By Holly Watt
Washington Post Staff Writer
Thursday, July 10, 2008 2:04 PM
The country's largest medical association today issued a formal apology today for its historical antipathy toward African American doctors, expressing regret for a litany of transgressions, including barring black physicians from its ranks for decades and remaining silent during battles on landmark legislation to end racial discrimination.
The apology marks one of the rare times a major national organization has expressed contrition for its role in the segregation and discrimination that black people have experienced in the United States.
The American Medical Association (AMA) issued the apology after assembling a panel of experts to analyze the history of the racial divide in medicine. The independent panel has produced a report, due to be published in the July 16 Journal of the American Medical Association, which explores the historical discrimination.
"The apology is important because a heritage of discrimination is evident in the under-representation of African Americans in medicine generally and in the AMA in particular," said the report's lead author, Robert B. Baker, professor of philosophy at Union College in Schenectady, N.Y., and director of the Union Graduate College-Mount Sinai School of Medicine Bioethics Program.
"Patterns of segregated medicine still haunt American health care. The legacy of these decisions affects minority patients on a daily basis," Baker said.
Ronald M. Davis, the immediate past president of the AMA, said his organization was proud to support the research into the history of the racial divide.
"By confronting the past we can embrace the future," he said in a statement posted today on the AMA Web site. "The AMA is committed to improving its relationship with minority physicians and to increasing the ranks of minority physicians so that the workforce accurately represents the diversity of America's patients."
The panel noted that the AMA permitted state and local medical associations to exclude black physicians, effectively barring these doctors from the national organization. In the early 20th century, the organization listed black doctors as "colored" in its national physician directory. In addition, the AMA was silent during debates over the landmark Civil Rights Act of 1964, and, for years, declined to join efforts to force hospitals built with federal funds to not discriminate.
In a commentary on the panel's report, Davis said many of the organization's questionable actions reflected the "social mores and racial discrimination" that existed for much of the country's history. But, he wrote, that should not excuse them.
"The medical profession, which is based on a boundless respect for human life, had an obligation to lead society away from disrespect of so many lives," Davis wrote. "The AMA failed to do so and has apologized for that failure."
"Our goal is to identify and study racial and ethnic health care disparities in order to eradicate them," Davis said.
Richard Allen Williams, a clinical professor of medicine at the University of California at Los Angeles and the president of the Minority Health Institute, said the apology is "an excellent gesture of goodwill."
"I applaud the AMA for doing this. In the current climate of health care, it is a very timely gesture," he said. "Less than five percent of physicians are African Americans, and that needs to be changed. This cannot be changed by African American physicians alone, and we all need to move forward together."
Otis W. Brawley, chief medical officer of the American Cancer Society, welcomed the apology. He is a member of the National Medical Association, a predominantly black group that was established in 1895 in response to the AMA policy that allowed the exclusion of black doctors.
"Any sort of acknowledgment that blacks were excluded is a positive step," Brawley said. "But I'm much more interested in the future than in the past. I would like to see a focus on getting quality care for all people."
The AMA was founded in 1847 by Nathan S. Davis, a doctor from New York. Today, it has almost 250,000 members and supports education and research programs, but in recent years has been losing membership.
Today's apology is the latest expression of regret by government entities and businesses in recent years.
In the past, states including Alabama, Maryland, North Carolina, New Jersey, Virginia and Florida and businesses such as Wachovia have expressed regret for their role in slavery. Last year, the governing board of the University of Virginia became the first to pass a resolution over the "regret for its use of enslaved persons from 1819 to 1865."
In 2005, the Republican Party said it was sorry for its racially tinged "southern strategy," which it adopted during Richard M. Nixon's 1968 campaign.
President Bill Clinton in 1997 expressed regret for the experiment in which U.S. government researchers used black men to study syphilis in Tuskegee, Ala., starting in 1932. Instead of treating almost 400 men who had been infected by syphilis, the researchers gave the men placebos and then observed the progression of the disease. The study continued until 1972 and ended when its existence was leaked to the media. Clinton called the study "deeply, profoundly, morally wrong."
The apologies issued by institutions are often carefully worded to ensure that they do not become liable for financial reparations.
According to the AMA's online chronology, the association has also been slow to respond to the issue of discrimination against black doctors.
In 1939, the organization stated that it "emphatically deprecated discrimination." At the same time, the AMA recognized county societies' "right of self-governance in local matters, including membership."
In 1954, the AMA refused to allow the Old North State Medical Society, which represented black physicians in North Carolina, to be admitted to the association, just as the North Carolina Medical Society had refused to lift its racial barriers.
Today, the philanthropic arm of the AMA provides scholarships to support minority medical students and has created the Minority Affairs Consortium to promote the training of minority doctors. Eleven students were awarded funding through the AMA Foundation Minority Scholars Award this year.
The AMA helped develop the Doctors Back to School program, which is designed to encourage students to train for careers in medicine.