It has been a sobering and difficult couple of weeks in the aftermath of the killing of George Floyd. His killing, captured in a graphic and horrifying video, was followed by peaceful protests and destructive riots both of which rightfully shook our state’s, and our country’s, arrogant claims of exceptionalism. Early claims by state and local leadership that the destruction and looting were the primary result of “outsiders” provided an easy excuse to avoid looking at ourselves. But let’s be honest – bigotry, oppression, and racism exist in Minnesota. And, no, it is not just a “city” or “urban” problem – these behaviors can be found in every community in our state and across the country. Will this time be different? Will, as his 6-year daughter Gianna said, George Floyd change the world?
The MMA was founded, in part, to “…improve health and protect the lives of the community.” That same goal exists today as part of the MMA’s mission to, “make Minnesotans the healthiest in the nation.” Historically, physicians and the MMA have worked to improve health and protect lives by championing excellence in clinical care and by advocating for traditional public health interventions where the threat was most obvious – clean air and water, vaccinations, tobacco control, nutrition, exercise, seat belts, helmets, etc. More recently, the MMA declared gun violence a public health crisis.
The MMA has also been committed to addressing Minnesota’s persistent and pernicious racial and ethnic health disparities and has begun efforts to increase the number of African American men entering medical school. To be honest, however, we count the MMA among those organizations that have spent more time talking about and analyzing the problems of health disparities and less time combatting much of the root cause (systemic racism) or demanding change in our society.
Disparities in health are familiar to all of us – consider differences in mortality rates, birth outcomes, suicide, and COVID-19 infections, to name just a few. Yet these are largely the sequelae of long-standing, institutionalized racism – historic discrimination and bias in housing, employment, education, and more.
So where do we go from here? We must all do the work to dismantle the legacies and policies that enable racism and bias, and we must dedicate ourselves to rooting it out of our health care organizations. As individuals and as members of our Minnesota medical profession, we need to listen; we need to hear from those voices that express how simply being Black, Indigenous, Hispanic, or another person of color too often challenges their ability to attain their full potential as human beings. We need to seek out ways that the strength and influence of physicians’ voices can make a difference.
We must all look critically at how our clinics, hospitals, medical staffs, and professional organizations are contributing to making the necessary changes:
- Do diversity and inclusion policies exist and, more importantly, are they activated and lived out in behaviors?
- Do we have policies to reject racism by patients to protect medical and non-medical staff from abuse?
- Do our organizational leaders promote an anti-racism culture and reflect and amplify the values of inclusion and equity?
- Do we fully utilize the expertise and experience of our minority colleagues?
- Do we honestly assess policy change that questions the status quo?
- Do we invoke a “health equity timeout” to examine whether new policies and practices advance or stifle progress?
- Do we recognize the lived experience of racism, microaggressions, and social determinants as risk factors for disease?
- How do we reveal and resolve our explicit and implicit biases in the care of patients and the conduct toward our minority colleagues?
- As individual members of society, have we ever projected blame for police brutality on the victims?
If we look back and examine ourselves, it should not have taken worldwide protests to come to this point. After all, what happened to George Floyd, sadly, is not new. As physicians we are leaders in our communities, and we need to be an integral part of these solutions. It is, and always has been, our role as physicians to speak up for those whose voices are not heard.
With humility, we call for an end of observing the problem. Now is the time to act! We have called upon our Policy Council, Public Health Committee, and Health Equity Advisory Committee to work together to identify both urgent short-term and long-term additional actions the MMA must take. Please
share your thoughts, ideas, and recommendations for their consideration. On behalf of the MMA, we will listen, learn, and leverage our capacity to make a bigger difference. Please help us realize our goal to make Minnesotans – ALL Minnesotans –the healthiest in the nation so that all Minnesotans can realize the liberties guaranteed to us all.
Keith Stelter, MD, MMA President
Randy Rice, MD, MMA Board Chair
Dionne Hart, MD, MMA Board Member and CO-Chair, MMA Health Equity Advisory Committee
Janet Silversmith, MMA CEO