Fallout from JAMA Podcast Continues

March 10, 2021 — One of the country’s top medical research journals is facing calls for an investigation after a controversial — and since deleted — podcast questioned whether structural racism exists.

More than 2,000 people have signed a petition on Change.org calling for an investigation at JAMA — the journal of the American Medical Association — after the February podcast, called “Structural Racism for Doctors: What Is It?”

The host of the podcast, Edward Livingston, MD, deputy editor at JAMA for clinical reviews and education, has also been criticized. During the podcast, Livingston, who is white, said, “Structural racism is an unfortunate term. Personally, I think taking racism out of the conversation will help. Many of us are offended by the concept that we are racist.”

Now, Livingston’s status at JAMA is unclear. Asked if Livingston still worked for the journal, a JAMA spokesperson would only say, “No comment.”

The audio of podcast has been deleted from JAMA’s website. In its place is audio of a statement from JAMA Editor-in-Chief Howard Bauchner, MD. In his statement, which he released last week, he said the comments in the podcast, which also featured Mitch Katz, MD, were “inaccurate, offensive, hurtful and inconsistent with the standards of JAMA.”

Katz is an editor at JAMA Internal Medicine and CEO of NYC Health + Hospitals in New York City.

Also deleted was a JAMA tweet promoting the podcast episode. The tweet said: “No physician is racist, so how can there be structural racism in health care? An explanation of the idea by doctors for doctors in this user-friendly podcast.”

The incident was met with anger and confusion in the medical community.

Herbert C. Smitherman, MD, vice dean of diversity and community affairs at Wayne State University School of Medicine in Detroit, noted after hearing the podcast that it was a symptom of a much larger problem.

"At its core, this podcast had racist tendencies. Those attitudes are why you don't have as many articles by Black and brown people in JAMA," he said. "People's attitudes, whether conscious or unconscious, are what drive the policies and practices which create the structural racism."

Katz responded to the backlash last week with the following statement: "Systemic racism exists in our country. The disparate effects of the pandemic have made this painfully clear in New York City and across the country.

“As clinicians, we must understand how these structures and policies have a direct impact on the health outcomes of the patients and communities we serve. It is woefully naïve to say that no physician is a racist just because the Civil Rights Act of 1964 forbade it, or that we should avoid the term ‘systematic racism’ because it makes people uncomfortable. We must and can do better."

JAMA is an independent arm of the American Medical Association, which immediately condemned Livingston’s stance in a statement from CEO James L. Madara, MD.

The AMA’s House of Delegates passed policy stating that racism is structural, systemic, cultural, and interpersonal and we are deeply disturbed — and angered — by a recent JAMA podcast that questioned the existence of structural racism and the affiliated tweet that promoted the podcast and stated ‘no physician is racist, so how can there be structural racism in health care?’”

He continued, “JAMA has editorial independence from AMA, but this tweet and podcast are inconsistent with the policies and views of AMA and I’m concerned about and acknowledge the harms they have caused. Structural racism in health care and our society exists and it is incumbent on all of us to fix it.”

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