May 13, 2021 – The American Medical Association released a three-year strategic plan to address long-standing health inequalities that hurt marginalized communities and to improve WADA’s performance in this regard.
The 82-page report, which was created by the association’s Center for Health Equity, advocates both for internal changes at WADA and for changes in the way the association approaches racial inequalities in general. .
The report was released just two months after WebMD reported that a podcast hosted by AMA’s main newspaper was criticized as racist and out of touch. In the podcast, titled “Structural Racism Among Doctors – What Is It?”, A JAMA The publisher argued that structural racism does not exist. He eventually resigned and the journal’s senior editor was put on administrative leave.
The AMA Report’s new strategic framework “is driven by the overwhelming need for equity-focused solutions to address the harms produced by systemic racism and other forms of oppression for Blacks, Latinx, Indigenous, Asians and other people of color, as well as people who identify as LGBTQ + and people with disabilities, ”WADA said in a press release. “Its urgency is underscored by the current circumstances, including inequalities exacerbated by the COVID-19 pandemic, ongoing police brutality and hate crimes targeting Asian, black and brown communities.”
The plan includes five main approaches to tackle inequalities in healthcare and AMA:
- Implement anti-racist equity strategies through WADA practices, programming, policies and culture.
- Build alliances with marginalized physicians and other stakeholders to enhance the experiences and ideas of historically marginalized and minority health leaders.
- Strengthen, empower and equip physicians with the knowledge and tools necessary to eliminate structural and social inequalities in health.
- Ensure fair opportunities for innovation.
- Promote truth, racial healing, reconciliation and transformation of WADA’s past by considering how policies and processes have excluded, discriminated against and harmed communities.
As the report acknowledges, WADA has a long history of exclusion and discrimination against black doctors, for which the association publicly apologized in 2008. Over the past year, WADA has reaffirmed its commitment to fight against this heritage and to be proactive in health matters. equity.
Among other things, the association described racism as a public health crisis, said race has nothing to do with biology, said police brutality is the product of structural racism, and called the federal government to collect and release COVID-19 race / ethnicity data. He also removed the name of AMA 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 a mandate to “mainstream health equity throughout the organization”. Aletha Maybank, MD, has been appointed WADA’s Health Equity Officer to lead the center.
In the report Maybank helped write, WADA discusses the consequences of individual and systemic injustice against minorities. Among these consequences, the report says, are “segregated and inequitable health systems”.
The “equity-focused solutions” listed in the report include:
- End the segregation of health care.
- Establish national standards for equity in health care and racial justice.
- End the use of race-based clinical decision models.
- Eliminate all forms of discrimination, exclusion and oppression in the education, training, hiring and promotion of physicians and physicians.
- Prevent exclusion and ensure equal representation of Blacks, Indigenous people and Latinos in admissions to medical schools, medical schools and hospitals
- Ensure equity in innovation, including design, development, implementation, as well as support for equitable innovation opportunities and entrepreneurship.
- Strengthen the links and coordination between health care and public health.
- Recognize and repair past wrongs committed by institutions.
Changing medical education
In an exclusive interview with WebMD, Gerald E. Harmon, MD, President-elect of AMA, chose medical education as an area ripe for change. “One of the most endangered phenotypes on the planet is the black male doctor,” he said. “Their number of applicants for medical schools continues to decline. We have a growing number of women in medical schools – over 50% of trainees are women – and more and more black women are entering medical school, but black men in medical schools are one endangered species.
“We are trying to make the physician workforce look like the patient workforce.”
Harmon cited the “pipeline program” at Morehouse School of Medicine in Atlanta and AMA’s “back to school doctors” program as examples of efforts to attract minority high school students to higher education. careers in the health field. There is still a lot to do, he added. “We need to put fairness and representation within our medical staff so that we can provide better and more reliable care to under-represented patients.”
Putting order in the house of AMA
In its report, WADA also made recommendations on how it could improve equity within its own organization. Over the next 3 years, among others, tThe association plans to improve the diversity of leaders of WADA and its journal, JAMA; train all staff in fairness requirements; and develop a plan to recruit more racial and ethnic minorities, LGBTQ + people and people with disabilities.
Maybank, WADA’s head of health equity, told WebMD she would not describe the efforts as affirmative action. “It’s beyond affirmative action. These are intentional activities and actions to ensure fairness and justice within WADA. “
WADA must take a deep look at its own processes and determine “how inequity manifests itself on a day-to-day basis,” she said. “Whether it’s through hiring, innovation, publishing or communications, everyone needs to know how inequalities manifest and how their own mental models can exacerbate inequalities. People need tools to challenge themselves and critically question racism in their processes and what they can do about it. “
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