CHICAGO — The American Medical Association on Thursday issued a formal apology for more than a century of discriminatory policies that excluded blacks from participating in a group long considered the voice of U.S. doctors.

The apology stems from initiatives at the nation's largest doctors' group to reduce racial disparities in medicine — from the paltry number of black physicians to the disproportionate burden of disease among blacks and other minorities.

"The AMA is committed to improving its relationship with minority physicians and to increasing the ranks of minority physicians so that the work force accurately represents the diversity of America's patients," Dr. Ronald Davis, the group's immediate past president, said in a statement posted on the AMA's Web site.

Davis said that "by confronting the past we can embrace the future."

The apology comes more than 40 years after AMA delegates denounced policies at state and local medical societies dating to the 1800s that barred blacks. For decades, AMA delegates resisted efforts to get them to speak out forcefully against discrimination or to condemn the smaller medical groups that historically have had a big role in shaping AMA policy.

While the national organization didn't have a blatant policy against black doctors, physicians were required to be members of the local groups to participate in the AMA, Davis said in a phone interview.

"To the extent that our practices may have impeded the ability of African-American physicians to interact collegially with white physicians, it's conceivable" that patient care was harmed, Davis said. "That would certainly be another reason why we would have profound regret for our past practices."

Davis said he hopes the apology "will hasten healing between the AMA and our African-American physician colleagues so that we can create a better future for our patients, our communities and the medical profession."

The apology might seem belated, but it isn't the AMA's first for its discriminatory history. Dr. John Nelson, then AMA's president, offered a similar apology at a 2005 meeting on improving health care and eliminating disparities, sponsored by the government's Agency for Healthcare Research and Quality.

That came a year after the AMA joined the National Medical Association, a black doctors' group, and other minority doctors' groups in forming the Commission to End Health Care Disparities.

The new apology is a more formal acknowledgment of the AMA's embarrassing past, and is also part of the AMA's efforts to improve an image that in recent years has lost its luster. In many circles, the AMA is seen as a stodgy trade group focused on doctors' rather than patients' best interests.

Many black physicians applauded the AMA's move.

"It is true that what the AMA did historically was awful," said Dr. Otis Brawley, the American Cancer Society's chief medical officer. "There were AMA local chapters that actually had rules against black members well into the late 1960s, and policies that made blacks not feel comfortable well into the 1980s."

Brawley, who is black, said he's never been an AMA member, but that the apology "certainly makes me much more interested in working with them."

Dr. Nelson Adams, president of the National Medical Association, said the apology is courageous and "extremely important."

AMA's discriminatory actions hurt black doctors and kept many from working and caring for patients, Adams said. That's because in many places doctors couldn't work in hospitals unless they were members of local medical societies, he said.

He said there's evidence that black patients fare better when treated by black doctors, so these policies could have contributed to poor health care for blacks.

While blacks represent roughly 13 percent of the U.S. population, less than 3 percent of the nation's 1 million doctors and medical students are black, Adams noted.

And according to 2006 data on AMA's Web site, less than 2 percent of AMA members and voting delegates are black.

"We've got a lot of work to do," Adams said.

Dr. Monica Peek, a Chicago internist and member of the AMA and National Medical Association, said the apology "creates an open and healthy dialogue for addressing these issues" that black doctors have long been aware of.

But she said AMA's actions don't lessen the need for a separate group representing black doctors.

Addressing health disparities hasn't always been a part of AMA's mission "but it's something that has never been off of NMA's radar," Peek said.

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