CHICAGO —  The American Medical Association today urged medicine to address inequity and discrimination not only in interactions among physicians and patients, but also at the institutional level by exploring how policies and practices of health care institutions shape patients’ experience of health, illness, and care.

Members of the AMA’s House of Delegates voted to adopt guidelines addressing systemic discrimination in medicine including the use of stigmatizing language and policies and practices that are an obstacle to equitable care.

“To make meaningful progress in achieving equitable care, physicians must recognize how the pathologies of social systems impact their patients’ lives,” said AMA Board Member, David H. Aizuss, M.D. “The commitment to serve patients in need means that we have an obligation to examine prevailing attitudes, habits, policies, and practices that determine what care is available to who and to take steps to remove or re-engineer obstacles that undermine the ability to ensure equitable care for all.”

According to the newly adopted guidelines, physicians should:

• Cultivate self-awareness and strategies for change
• Recognize and avoid using language that stigmatizes or demeans patients in face-to-face interactions and entries in the medical record
• Use social history to capture information about non-medical factors that affect a patient’s health status and access to care to inform their relationships with patients and the care they provide
• Support one another in creating opportunities for critical reflection across the institution
• Identify institutional policies and practices that perpetuate or create barriers to equitable care
• Participate in designing and supporting well-considered strategies for change to ensure equitable care for all

The guidelines also recommend that hospitals and other health care institutions:

• Support efforts within the institution to identify and change institutional policies and practices that may perpetuate or create barriers to equitable care
• Engage stakeholders to understand the histories of the communities they serve and recognize local drivers of inequities in health and health care
• Identify opportunities and adopt strategies to leverage their status within the community to minimize conditions of living that contribute to adverse health status

“Neither individual physicians nor health care institutions can entirely resolve the problems of discrimination and inequity that underlie health disparities, but they can and must accept responsibility to be agents for change,” said Dr. Aizuss.

Through research, collaborations, advocacy, and leadership, the AMA believes in supporting system-level solutions and identifying and addressing root causes of health inequities while elevating their importance to patients, communities, and stakeholders. In late May, the AMA and other partners launched its Rise to Health Coalition which aims to unite individuals, organizations toward making health equity actionable and work collaboratively to advance optimal health for all.