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The American Medical Association (AMA) released a Tuesday to "dismantle structural racism starting from within the organization," noting that "equity work requires recognition of past harms and critical examination of institutional roles upholding these structures."

"The framework of the plan ... is driven by the immense need for equity-centered solutions to confront harms produced by systemic racism and other forms of oppression for Black, Latinx, Indigenous, Asian, and other people of color, as well as people who identify as LGBTQ+ and people with disabilities," the organization . "Its urgency is underscored by ongoing circumstances, including inequities exacerbated by the COVID-19 pandemic, ongoing police brutality, and hate crimes targeting Asian, Black, and Brown communities."

The plan was originally supposed to be released Wednesday, but was pushed up to Tuesday after an unnamed news organization obtained the plan ahead of the event. It has five parts:

• Embed equity and racial justice throughout the AMA by expanding capacity for understanding and implementing anti-racist equity strategies via practices, programming, policies, and culture. That includes "ensuring equitable structures, processes and accountability in the AMA's workforce, contracts and budgeting, communications and publishing," according to its plan.
• Build alliances with marginalized physicians and other stakeholders through developing structures and coalitions to elevate the experiences and ideas of historically marginalized and minoritized healthcare leaders. The plan calls for "establish[ing] a coalition of multidisciplinary, multisectoral equity experts in healthcare and public health to collectively advocate for justice in health."
• Push upstream to address all determinants of health and root causes of inequities by strengthening, empowering, and equipping physicians with the knowledge of and tools for dismantling structural and social drivers of health inequities. One tactic here involves "equip[ping] physicians and health systems to improve services, technology, partnership and payment models that advance public health and health equity."
• Ensure equitable structures and opportunities in innovation through embedding and advancing racial justice and health equity within existing AMA efforts to advance digital health. Here the AMA pledged to "center, integrate and amplify historically marginalized and Black, Indigenous, Latinx and people of color who are health care investors and innovators."
• Foster pathways for truth, racial healing, reconciliation, and transformation for AMA's past by accounting for how policies and processes excluded, discriminated against, and harmed communities, and by amplifying and integrating the narratives of historically marginalized physicians and patients. As part of that effort, the AMA said it will "repair and cultivate a healing journey for those harms."

The AMA noted some of the actions it has taken in the past few years to address these issues, including launching its Center for Health Equity -- with its Chief Health Equity Officer Aletha Maybank, MD, MPH -- in 2019. The press release also listed actions the AMA has taken in the past year, including:

• Passing relevant policies, including those acknowledging racism as a public health threat, ridding race as a proxy for biology, and recognizing police brutality as a product of structural racism
• Launching the Medical Justice in Advocacy fellowship to advance equity in medicine
• Removing the name of AMA founder Nathan Davis, MD, from an annual award and display in recognition of his contribution to explicit racist exclusion practices
• Calling on the federal government to collect and release COVID-19 race/ethnicity data
• Investing financially in Chicago's West Side neighborhoods

In an on the organization's website, AMA president-elect Gerald Harmon, MD, acknowledged that the association wasn't the first organization to take these steps. "Many organizations have been speaking out against racial and social injustices in health and working to solve them for decades," he wrote. "We applaud all of those who have shined a spotlight on inequities and sought to address them. We want to be part of this solution because we believe we can help. We believe that by leveraging the power of our membership, our influence, and our reach we can help bring real and lasting change to medicine."

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