The Gay and Lesbian Medical Association ( GLMA ) and the American Medical Association ( AMA ) issued a joint statement March 15 promising to work together to reduce healthcare disparities affecting LGBT individuals.
Observers see this as a positive development that could foster greater access to medical services as well as better sensitivity training for medical professionals.
Following recent comments by AMA President Dr. John Nelson, in support of a New York medical school's decision to ban its LGBT student association, many wondered whether the national physicians' group was out of touch with modern notions of diversity.
After Dr. Nelson's remarks were reported in the press, pressure mounted for the association to issue an apology. Two statements were eventually released. One reiterated the AMA's clear policy against discrimination based on sexual orientation. In the other, Dr. Nelson expressed regret that his comments had been misrepresented.
At the time, a number of AMA employees were deflated by their leader's failure to forcefully denounce the gay ban. Equally upsetting was the fact that by pretending to have spoken on their behalf, Dr. Nelson had cast a shameful shadow on the organization's members and staff.
'Does Dr. Nelson really believe that physicians in training will learn about caring for all patients with respect and compassion at a medical school that enforces policies promoting intolerance?' was the reaction of an employee who asked to be identified simply as a straight ally. 'It can be frustrating and discouraging to invest so much professional energy into an association and then to have one of its spokespeople make these offensive remarks. Along with embarrassment, it creates additional work for the staff, which has to do some quick damage control.'
A gay member of staff in the Professional Standards Group said, 'I found Dr. Nelson's comments very dispiriting.' On the day the remarks were reported, two ex-employees contacted her wanting to know what was going on. She said she had no explanation.
Alan Wells, an openly gay man working in the AMA's Institute for Ethics, was giving a guest lecture at a medical school in Reno, Nev., when students showed him the news report on Dr. Nelson. 'I was aghast,' he said. 'The students were very offended and started saying they would quit the AMA in protest.'
Wells said he tried to reassure them that his president had not followed the script. He also told them that he had always felt comfortable in his work unit, that the AMA offers domestic-partner benefits, and has enacted strict non-discrimination policies.
Others shared Wells's ambivalence. Asked for his take on the situation, a gay man who had previously left the AMA to take up a position in a different field declared, 'The AMA is a very conservative institution. I had a very liberal boss and colleagues, who knew I was gay. But I also felt that my experience of an inclusive atmosphere came more from my immediate environment than from the larger AMA culture.'
Referring to Dr. Nelson's self-professed Mormon faith, another former employee, who eventually left the organization after experiencing an allegedly hostile work environment, had this to say: 'I am not interested in vilifying John Nelson, but I am scared to death of what his religion and other religious beliefs dictate. How will gay rights ever move forward when we are faced with hundreds of thousands of other Americans whose religious beliefs teach them that homosexuality is evil and sinful?'
In the face of internal dissatisfaction and attacks on its reputation, it became increasingly clear to the association that something had to be done. As GLMA and the AMA were both scheduled to be in Washington, D.C., in early March, Joel Ginsberg, the executive director of GLMA, extended an invitation to Dr. Nelson to meet and discuss certain concerns LGBT medical students and professionals would like to see addressed by the AMA.
While it was not the AMA who reached out to the specific community it had offended, accepting the offer sent a strong signal and represented a step in the right direction.
Having been a student representative himself in his days at the University of Texas Medical Center, Wells expressed confidence in GLMA's approach. 'I wholeheartedly endorse GLMA's response. It is solution-driven. They need to get a place at the table,' he said.
In January, the AMA, in conjunction with the National Medical Association ( NMA ) , the nation's oldest and largest organization of African American doctors and healthcare professionals, and the National Hispanic Medical Association ( NHMA ) , announced the creation of The Commission to End Health Care Disparities. The three partners make up the secretariat of the commission. Through a process that began in 2003, 37 other medical associations and societies were also consulted. The announcement listed 27 member organizations who will take part in the new endeavor. GLMA was not one of them.
While the secretariat recognized that sub-groups of vulnerable patients exist, the commission was devised to focus primarily on racial and ethnic disparities. At the March meeting, GLMA asked the AMA to expand the scope of its work to include issues of concern to the LGBT population. The joint press release that followed the official encounter indicated that the AMA now intends to commit itself to this additional goal.
Representatives of the NMA and the NHMA did not attend the meeting. As of March 17, neither group had issued a statement relating to the proposed change in the commission's mission. Ginsberg said it was his understanding that 'the AMA leadership is discussing next steps with them directly.'
