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Brian Williams, MD, a trauma surgeon and professor at the University of Chicago Medicine, was on duty at Dallas's Parkland Hospital in July 2016 when a black sniper shot 12 police officers, five fatally.

The shooting happened during a Black Lives Matter protest that was sparked by the death of two other black men killed days earlier by police officers: and .

Williams found himself condemning the Dallas shootings during a a few days later -- and now he strongly believes that it's a "moral imperative" for physicians to speak out against discrimination and police brutality.

But that doesn't mean physicians need to take to the streets with signs.

The actions of a single police officer have had international repercussions, said Williams, speaking of George Floyd's death in Minneapolis on May 25.

"Now, imagine one person doing something like that, but it has positive impact. Anyone can have an impact if they recognize the power of their voice. So, those of us that are in positions of stature ... we should use that power for good," he said.

Power to Change Practice

Anthony Chin-Quee, MD, a locum tenens otolaryngologist and author in Los Angeles, recalled a white friend who apologized for not acknowledging that the unequal treatment Chin-Quee endured as a resident wasn't in his head.

Because his friend was also a resident at the time, he was afraid of being penalized "for saying what was right."

Instead of forgiving his friend or shrugging off his apology, Chin-Quee asked his friend to "tap into" his own discomfort.

Now that he's an attending in a "seat of power," Chin-Quee said he told his friend, "you need to make the decision to engage your colleagues in a way that makes you and them feel uncomfortable."

Without setting that precedent, Chin-Quee warned, he's perpetuating the same experiences that made him feel so ashamed as a resident.

No matter how much leaders and organizations focus on sending the right messages and building diversity initiatives, "you're welcoming them to a hostile environment, if you don't ... recognize how much power you have and how much power you might need to give up," to make medicine a profession that values minorities' lives and experiences, Chin-Quee said.

Ed McDonald IV, MD, of the University of Chicago Medicine, champions change in another way.

A trained chef, McDonald teaches healthy nutrition in the communities he serves as a "productive form of protest," as he put it. He also lobbies his local representatives about passing bills to increase access to dietitians.

Black people have an increased risk of dying from hypertension, high blood pressure, and from obesity, and his work helps to address those disparities, he said.

However, McDonald also believes that street protests "definitely have value" and he's pleased to see them growing more diverse. "I think it's more powerful for non-black people to protest," he said.

The world should already know that black people are upset, so it's more meaningful for people to see that others share that anger, McDonald explained, because that's how solutions are found.

Ernest Grant, PhD, RN, president of the American Nurses Association, said nurses "have the opportunity and the responsibility to use our voices to call for change."

In a issued last week, Grant pointed to the "unjustified killings" of not only Floyd but also and .

"To remain silent is to be complicit," Grant said in his statement, while calling on his colleagues to educate themselves and others about "the systemic injustices" inciting protests around the country.

Those nurses who choose to protest should do so peacefully, he said, but another way nurses can protest without physically joining one is to leverage their vote in November.

Grant encouraged his colleagues to vote for candidates who could provide solutions to ongoing inequities and racial injustices.

Denouncing bigotry and prejudice should be easy, said Alden Landry, MD, MPH, assistant professor of emergency medicine at Beth Israel Deaconess Medical Center in Boston, but for some organizations it hasn't been.

Where he expects organizations to struggle the most is in trying to "put money where their mouth is," he said.

Those that are really committed will develop anti-racism training, find ways to create more diverse leadership, and work to address gaps in wealth, education, employment, and health insurance in their community.

Otherwise institutions are just paying lip-service and finding ways to "make ourselves feel good."

More from Organized Medicine

During its annual meeting on Sunday, the American Medical Association issued a statement denouncing police brutality and "pledged action to confront systemic racism." This was issued in addition to an initial .

But as Patrice Harris, MD, outgoing president of the AMA, told 番茄社区, "we have to move beyond just talking about it and ensure that there's accountability to action."

Harris, who is black, also stressed the need to "get comfortable with uncomfortable conversations."

"If people aren't uncomfortable [and] aren't willing to look at their own internal biases ... I will submit to you that we really aren't doing the work."

Aletha Maybank, MD, MPH, the AMA's first chief health equity officer, said at a recent "town hall" sponsored by the group that people and organizations "need to look internally" to move forward.

"There's still a lot of reconciling of our past that we need to really do as AMA," and other medical organizations as well, in order to confront racism.

In 2008, for decades of excluding black physicians. It that the group took a clear stance against state and local medical societies' bans on black members.

Because for many people this may be a "new space," Maybank pointed her colleagues to the AMA's " page that, among other things, lists strategies for developing "anti-racist" practices and policies.

"We need to name and call out racism" and to amplify that message that "racism is a public health threat," she said.

With regard to COVID-19, the AMA has also advocated for better data collection, to learn "who's getting sick and the reasons why."

It isn't just underlying medical conditions but also "underlying social conditions," including where people live, the kinds of jobs they hold, and their reliance on public transportation, that impact illness.

"We know black communities and Latinx communities in certain places .... have more likelihood to have to go to work and be essential workers during this time and that created greater exposure," she said.

Maybank also encouraged physicians to speak to their patients about how racism affects them.

Seeing a public murder, she said, alluding to Floyd's death, whether as a bystander or on TV, is a negative experience for people.

"The conversation is critical," she said. "The commitment is critical."

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