Dr. Howard Bauchner will step down after another editor suggested “taking racism out of the conversation” on a journal podcast.Dr. Howard Bauchner during a C-Span appearance in September. He will step down from JAMA at the end of June. Credit... C-Span.org
June 1, 2021
Following an outcry over comments about racism made by an editor at JAMA, the influential medical journal, the top editor, Dr. Howard Bauchner, will step down from his post effective June 30.
The move was announced on Tuesday by the American Medical Association, which oversees the journal. Dr. Bauchner, who had led JAMA since 2011, had been on administrative leave since March because of an ongoing investigation into comments made on the journal’s podcast.
Dr. Edward Livingston, another editor at JAMA, had claimed that socioeconomic factors, not structural racism, held back communities of color. A tweet promoting the podcast had said that no physician could be racist. It was later deleted.
“I remain profoundly disappointed in myself for the lapses that led to the publishing of the tweet and podcast,” Dr. Bauchner said in a statement. “Although I did not write or even see the tweet, or create the podcast, as editor in chief, I am ultimately responsible for them.”
Last month, the A.M.A.’s leaders admitted to serious missteps and proposed a three-year plan to “dismantle structural racism” within the organization and in medicine. The announcement on Tuesday did not mention the status of the investigation at JAMA. The journal declined further comment.
“This is a real moment for JAMA and the A.M.A. to recreate themselves from a founding history that was based in segregation and racism to one that is now based on racial equity,” said Dr. Stella Safo, a Black primary care physician at the Icahn School of Medicine at Mount Sinai in New York.
Dr. Safo and her colleagues started a petition, now signed by more than 9,000 people, that had called on JAMA to restructure its staff and hold a series of town hall conversations about racism in medicine. “I think that this is a step in the right direction,” she said of the announcement.
But other critics said they were withholding judgment to see how the organization addressed what they saw as pervasive neglect of covering racism’s impact on health in its journals.
“In the entire history of all the JAMA network journals, there’s only been one non-white editor,” noted Dr. Raymond Givens, a cardiologist at Columbia University in New York. In October, Dr. Givens wrote to Dr. Bauchner, noting that editors at the JAMA journals were overwhelmingly white and male. Dr. Bauchner did not respond, according to Dr. Givens.
“This is not cause to celebrate,” he said of the announcement, adding that he had not intended to jeopardize Dr. Bauchner’s job. Nor will appointing a top editor of color resolve the issues, Dr. Givens said.
“Looking for just a person of color misses the point,” he added. “I’m more interested in a bold voice. I want somebody who is willing to take a stand, push to move things forward.”
The podcast that set the events in motion aired on Feb. 24 and did not include any Black researchers or experts on racism in medicine.
“Structural racism is an unfortunate term,” Dr. Livingston, who is white, said on the podcast. “Personally, I think taking racism out of the conversation will help. Many people like myself are offended by the implication that we are somehow racist.”
The podcast was promoted with a tweet from the journal that said, “No physician is racist, so how can there be structural racism in health care?” Following widespread protest in the medical community, the journal took down the podcast and deleted the tweet.
“Comments made in the podcast were inaccurate, offensive, hurtful and inconsistent with the standards of JAMA,” Dr. Bauchner said in a statement released a week later. “We are instituting changes that will address and prevent such failures from happening again.”
Dr. Livingston later resigned, and the A.M.A. placed Dr. Bauchner on administrative leave on March 25.
The JAMA family of journals added four new titles under Dr. Bauchner’s leadership, and expanded to include podcasts, videos and new, shorter article types. But critics noted that the journals rarely addressed structural racism in medicine, and more often published papers linking health disparities to socioeconomic or biological factors.
Dr. Bauchner’s exit offered the journals a chance to improve, said Dr. Mary Bassett, professor of the practice of health and human rights at Harvard University.
“Medical journals have helped build the racist idea that races have intrinsic differences that have a bearing on health,” Dr. Bassett said. Journals are “challenged to embrace, not only accept, racism as a health issue.”
Dr. Bauchner told The New York Times last month that JAMA had published “more than 100 articles on issues such as social determinants of health, health care disparities and structural racism over just the last five years.” He also noted that JAMA accepted only a tiny fraction of the manuscripts it had received.
He said in the statement on Tuesday that the journal would be better served by his resignation. “The best path forward for the JAMA Network, and for me personally, is to create an opportunity for new leadership at JAMA,” he said.
In an editorial published in JAMA on Tuesday, colleagues at the journal lauded Dr. Bauchner’s leadership, saying he “has left an indelible legacy of progress, innovation and excellence in medical journalism.”
The A.M.A. said it has begun a search for Dr. Bauchner’s replacement. The journal’s executive editor, Dr. Phil Fontanarosa, will serve as interim editor in chief.
Whoever the new editor may be, he or she will need to acknowledge the profound impact of structural racism on health outcomes for communities of color, Dr. Bassett said.
“Racism works in ways that are structural and not simply as the result of ignorant, misguided or even racist individuals,” she added. “As a new editor in chief is sought, there will be a chance for JAMA to lead in dismantling this idea. I hope they grab it.”