The nation's chief medical association apologized yesterday for decades of past discrimination against African-American physicians, when it effectively denied membership to many black doctors - which many believe has left a legacy of separate and unequal care.
The American Medical Association released an article and commentary acknowledging discriminatory practices that, although ended decades ago, still affect medical care. For example, until 1968 it limited membership to doctors who were also members of a state-level affiliate - many of which were segregated.
In response, black doctors formed their own associations, which the AMA refused to recognize.
"We applaud the AMA for coming forward with information that is not pretty," said Dr. Nelson Adams, president of one of those groups, the National Medical Association, a mostly black medical group started over a century ago. "It represents a time to celebrate where we are."
Others were less gentle. "I'm grateful for the apology. But the time for apologies is long since past," said Dr. Levi Watkins, a cardiologist at Johns Hopkins Hospital, as well as associate dean of the medical school. Watkins, 62, who grew up in pre-civil rights era Montgomery, Ala., was the first black person to attend Vanderbilt Medical School. He has long been involved in civil rights.
He noted that many studies show that every year in this country, 120,000 extra deaths occur among African-Americans because of disparities in care between whites and blacks. Watkins said that institutional racism remains entrenched in health care. "Right now," he said, "I would like apologetic action."
Without membership in medical societies, black physicians were denied admitting privileges at hospitals, financial support such as loans to open practices, leases for office space and even medical malpractice insurance, said Dr. Matthew Wynia, director of the AMA's Institute of Ethics. Continuing education was also difficult because black doctors couldn't attend meetings to learn about new treatments and research.
"The legacy of this history is still with us today," he said. The proportion of black doctors remains the same as it was in 1910 - about 2.5 percent, Wynia said.
The study, to be published next week in the Journal of the American Medical Association, grew out of the Commission to End Health Care Disparities, a work group co-chaired by the AMA and the NMA. One of the issues high on the list was mistrust of the medical association by African-American patients and even some doctors, Wynia said.
