In a recent interview with Keith Eddings of The Journal News, an online publication out of New York state, Dr. John Nelson, President of the American Medical Association ( AMA ) allegedly said he saw no reason to disagree with a medical school's decision to ban a GLBT student group. While it would have been Dr. Nelson's right to express a personal view on the matter, it became an all together different proposition when he supported his comment by adding that he was speaking on behalf of the national organization for which he is the de-facto spokesperson.
The problem is that the AMA has clear guidelines against discrimination based on sexual-orientation.
Those include policies on 'Civil Rights and Professional Responsibility'; 'Continued Support of Human Rights and Freedom'; 'Nondiscrimination Toward Medical School and Residency Applicants on the Basis of Sexual Orientation.' As a private employer, the AMA also has an 'Equal Employment Opportunity/Affirmative Action' provision.
Dr. Nelson was speaking to the Westchester County Medical Society Feb. 10 and it is prior to his address that he answered a reporter's question regarding the ban at New York Medical College (NYMC). Sources at the AMA said he had been briefed about the controversy surrounding the ban and was aware of the AMA's anti-discrimination policies.
Surprisingly, Dr. Nelson spoke of the private institution's right to implement its own rules and compared the ban on the gay student group to the ban on Coca-Cola at Brigham Young University. He apparently justified his position by stressing that he was not speaking as a Mormon (he resides and is in a private practice in Salt Lake City, Utah), but as president of the AMA. Nelson also declared that physicians should treat gays 'with dignity, with respect and with absolute confidentiality.' Although this may reassure gay patients, it did not exactly imply that gay students training to become doctors are entitled to the same courtesy.
Although the general public may assume that the Chicago-based AMA represents the entire medical profession, it counts approximately 250,000 members out of the country's estimated 700,000 or so licensed physicians. In effect, roughly ten percent of AMA members are medical students.
The AMA has undertaken several public awareness campaigns over the last few years. A philanthropic initiative called Worldscope, whereby doctors can donate stethoscopes to far away colleagues in developing countries, was launched in 2003. This year, the AMA's Ethics Institute is collaborating with the U.S. Holocaust Memorial Museum on an ongoing multi-city lecture series exploring the role doctors played in the crimes of Nazi Germany. Endeavors like these testify to a broader consciousness and are genuinely laudable.
But as a professional association, the AMA's most high-profile activity is legislative. To this effect, it has an office in Washington D.C., where it lobbies Congress and testifies at various hearings. The group's primary objective is medical liability reform. It advocates for a reduction of medical malpractice suits and a cap on non-economic damages awarded by juries. The repeated references to 'frivolous medical lawsuits' in last year's presidential and vice-presidential debates suggest that they have the Bush Administration's ear.
In 2004, the association hired its first chief marketing officer, whose mandate includes 're-branding' the AMA so as to make it more appealing to prospective members. Ironically, with a motto like 'Together We Are Stronger' the right-leaning group now almost sounds like the Kerry-Edwards campaign.
Asked for an official response to Dr. Nelson's comments, the AMA released two statements 'relating to news reports involving the situation at New York Medical College.' The situation, of course, had much more to do with Dr. Nelson's remarks as the headline of Mr. Eddings's article clearly shows ('AMA Chief Defends Ban on Gay Group').
The first official statement asserts that the AMA has 'zero tolerance for discrimination in any form,' which, as previously mentioned, is in accordance with the association's policies. It goes on to point out that the AMA House of Delegates established an advisory committee to its Board of Trustees to address issues of interest to LGBT doctors and patients.
This may sound promising, but the birth of this advisory committee is turning out to be a very slow one. As reported in these pages last June, the AMA's Young Physicians Section had submitted a resolution calling on the AMA to explore the development of a GLBT Physician Special Interest Group back in June 2003. Such affinity groups already exist for women physicians, residents and fellows, young physicians, international medical graduates, among others.
Resolution 612 was adopted and the Council on Long Range Planning and Development was mandated to look into the issue. It reported to the Board of Trustees ླ men, 2 women, no visible minorities), which in June 2004 announced that an advisory committee with a two-year tenure would be created instead of a full-fledged, permanent, Special Interest Section. The nomination process has begun and appointments are expected in April—almost two years after the original request.
The second statement is attributed to Dr. Nelson himself. He declares that he is 'opposed to discrimination for any reason.' Accusing Mr. Edding's article of taking the Brigham Young example out of context, Dr. Nelson insists that he does not share the portrayed negative attitude toward gays and lesbians. He apologizes 'to anyone who may have been offended by what they read,' thus distancing himself from the reported comments. It is telling that his statement does not include any reference to, nor denial of, his reported support of NYCM's ban of the LGBT group. The 1,000 AMA staff in Chicago may also feel they deserve a special apology as Dr. Nelson declared that he was speaking on their behalf when he defended the ban of the GLBT student group.
The Gay and Lesbian Medical Association (GLMA) also issued a statement expressing its disappointment with Dr. Nelson's partial apology. Executive Director Joel Ginsberg said, 'Casually homophobic remarks like this are damaging to people's health and are a large part of why GLMA still needs to exist.'
GLMA is planning to invite Dr. Nelson and other AMA staff to meet with GLMA leadership next month when both associations hold respective conferences in Washington, D.C.
This controversy probably will not force Dr. Nelson to resign his position as president of the AMA, especially since his term expires this coming June. But it is certain to increase the amount of attention the association will attract from LGBT and anti-discrimination groups.
The negative publicity is bound to have a detrimental effect on marketing efforts and will possibly keep LGBT physicians from joining the AMA. It will be interesting to see what the new advisory committee on LGBT issues has to say about their out-going president.
