June 1, 2021 – Howard Bauchner, MD, will step down as editor of JAMA, the journal of the American Medical Association – one of the most widely circulated medical journals in the world – after the fallout from a podcast and a February tweet about structural racism in medicine.
The announcement comes just days after a group of doctors wrote to AMA executives criticizing a racial equity and justice plan released by the AMA last month.
“I remain deeply disappointed with myself for the shortcomings that led to the publication of the tweet and podcast. While I did not write or even see the tweet, or create the podcast, as editor, I am ultimately responsible for it, ”Bauchner said in a statement. “I share and have always supported WADA’s commitment to dismantle structural racism in American medical institutions, as evidenced by numerous publications in JAMA on this and related topics, and we look forward to personally contributing to this work in the future. To advance equity in medicine, my contributions will be better accomplished in other areas. “
Bauchner had been on administrative leave for several weeks as the incident was investigated by an independent panel, WADA said.
The backlash began after 16 minutes JAMA podcast, released on February 23, which was billed 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 health care? An explanation of the idea of physicians for physicians in this user-friendly podcast, ” JAMA wrote in a now-deleted tweet promoting the episode.
The episode featured host Ed Livingston, MD, who was then associate editor of clinical journals and education at JAMA, and guest Mitchell Katz, MD, president and CEO of NYC Health + Hospitals, and associate editor of JAMA Internal Medicine. In the podcast, Livingston, who said he “doesn’t 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. of the term “racism” and focus on socio-economic status.
Critics of the podcast said it was harmful and deaf, and pointed to several discriminatory articles that had been posted in JAMA as recently as last summer.
Livingston resigned on May 10 from his post as associate editor of the newspaper.
After calls from several doctors of color to fight against the currents of racism that have lasted for decades within the AMA, the association published the outline of a plan to fight against racial injustice and inequalities health matter.
The aftermath reached new levels of contention last Friday, when a letter five doctors sent to WADA’s leadership hit Twitter. Carl G. Streed Jr., MD, a member of the Division of General Internal Medicine and Primary Care at Brigham and Women’s Hospital in Boston, tweeted the text of the letter, in which those who signed it called the censorship Livingston and Bauchner of “hasty, perhaps a stain on free speech and perhaps also an example of reverse discrimination.” “
Streed has since deleted the post.
The authors of the letter also criticized WADA’s strategic plan to combat racism, saying: “The language of the report uses terminology that is foreign to most of us. This use of unknown multisyllabic terms often leads to misinterpretations and certainly slows down the reading of the report. Rewriting parts of the document would improve comprehension, as would the teaching modules suggested above. Think about health literacy! “
The letter goes on to say, “White men are repeatedly characterized [in the AMA plan] as repressive and to some extent responsible for inequalities. It has impressed many as an aggressively broad generalization and involves reverse discrimination against white males. “
Only one person who signed the letter, Claudette Dalton, MD, responded to a request for comment, saying she was “instructed to refer you to media relations at WADA.”
WADA provided a statement that did not specifically address the letter or the allegations of “reverse discrimination” by its authors.
“The answer to this important plan runs the gamut – some say it goes too far, and others say not far enough,” said the statement by WADA President Gerald Harmon, MD. “But social inequalities and their consequences for families, healthcare and the future of our nation are far too great for WADA to be a passive bystander as our mission is to improve the health of the nation. The existence of racism in medicine and in society, both historically and today, is not in dispute. The only question is how we, as physicians, will lead to deal with its health implications. “
Raymond Givens, MD, one of the many black doctors who met with AMA several weeks ago, called the letter “word salad” and said it illustrates the depth of the problem.
“They’re doctors, I’m sure they’re pretty brilliant people,” said Givens, assistant professor of medicine at Columbia University Medical Center in New York City. “But something happens very often – this ability to really reason and to think in complicated ways seems to completely break down when we talk about issues like these.”
Givens called for more doctors of color to take part in the debate, especially from the National Medical Association, which advocates for doctors and patients of African descent. However, they did not respond to his outreach and did not resend emails from WebMD.
But there was a point of agreement between those who signed the letter and Givens.
“Yes, I don’t agree with much of what I’ve read, but would love to have the opportunity to speak to these people if there was an opportunity to go beyond sound clips and prepackaged ideas, ”he says. “They talked about wanting to debate and discuss it in the [AMA] House of Delegates. Sounds like a good idea. “
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