Following a huge backlash that flared after the Journal of the American Medical Association aired a podcast and posted a tweet questioning whether structural racism exists in medicine, the American Medical Association announced Tuesday that the journal’s editor-in-chief, Howard Bauchner, will be stepping down at the end of June.
The move was seen as a major victory for physicians of color, and their white allies, who were so angered by the podcast and an associated tweet that read “No physician is racist, so how can there be structural racism in healthcare?” that they rose in protest against the influential journal and the powerful medical lobbying group.
“It’s wonderful,” said Brittani James, an assistant professor of clinical family medicine at the University of Illinois College of Medicine who helped start a petition calling for widespread change at JAMA that has attracted more than 9,000 signatures. “My biggest takeaway is that our voices can really influence how things go.”
James said she would continue to watch the issue closely to learn the outcome of the AMA’s investigation into the podcast, which aired in February, and the related tweet. “The state of affairs at JAMA is not what we want to have moving forward,” she said. “This move makes me hopeful, but I’m very interested in the result of that investigation.”
The podcast was not created by Bauchner, but by JAMA deputy editor Edward Livingstone, who resigned in March as outrage grew. But Bauchner, who had been on administrative leave, said he took responsibility for both the podcast and tweet. “I remain profoundly disappointed in myself for the lapses that led to the publishing of the tweet and podcast,” he said in a statement released Tuesday by the AMA.
The podcast featured a discussion between Livingstone and Mitchell Katz, an editor at JAMA Internal Medicine and CEO of NYC Health + Hospitals. In the episode, Livingstone questioned whether racism could be embedded in society since it is illegal and questioned whether it was necessary to use the term racism since it might make people feel bad. Katz has condemned the podcast, which has been withdrawn by JAMA, and said he was not part of its production.
“It’s a sign of good leadership that Dr. Bauchner is taking responsibility with this announcement,” said Siobhan Wescott, an Alaskan Native physician and longtime AMA member and leader within the organization’s Minority Affairs Section. “I genuinely hope the change opens up the opportunity for JAMA to rethink structure, leadership, and processes that held JAMA back from excellence in handling race.”
The AMA did not release the results of its ongoing investigation, but said JAMA Executive Editor Phil Fontanarosa would serve as interim editor-in-chief and that a committee being formed to search for a new editor would be led by Otis Brawley, a professor of oncology and epidemiology at Johns Hopkins University who is Black and whose research focuses on closing racial, economic, and social disparities in medicine.
Many scientists have criticized the JAMA journals for not publishing or prioritizing research on health inequities and racism and for having editorial boards that are overwhelmingly white.
Raymond Givens, a cardiologist who led a major analysis of the lack of diversity among JAMA editors, said he felt there was still much to do to improve the situation at JAMA and the AMA. “My goal isn’t about a person but about societal change. I don’t see this as a cause for celebration but a call to get to work,” he tweeted.
James said major change and the welcoming of new voices at the journal were long overdue. “JAMA did not get into the state it’s in because of any single person,” she said. “There is a culture of white supremacy that has to change.”
She also credited the power of social media with amplifying the voices of people of color and helping to usher in change so quickly at an organization with a racist past that has been slow to acknowledge its history and take necessary action to address health inequities that physicians have at times been part of maintaining.
She pointed to the fact that just last week, the AMA quickly addressed a letter that was circulating from some of its delegates questioning the association’s new plan to address racism in health care. “The existence of racism within medicine and society, both historically and present day, is not up for dispute,” incoming AMA President Gerald Harmon said in a statement in response to that letter. “The only question is how we, as physicians, will lead in confronting the health implications of it.”