AMA Apologizes for Institutionalized Racism: Another Look

In mid-July Jessie did a post on the AMA apology, but I would like to add a bit more on this issue, especially about how racism works in US medicine. One good result from anti-racism efforts in the last decade may be that we are getting more serious apologies from white organizations about slavery or Jim Crow segregation. Harriet Washington reports in a late July 2008 New York Times article on one of the most institutionally racist sectors of our society, U.S. medical care institutions. Highly (photo of AMA building: Steve and Sara) and blatantly segregated until the late 1960s, she notes, the American Medical Association has recently apologized the National Medical Association, the country’s leading black medical association:

An apology to the nation’s black physicians, citing a century of ”past wrongs.”

From the beginning, U.S. medicine’s institutions have been racially and gender segregated, but Jim Crow and gender segregation increased in the early 1900s with the implementation of private and government “reforms” designed to get rid medical practitioners who were not officially licensed—which usually meant they were not from the more elite (almost all white) medical schools and often practiced various kinds of folk medicine (including midwives). These reforms did raise U.S. medical standards, at least for allopathic mainstream medicine, yet also effectively excluded many white women and practitioners of color from their traditional medical practices. And Jim Crow segregation became very central to this newly reformed medical system:

. . . black patients and doctors were often relegated to subterranean ”colored” or charity wards or banned from hospitals altogether; they had responded with their own hospitals and medical schools, at least seven of which existed in 1909. By 1938, the situation had grown so dire that Dr. Louis T. Wright of Harlem Hospital declared, ”The A.M.A. has demonstrated as much interest in the health of the Negro as Hitler has in the health of the Jew.”

Washington notes that the American Medical Association continued to be a problem until the end of the civil rights movement era:

The Civil Rights Act of 1964 passed without active support from the A.M.A. Title VI of the act closed the Hill-Burton loophole: segregation within hospitals became illegal….But for African-American and other antisegregationist physicians, there remained a final bastion of racial exclusion to conquer: the A.M.A.

Demands by African American physicians and some white allies that the association desegregate were ignored by its leadership until the late 1960s. From 1963 to 1968 the association had to endure public protests against its racist practices. In 1968 the association finally took action to end legal segregation in its constituent state societies.

Still, today, the percentage of U.S. physicians who are African American (2.2 percent) is still smaller than it was in 1910 (2.5 percent). And our medical care system is riddled with numerous kinds of institutional racism, as recent research reports (see various chapters here and chapter 7 here) frequently make clear. There are some very good scholarly bloggers like U. Dayton’s Prof. Vernellia Randall (see her great website here) who have given even more details on how such institutionalized racism works and how it is a violation of international human rights and anti-discrimination laws.

Note: I have given more than 100 invited lectures over the years on my research on racism at many schools and colleges within our top universities and liberal arts colleges across the country, and I have only had one invited lecture cancelled–ever. This was after two faculty members saw at the xerox machine the handout (it had quotes from whites making various racist comments, from my research interviews) that I was going to talk about. This was a Florida medical school, which had invited me and other researchers to talk about racial matters because they had had racist graffitti in their medical school classrooms. They reportedly still have problems today.


  1. Curious Joe- what year did the Florida cancellation occur in?

    Slightly off topic, but d0 you recall the case of the woman who died in the waiting room of a NYC psychiatric ward, as guards and other waiting patients watched her die on the floor? It is a truly a despicable story. While it doesn’t address this specific example of US Medicine’s institutional racism, it does highlight what happens when those on the lower economic rung are left to deal with crappy hospitals staffed by employees who don’t much value the lives of those they are entrusted to care for

  2. Thanks for writing about this. I’m a POC and a med student, and I’ve been really frustrated with some of the issues I’ve encountered during the course of my education: everything from the lack of diversity among faculty to implicit enforcement of negative stereotypes about patients of color to superficial cultural competency courses. I was glad to see the AMA apology, but I’m much more interested in seeing the organization, as well as med school administrations, address current problems.

  3. GDAWG

    The science girl in a typical apology and the normal course of events, the corrections you speak about would be on par with the reparation aspect of the apology. That is, an express regret, and an expression of concrete action(s) to provide redress the matter. But, alas, UR talking about apologizing and making amends to Black folks, for the most part. And, as such, there is no way that the symbolism aspect will go farther than that. Even for the AMA. No pun intended, but truly sickening.

  4. GDAWG

    Sorry ‘TheScienceGirl for the typos. But the first sentence should have said– The typical apology in the normal course of events and the corrections you speak about…….

  5. GDAWG

    Finally, A report released in 1910 by Abraham Flexner really devastated medical education for Black Americans. Flexner was commissioned by the AMA to study medical education in America and Canada, and in doing so, he visited 155 medical school in said countries. A the time there between 7 or 11 Black Medical Schools in existence. The report released in 1910 closed all but two of the Black Medical schools, Howard and Meharry. And, as a result, the number of Black doctor produced dropped considerably because, obviously, white school were not going to pick up the slack. They had quotas, of sorts, whereby, they would accept only 1 0r 2 Black students per year, if that. And this depended on where they were located, of course. In the souht. You can forget about it. In any event, the number of Black American doctors did not start to increase until the Civil Rights era, in large part. Just as the number of women doctors did. Moreover, the number of American medical schools schools catering to Black Americans did increase until the addition of Morehouse Medical School in Atlanta, Georgia and Charles Drew in Los Angeles, California. Still compapratively speaking the numbers are still anemic despite the addition of the new schools and open enrollments.
    I personally think a more worthy apology for the AMA would be to:
    1. Adopt an Black undergraduate college Pre-med program and memtor the students.
    2. Scholarships for aspiring ” Black American” students interested in Medicine.
    3. Have local chapters since they were the real culprits in the mess, adopt inner city schools where “Black Americans” predominate and instutue mentorship programs and other supopporttive measures.
    This would make their apology meaningful. Otherwise it’s not worth the paper it’s printed on because their actions caused ‘real damage’ for scores of years, to potentially hundreds of thousands of patients their families, and Black Doctors.

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