Incoming JAMA editor says the journal’s issues handling race are ‘not unique to JAMA’

In her most pointed public comments since her selection as JAMA editor-in-chief, Kirsten Bibbins-Domingo acknowledged she had a visceral reaction to the podcast scandal that led to her predecessor’s departure. But ultimately, she wasn’t surprised.

“I would like to say I have never heard the types of sentiments that were expressed in the podcast, but those happen fairly commonly,” Bibbins-Domingo said during a Q&A with STAT Executive Editor Rick Berke at a Wednesday dinner honoring her and other members of the inaugural STATUS List at Fenway Park in Boston. “For me, the issues that were so prominent to place JAMA in the news were not surprising issues. They’re not unique to JAMA.”

Bibbins-Domingo, an internist, epidemiologist, and health-equity researcher, will be the first person of color to serve as editor-in-chief of the Journal of the American Medical Association when she starts on July 1. Howard Bauchner stepped down as editor-in-chief last June after JAMA aired a podcast in February 2021 questioning whether structural racism exists in health care and the organization posted a tweet reading, “No physician is racist, so how can there be structural racism in healthcare?”

Asked about her own experiences with structural racism, Bibbins-Domingo said, “I think for those of us who have identities who are not part of the main culture in science and medicine, it’s hard to pinpoint any specific signature event. I really do say that the structures have been designed historically to not necessarily be welcoming of everybody.”

Bauchner wasn’t part of the original podcast episode, but published a follow-up conversation in March 2021 with three esteemed Black scholars. In it, he asked questions including, “Do you have an idea of why the term racism is so charged for white people like me?”

“His response was really very remedial and disturbing,” STATUS List honoree Siobhan Wescott said at the event. Wescott, the first endowed professor and director of American Indian health at University of Nebraska Medical Center’s College of Public Health, said Baucher’s response led her to publish a public rant on Twitter for the first time. Bibbins-Domingo, asked if she had a similar response as Wescott, acknowledged that she did.

The Wednesday event was something of a who’s-who in the medical and life sciences world. Another honoree was Johns Hopkins University professor of epidemiology and oncology Otis Brawley, who chaired the JAMA editor selection committee that led to Bibbins-Domingo’s appointment, and New England Journal of Medicine Editor-in-Chief Eric Rubin.

Bibbins-Domingo said she didn’t think she would get the job, and the interviews were “some of the most intense” she had ever had.

Brawley said that Bibbins-Domingo immediately came to mind when the search committee was weighing who could take over a journal in the midst of an upheaval. But she had also been on Brawley’s radar for more than a decade — he said he was impressed by the way she dealt with politicians like the late Rep. John Dingell while serving on the U.S. Preventive Services Task Force.

“John Dingell was asking a lot of very tough questions of the U.S. Preventive Services Task Force practicing what I would call very orthodox science, the kind of stuff we need to do, as opposed to political stuff that’s not really science, but really political BS. Kirsten was incredibly good at dealing with these politicians,” Brawley said. “She could handle these folks. I’d love to see you handle a room of children.”

Bibbins-Domingo was named to the inaugural STATUS List for her work addressing health inequities in the U.S., including a paper she co-authored in 2021 that showed that Covid-19 hit California’s Latino population harder than any other group in the state, with immigrants and essential workers dying at the highest rates.

The Covid-19 pandemic, she said, has both highlighted and sometimes deepened medical mistrust. “Even the issues of equity that have been highlighted in the pandemic have led to narratives of ‘us’ and ‘them,’” she said. “I do think it is incumbent upon all of us, those who are publishing the outstanding science, those of us publishing about the life sciences, to constantly think through and challenge our own assumptions about the best way to communicate that.”

That work has already started at JAMA: All 13 of the publication’s specialty journals have named an equity editor, and the flagship journal is set to announce who will serve in that role soon.

Rubin said that he was looking forward to working with another “basic scientist” and learning from Bibbins-Domingo. He also offered one bit of advice for her: “Being a journal editor is a great way to make friends, until you reject their papers.”

Both JAMA and NEJM influence the way medicine is practiced in the U.S. But which one is best, Berke asked Bibbins-Domingo and Rubin — which journal is equivalent to car rental company Hertz, and which one is Avis?

“I’m going to duck that question, but say that, in 2010, Kirsten published her biggest paper in the New England Journal of Medicine,” Rubin replied, eliciting laughter and applause from the crowd.