commission to End Health Care Disparities, which consists of more than 50 state medical associations and other groups. As Dr. Davis put it, the coalition's goal "is to identify and study racial and ethnic health care disparities in order to eradicate them." Among its efforts is studying the implications of pay-for-performance and quality-reporting programs for health care disparities.

Meanwhile, the AMA-created Minority Affairs Consortium is a voice for minority doctors in the Association. In collaboration with the consortium, the AMA Foundation each year provides $10,000 scholarships to student winners of the foundation's Minority Scholars Award. A dozen students received the award this year.

The National Medical Assn., which represents the nation's black physicians, has accepted the AMA's apology, and its leaders said the moment should be used to generate more change. NMA President Nelson L. Adams, MD, has called on the AMA to work with his organization to recruit more black students into the profession, help reduce health disparities among minorities and make cultural competency training mandatory.

With its apology, the AMA has taken a big step toward improving relations. It's a healing that can bring the AMA and other physician organizations closer together in their joint efforts to increase the ranks of minority physicians and reduce the disparities that still exist in our health care system.