The shortage of Black physicians is one of the biggest on-going problems in the Black community. The lack of African American physicians affects Black life expectancy, patient health outcomes, and quality of life. It also affects African-American wealth, career opportunities, and education.
In 1910 Flexner Report led to the closing of eight black medical schools leaving only Howard Univeristy and Meharry Medical School.
One of the institutions responsible for the shortage of Black physicians is the American Medical Association.
The American Medical Association (AMA) was formed in 1847. It sought to professionalize and standardize the practice of medicine and medical education. In practice, the AMA also discriminated against Black physicians. Blacks were excluded from joining the AMA or attending AMA conventions.
Membership in the AMA is important because it provides access to opportunities not available elsewhere. Blacks were denied access to white hospitals, residencies and specialty practice training. Access to hospitals was the key issue for Black doctors as they wanted to continue their training, learn new medical techniques, and gain broader experience. The AMA practice of discrimination was widespread up until the civil rights movement.
The early AMA was dominated by State Medical Boards. To expand and grow, the AMA adopted many of the practices of southern state medical boards: Black doctors could not treat white patients, Black could not give blood to sick white people, and black physicians were inferior. The practices continued up to the civil right era and gradually ended with the passage of Medicare and Medicaid legislation.
Medicare and Medicaid outlawed discrimination in the medical field and use huge sums on money to enforce it. . Medicare and Medicaid built hospital and clinics around the US, during the 1970s and 1980s.
AMA physician directories included race
One example of discrimination practiced by the AMA is the racial coding in the official directory of physicians. The AMA published directories of physicians that include racial designations. The AMA used the label “Col” – or colored in the AMA medical directories between 1906 and 1938. (The Deep Roots of Racial Inequalities in US Healthcare)
In response to the discriminatory practice of the AMA, African American physicians formed the National Medical Association (NMA) in 1895. Membership was open to all regardless of race.
Historic Discrimination in the Medical Field
The Negro Yearbook, 1937-1938, p. 267, found that there were 1734 black doctors in 1900 and 3,077 in 1910.
A different researcher, Benjamin Chrisinger, digitized and analyzed the 1906 AMA physicians’ directory. He found that in 16 states, mostly in the South, there were 746 black doctors. (The Conversation)
Currently, in 2024, there are about 75,000 African American Physicians or about 5.7% of all doctors as calculated by BlackEconomics.com.
American Medical Association Apology
In July of 2008, the American Medical Association issued a historic apology to Black physicians in remarks delivered to the National Medical Association. Barack Obama has just won the Democratic nomination for president.
In remarks delivered by the past president of the AMA, Ronald M. Davis, MD, the AMA formally apologized.
AMA Past President Dr. John C. Nelson, in 2004, said in the letter that: “I myself, in 2006, expressed our own personal apologies to this august body. But today, on behalf of the American Medical Association, I unequivocally apologize for our past behavior. We pledge to do everything in our power to right the wrongs that were done by our organization to African-American physicians and their families and their patients.
“But this is also the moment we can stand as one, in tireless advocacy for access to high-quality health care for ALL Americans, regardless of race, ethnicity, gender, sexual orientation, and any other characteristic. “
AMA makes changes
The American Medical Association has also made changes and improvements to improve Black health outcomes. Many of the changes come from a resolution by the House of Delegates meeting in June of 2018.
In 2019, the AMA launched the Center for Health Equity. In 2021, the American Medical Association developed a strategic plan to “embed” health equity into the US healthcare system. The AMA program is called: Optimal Health for All.
The AMA has taken some steps to improve it’s image. The AMA has a web page called: “The history of African Americans and organized medicine” with several resources and links. The page includes an interesting PowerPoint: A History of African American Physicians & Organized Medicine.
It has also published and encouraged research on Black physicians and on disparities in health affecting minority groups.
It also removed a bust of Dr. Nathan Davis, who blocked integration efforts at the AMA in it’s early years.
The Apology was widely covered in the media in 2008
Group Apologizes for Its Racial Bias (NY Times)
Apology Shines Light on Racial Schism in Medicine (NY Times), July, 2008
Summary
The apology marks a rare public acknowledgment of past harm done to Black people by a major institution in US society. However, the program to improve Black health outcomes, called “Optimal Health for All” is weak at best.
Hey, at least they apologized.