Racism manifests in several forms—internalized, interpersonal, subversive, and institutionalized among them. The constructs that define and guide the various professional membership and honorific societies that constitute organized medicine in this country are not immune from harboring any, if not all, of these expressions of discrimination. Addressing structural bias and inequity at the organizational level requires authenticity, committed leadership, and transparent acknowledgement of transgressions both past and present. This commentary touches upon what “calling the question” must look like.

Protests against social injustice, initially dominated by African Americans, have evolved and now encompass a multigenerational mosaic. Although many of the demands are directed at our governing institutions, there is a growing resolve to expunge racism from all of our institutions of power, including our academic health centers. This is to be expected because health care systems, including academic medical centers, are microcosms of society, and there is a growing realization that they have both been complicit and have the capacity to address the shameful health inequities that persist in our country.1 The blame and expectation are justified. There are many examples of bias and discrimination in the history of academic medicine. At the same time, they are tremendously influential and can control the narrative that informs the practice of medicine, as well as refocus the training of physicians on the social aspects, as well as the biology of medicine. Slavery is largely responsible for a legacy of racism and injustice that directly affects medicine, as well as other social institutions.2 Recognizing the harm to patients that results from discrimination and racism, addressing racial injustice, and shielding vulnerable patients from harm better informs the meaning of “equitable” among the accepted components of health care quality.

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