Recently, the American Medical Association (AMA) apologized for supporting racist policies in the past that barred black physicians from joining the organization and for allowing segregation to flourish in the medical field.

The apology was prompted after the AMA convened a committee of experts to examine health care disparities between blacks and whites in the United States. The committee found that the AMA’s actions were “linked to the current paucity of African-American physicians, distrust of professional associations by some physicians, and contemporary racial health disparities.”

Given the findings and the AMA’s efforts to improve its image, the country’s largest organization of physicians had no recourse but to apologize. But, as some critics charge, the AMA’s actions caused irreparable damage.

“There’s a gross disparity there from the standpoint that African Americans don’t have enough doctors to take care of their medical needs,” says Richard Williams, a clinical professor of medicine at UCLA and president of the Minority Health Institute. “As a consequence, patients suffer because they don’t have enough doctors in their communities.”

The racial divide in medicine is radical. Less than 2 percent of AMA members are black, and less than 3 percent of America’s 1 million doctors and medical students are black. The numbers are compounded by un-quantifiable social aftershocks, such as the noted distrust African Americans have of doctors and medical institutions.

The problems have roots in the very foundation of the United States. In the wake of the Civil War, the nation was absorbing freed African Americans, but inequalities remained firmly fixed in place. The AMA faced battles on the status of blacks that played out on a national stage and was documented by both the mainstream and African-American press. The organization chose to pass on the integration issue, allowing its local AMA chapters to exclude black physicians as members.

In opting to support only professional unity, the AMA upheld the segregation status quo, says Robert Baker, the report’s lead author, and a professor of philosophy at Union College in Schenectady, New York.
As a result, African-American physicians were left with no options. They formed their own professional society that “didn’t have [the] clout or national recognition that the AMA had,” Baker says. “The pattern of segregation that the AMA recognized became implanted in medicine throughout the South and had deleterious effects on African-American health.”

The tacit support of segregation was made worse in the early 20th century. The national AMA created a directory of every physician in the United States. Next to the names of African-American physicians was a tiny “col” to alert potential patients certain doctors were “colored.”

“It was like the yellow star in Nazi Germany,” Baker says. “By singling them out, it made it harder for African-American physicians to get insurance and to have access to opportunities. By informing white patients of this, it triggered racial stereotypes and racial prejudice in the minds of potential white patients.”

In an effort to turn the AMA’s apology into action, Williams has proposed nationwide symposia to educate medical professionals and students about “cultural competency and the need for diversity and the elimination of health care disparities.” 

Continues Williams, “In most categories of disease, African Americans in particular have more [health] problems, from the standpoint of greater incidence, prevalence, as well as mortality, yet the greatest effort is not being made in the areas of greatest need.”

Currently, the AMA and the National Medical Association, traditionally an African-American medical society, are working together to address HIV disparities in the African-American community, to recruit more African Americans into health care and to make the effort to take “the apology and make it into a concrete agenda in which the two societies can work together to better serve African-American patients,” Baker says.

As part of their commitment to remedy the situation, the AMA’s philanthropic arm provides scholarships to support minority medical students. It also established the Doctors Back to School program to encourage minority students to train for careers in medicine.