A year after the prestigious medical journal JAMA was embroiled in controversy over a podcast seen as racist by critics, the American Medical Association has appointed a prominent health-equity researcher as the publication’s new editor-in-chief — the first person of color to hold the position.
Kirsten Bibbins-Domingo, a Black internist, epidemiologist, and health-equity researcher from the University of California, San Francisco, who has been a leading voice for equitable health care during the Covid-19 pandemic, will lead the Journal of the American Medical Association and the JAMA network of journals, the AMA announced Monday.
Bibbins-Domingo is replacing Howard Bauchner, a Boston pediatrician who held the position for 10 years, until he stepped down in June 2021 after JAMA aired a podcast and posted a tweet questioning whether structural racism exists in medicine. That incident led to an outcry over what many saw as deeply embedded structural racism within the journals and for having editors and editorial boards that were overwhelmingly white.
Bibbins-Domingo, a professor of medicine and chair of the Department of Epidemiology and Biostatistics at the UCSF School of Medicine, co-founded the UCSF Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital. Recently named to the inaugural STATUS list, STAT’s compilation of the most influential leaders in the life sciences, Bibbins-Domingo has spent her career focused on erasing health disparities, especially in cardiovascular care. Speaking to reporters Monday, she called the new position “truly a dream job.”
In an interview, Bibbins-Domingo told STAT that one reason she took the job was that she was convinced that JAMA leadership had already taken steps to address racism and bias, including hiring a health equity editor at each of the network journals. (A health equity editor at the flagship journal JAMA is to be named soon.) She said she would continue to push for more diversity among editors as well as additional changes. “I’ve really come to appreciate how much we need new voices in these conversations,” she said.
She will start her new position on July 1, taking over for Phil Fontanarosa, who has served as interim editor-in-chief since Bauchner’s departure. She is the second woman to lead the journals; Johns Hopkins University pediatrician Catherine D. DeAngelis held the position from 2000 to 2011.
Asked at a news conference about concerns that health equity research had long been marginalized in JAMA journals, Bibbins-Domingo said that will no longer be the case. “Health equity work to me is not separate work. It’s one of the major challenges in modern medicine and modern health care and in society at large,” she said.
Bibbins-Domingo said she still remembered the thrill of having a paper published in JAMA as a young researcher and said she had in numerous cases seen her own JAMA publications lead to change in both clinical practice and policy. She said this was one reason that it was important that JAMA remain a trusted voice, and a voice that advances the health of all patients. She said the health disparities throughout the Covid-19 pandemic are only widening, making it clear that continued focus on such issues is critical.
The importance of the journal in her personal and professional life, she said, was one reason the now-notorious podcast was particularly troubling for her. “It was painful for me because I do look to JAMA and to the high-profile journals to shape the way medicine will move in the future,” she told STAT. “It reflected a scientific blind spot and you never want that to happen in a journal.”
She went on to say “the naming of structural racism … is critical to understanding health and to understanding the stark inequities we see in health.” She said that much of the “blindness” to such issues “has to do with who is in the room making decisions” and that diversity would be a key focus for her. “We have seen that diverse teams are strong teams,” she said.
The appointment was met with immediate applause on Twitter. “Bravo and can’t wait for your leadership in this role,” said Utibe R. Essien, an assistant professor of medicine at the University of Pittsburgh. “This is huge news and a great choice,” tweeted Jeremy Faust, an ER physician and editor-in-chief of MedPage Today.
Even some of JAMA’s fiercest critics lauded the move. “Really excited to see this,” tweeted Stella Safo, an HIV physician in New York who helped start a petition drive against JAMA last year.
“See now I’m gonna have to rethink my current and continued boycott of @JAMAcurrent” tweeted Monica McLemore, editor-in-chief of the journal Health Equity and a researcher who studies reproductive health and rights in marginalized communities.
Ray Givens, a cardiologist at Emory who analyzed the lack of racial diversity among editors at JAMA, called the decision a good choice. “I expected them to choose a woman of color, to shield themselves against more criticism,” he told STAT. “But it was also the right thing to do.”
Added Siobhan Wescott, director of American Indian Health at the University of Nebraska Medical Center, who criticized the JAMA podcast: “She’s going to be a welcome breath of fresh air.”
The search for a new editor was led by Otis Brawley, a Black professor of oncology and epidemiology at Johns Hopkins University whose research focuses on closing racial, economic, and social disparities in medicine. The 18-member search committee was highly diverse and spent months in its search for a new leader. JAMA is one of the world’s most prestigious and widely circulated medical journals. The journals are editorially independent from the American Medical Association.
“Dr. Bibbins-Domingo is a first-rate physician-scientist with broad and deep credentials spanning biochemistry, clinical science, population science and academic research,” Brawley said in a statement. In addition to her work at UCSF, Bibbins-Domingo served as a member, vice chair, and chair of the U.S. Preventive Services Task Force. Brawley said her work guiding such complex enterprises “uniquely qualifies her to be JAMA’s next editor-in-chief.”
Some editors within JAMA were unhappy Bauchner stepped down, saying it was an overreaction to the podcast, which Bauchner was not directly involved with creating. It aired in February 2021 and involved a conversation between Ed Livingston, a deputy editor of JAMA, and Mitchell Katz, the president and CEO of New York City Health and Hospitals.
Bibbins-Domingo said she could not comment on Bauchner’s departure since she was not involved in the decision, but said that she saw the problems at JAMA as not being about an individual but being about “understanding that when a voice for American science and medicine nationally and globally has made a mistake they put things into place to correct that.”