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MADELEINE BRAND, host:

This is Day to Day. I'm Madeleine Brand.

ALEX COHEN, host:

And I'm Alex Cohen. In a few minutes, vacationing closer to home. We launch a new summer series.

BRAND: But first, a professional group of African-American doctors says it accepts the apology from the American Medical Association. The AMA today issued a formal apology for discriminating against African-American doctors and not allowing them to join the AMA. That exclusion led black doctors to form their own group many years ago, the National Medical Association, and Dr. Nelson Adams is president of the NMA. He's here now. Dr. Adams, welcome to the program.

Dr. NELSON ADAMS (President, National Medical Association): Thank you. I'm glad to be a part of it.

BRAND: First, before we get to this issue of the apology and your acceptance of it, please tell us what was your own experience? Did you encounter discrimination when you became a doctor?

Dr. ADAMS: Certainly not to the extent that took place generations before me and actually just a few years before me. By the time I came along, there was residual, but the doors were essentially open if you were properly credentialed.

BRAND: Well, so you accept the apology, but with some conditions, I understand.

Dr. ADAMS: There's three things that I think we all have to begin to focus on. Number one, back in 1980 when Margaret Heckler was secretary of HHS, she produced a report and one of the findings there was that it was clear that a commonness between the provider and the patient often impacted in a positive way on the outcome. So number one, we need collaboration to actively recruit more African-Americans into the medical profession. There are fewer African-American physicians per capita today than there were at the very beginning of the 1900s. In 1910, we actually had more African-American physicians per capita than we do today. [POST-BROADCAST CORRECTION: Margaret Heckler become Secretary of HHS in 1983, and issued the report in 1984.]

BRAND: That's a shocking statistic, or a surprising statistic. Can you flesh that out a little bit?

Dr. ADAMS: In the early 1900s, there were more than 20 medical schools, actually, that focused on the training of blacks. And shortly thereafter, because of many things including institutionalized racism, these schools went the way of the dinosaur. So there's been remission in the number of opportunities for training, was a big part of that. Those trends continue today and with some of the actions that have been taken in recent years, as related to affirmative action and the like, have also had a negative impact.

BRAND: And so what you're saying is that the result of that is that African American patients receive substandard care and are more prone to diseases like heart disease, diabetes, etc.?

Dr. ADAMS: Well, the two are certainly linked. The second point really deals with what you just talked about, and that's this whole issue of health disparities. A commitment to reduce health disparities among African-Americans and other communities of color is a must. I applaud the AMA and the NMA and other groups who came together a few years ago to form a commission to end health disparities. And that's a great first step. But much work needs to be done there, and we need a full commitment from all of us to do something about health disparities.

I'm saddened to say that the health of Americans is poor. We are in the lower quartile of health status of all industrialized countries. So for us to say we want to get to the point where white America is, is really not the point. All of America is in pretty bad shape as it relates to our health. A rising tide raises all of the ships, and indeed we need to raise the tide of the health status of our people. Not just some of us, but all of us.

Dr. ADAMS: And the third point, which I think is extremely important, is as it relates to how you deal with patients. This whole notion of what's called cultural competency has to be raised up. And it's basically a need for communication. We suggest that the AMA and NMA work together to provide for a requirement for medical schools and medical licensing to make cultural competency mandatory.

BRAND: Dr. Adams, you are the chief, the head of the National Medical Association. Why not merge your group with the AMA and make it stronger that way?

Dr. ADAMS: Well, you know, many of us are members of both organizations. I've been a member off and on of AMA for more than 20 years. I've been a member of NMA for 20-plus years. And the reason is simple. It's a matter of perspective. No one will focus on the concerns of our community, the African-American community that is, like African-Americans. It's pretty plain, pretty basic. The disparities that exist are there because the attention has not been given.

BRAND: Dr. Adams, thank you very much.

Dr. ADAMS: Thank you.

BRAND: We've been talking about the AMA's formal apology for years of discrimination with Dr. Nelson Adams, president of the African-American medical group the National Medical Association.

Less swag for doctors when NPR's Day to Day continues.

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