The American Medical Association last month apologized to African American physicians for decades of discrimination.
The organization's history and the relevance of its apology to Charlotte need broader exposure and understanding.
The history of U.S. medicine is plagued with a painful past – segregated hospitals, limited opportunities for medical training of blacks, federal support for clinical trials that used blacks for human experimentation and reduced access for blacks to medical care.
The AMA formed in 1847 to represent the interests of physicians practicing medicine in America. But much of the discrimination occurred in the practices of local and state chapters – including those in North Carolina.
Generations of discrimination
Until the mid-1950s, black physicians were denied full membership in the Mecklenburg County Medical Society and the N.C. Medical Society. That meant they couldn't be members of the AMA, and therefore weren't eligible to become board certified in their specialties. Generations of black physicians were not allowed to demonstrate professional equivalency to their Caucasian peers.
The Charlotte Medical Society, formed in 1900 for black physicians, dentists and pharmacists, became a support network for these professionals.
When the Mecklenburg County Medical Society voted to admit its first black member in 1954, the state medical society considered expelling the Mecklenburg group. It was two more years before the state society admitted black physicians.
In the meantime, black physicians were denied admitting privileges at Charlotte's three main hospitals. They admitted patients only to the all-black Good Samaritan Hospital, which opened in 1891 as the first private hospital in the country for blacks.
Mercy Hospital was the first Charlotte hospital to admit black patients – to a segregated 30-bed ward assigned to Negroes. It was 1963 before Charlotte Memorial Hospital (now Carolinas Medical Center) allowed black doctors on its medical staff. Presbyterian Hospital soon followed.
Good Sam closed in 1982 and was demolished in 1990. The Panthers' Bank of America Stadium now sits on its former site.
Until the 1960s, black physicians had difficulty obtaining residency training at accredited programs after graduating from primarily black medical schools.
Charlotte remained a largely segregated medical community into the 1990s. The pervasive perception was that “Black Medicine” was substandard to “White Medicine.” Caucasian physicians didn't refer patients to black colleagues. And although Caucasian physicians treated black patients, it was unusual for white patients to be treated by black physicians before the 1980s.
After criticism from black physicians in 1997, Carolinas Medical Center formed its Diversity Advisory Committee to address diversity matters and assist in minority recruitment. It organizes an annual “Diversity in the Workplace” symposium for the Charlotte health-care community.
Novant Health, which owns Presbyterian Healthcare, formed its Corporate Diversity Council to coordinate diversity initiatives.
Why AMA apology matters
Why does this history matter? Many will say there is little gained by revisiting this past, which few if any in today's healthcare environment had anything to do with.
In its apology, the AMA acknowledged the scientific importance of these discriminatory practices and their contribution to the diminished health status of blacks compared to whites.
The Institute of Medicine published a landmark study (2002) titled “Unequal Treatment.” It provided scientific validation that minorities in this country experience worse health outcomes compared to whites. This is evident irrespective of education, socioeconomic status, access to healthcare and health insurance coverage. Several factors contribute, including poverty, racism, discrimination and stereotyping among healthcare providers and institutions.
In Charlotte, some progress
Small strides have been made in race relations in Charlotte medicine over the past two decades. Physician groups are becoming integrated, albeit at a glacial pace. Black physicians now serve as members and officers of the MCMS Board.
Still, diversity in hospital administrative leadership is lacking. Much more can and should be done.
Six years after an Institute of Medicine report linked racism in medicine to health disparities in minorities, the AMA has done the right thing in apologizing for generations of discrimination. American medicine must become inclusive of qualified minorities at all levels of representation, in a manner that reflects of the complexion of our communities.
Martin Luther King was poignant when he stated: “Of all the forms of inequality, injustice in healthcare is the most shocking and most inhumane.”
Why is it important to remember this? Because those who fail to heed the lessons of history are destined to repeat them.