To promote health equity, medical associations are embracing restorative justice

The history of racism in medicine continues to affect healthcare today.

Professional associations, however, are taking steps toward truth and reconciliation for their pasts, which is an essential component to advance equity and racial justice.

During a featured session sponsored by the Robert Wood Johnson Foundation and the American Medical Association Foundation as part of Becker's Virtual Event in September, leaders from three prominent national health associations discussed pathways to equity both within their organizations and across medicine:

  • James L. Madara, MD, CEO and executive vice president, American Medical Association (AMA)
  • Mark Del Monte, CEO and executive vice president, American Academy of Pediatrics (AAP)
  • Saul Levin, MD, CEO and medical director, American Psychiatric Association (APA)

Four key learnings were:

1. Leading medical associations are acknowledging and addressing the structural racism in their pasts. "American medicine is a mess when it comes to equity and inclusion, and the AMA had a role in that," Dr. Madara said. "One of our plans is truth and reconciliation of our own past and repairing some of the harms we've created."

During the APA's early days, members voted to segregate hospitals. "From the beginning of our formation, there was structural racism," Dr. Levin said. "How do we now atone for that? We have to look within ourselves and have an honest conversation."

Mr. Del Monte shared a similar perspective: "We need to acknowledge the role that the AAP has played in segregating the profession. We've fostered that through structural approaches and we need to apologize for that."

2. As organizations pursue restorative justice, they are aligning this work with their core missions. The AMA's mission is to promote the art and science of medicine and the betterment of public health. Achieving this goal, however, is impossible given the health inequities that exist in American society. In response, the AMA established the Center of Health Equity and developed a strategy focused on equity and inclusion. Health equity is now deeply embedded across the work of the AMA, influencing its overall strategy and touching every program, priority and initiative. 

3. The AAP has a dual mission: obtaining the optimal health and well-being for children, as well as supporting the professional needs of its members. "We approach this with the idea that systemic and structural problems require systemic and structural solutions," Mr. Del Monte said. "To improve the lives of children, we need a workforce that reflects their experience. Overcoming structural barriers to physician careers for black and brown people is a priority."

The APA has created a division of diversity and health equity and drafted a strategic plan for diversity, equity and inclusion. "We can't repeat the mistakes of the past. Over the next five to ten years, we need to focus on social determinants of mental health," Dr. Levin said.

4. Trust is built over time through listening and honest effort. Deep listening internally and externally is critically important. "Everyone has stories that are meaningful to them and you have to honor that," Dr. Madara observed. "Give people space, so they have the freedom to speak up. That permits people to be more open and trusting." There is no substitute for dialogue and being open. Trust is earned every day through an organization's actions and the trust that is earned can be lost very quickly.

The journey to greater equity in medicine will be long and the playbook is unwritten. "There's so much to do that none of us should be inventing this by ourselves in a silo," Mr. Del Monte said. "We can learn from each other and across organized medicine."

To learn more about the event, click here.

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