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Origins of a Racial Divide

Robert B. Baker, PhD; Harriet A. Washington, BA; Ololade Olakanmi, BA; Todd L. Savitt, PhD; Elizabeth A. Jacobs, MD, MPP; Eddie Hoover, MD; Matthew K. Wynia, MD, MPH

JAMA. 2008;300(3):306-313. Published online July 10, 2008 (doi:10.1001/jama.300.3.306).

Like the nation as a whole, organized medicine in the United States carries a legacy of racial bias and segregation that should be understood and acknowledged. For more than 100 years, many state and local medical societies openly discriminated against black physicians, barring them from membership and from professional support and advancement. The American Medical Association was early and persistent in countenancing this racial segregation. Several key historical episodes demonstrate that many of the decisions and practices that established and maintained medical professional segregation were challenged by black and white physicians, both within and outside organized medicine. The effects of this history have been far reaching for the medical profession and, in particular, the legacy of segregation, bias, and exclusion continues to adversely affect African American physicians and the patients they serve.

Author Affiliations: The Union Graduate College–Mount Sinai School of Medicine Bioethics Program, and Department of Philosophy, Union College, Schenectady, New York (Dr Baker); Visiting Scholar, DePaul University College of Law, Chicago, Illinois (Ms Washington); Institute for Ethics, American Medical Association, Chicago, Illinois (Mr Olakanmi and Dr Wynia); Department of Medical Humanities, Brody School of Medicine, East Carolina University, Greenville, North Carolina (Dr Savitt); Collaborative Research Unit, Stroger Hospital of Cook County, and Rush University Medical Center, Chicago, Illinois (Dr Jacobs); Editor, Journal of the National Medical Association (Dr Hoover); and University of Chicago Hospitals, Chicago, Illinois (Dr Wynia).

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