To the Editor:

Since March 2020, the COVID-19 pandemic emphasized inequities in the USA, health care systems, and even within ourselves. Identifying and acknowledging the problem are critical first steps. But how do we tackle a complex problem so deeply entrenched in society?

It is difficult to care for others when we cannot care for our own, especially ourselves. This care has been particularly challenging for Asian American physicians. While we acknowledge the potential limitations and inaccuracies in these terms, for the purpose of brevity, Asian, Asian American, and Asian American Pacific Islander (AAPI) will be used interchangeably to refer to the Asian and Pacific Islander diaspora. The rise of anti-Asian hate during COVID-19 increased for both the general public and health care workers. In fact, even before the pandemic, AAPI physicians were more than twice as likely to experience bias, harm, and discrimination by patients and coworkers than their White counterparts [1]. While the AAPI community is often not considered an underrepresented minority group in medicine, as they comprise 17% of the physician workforce, they often receive minimal consideration in diversity, equity, and inclusion (DEI) efforts [2]. It is important to note that if the AAPI umbrella data can be disaggregated, we would almost certainly uncover underrepresentation among many ethnic groups. Given the high rates of bias, harm, and discrimination faced by AAPI health care workers, it is imperative that their voices are included in the DEI space. Furthermore, AAPI physicians are underrepresented in academic leadership positions [3].

Peer support groups, also known as affinity groups, are often an untapped opportunity, largely due to their “small size and private nature,” and may be part of the solution [2]. Working in a large academic department, it is challenging to create connections between colleagues, especially during COVID-19 and a virtual world. But challenges also create opportunities for innovation and growth. Affinity groups are difficult to study due to their nature, yet in the business world, it is largely accepted and known that groups can “build and scale empathy at a faster rate than anything else” [4].

At the MedStar Georgetown University Hospital Department of Psychiatry, we capitalized on this opportunity as AAPI faculty grappled with long-standing institutional structural racism and the rising anti-Asian sentiments around the USA. Some of us also are separated from family overseas. With these additional weights to carry, we desperately needed to be seen, heard, and understood. For these reasons, the AAPI Faculty Affinity Group for psychiatrists and psychologists in our department was created with support from the American Academy of Child and Adolescent Psychiatry’s AAPI caucus and inspiration from another minority affinity group in the department. Leadership fully supported the formation of the group, as DEI initiatives in the department already were among top priorities. To our knowledge, this is the first group of its kind in an academic psychiatry setting.

The nine faculty members who identified as members of the AAPI community were contacted by email in summer 2021, asking them to invite any other faculty within the department whom the organizers may have inadvertently missed. All nine reported interest in coming together to form a new affinity group. The final size of the group was 11, including the authors. At the inaugural meeting, held about a year after some of the faculty had joined the department, many shared it was the first time they were meeting someone in-person from work. The group identified that establishing community and making connections were the most important activities, followed by learning and processing, then professional development. Key words shared by the group included connection, friends, and community.

Group formation is not without its challenges. According to the Tuckman model [5], there are four stages: forming, storming, norming, and performing. In our first year, we stayed in the “forming” phase, as we explored the history of AAPI in America together and also with the department, through a department learning session. We began discussions with Georgetown’s Black Faculty and Staff Association for future collaboration, community building, and solidarity. No group is truly complete without socialization, which remained difficult to do frequently in the first year, due to surges in COVID-19 cases.

As we enter our second year, our aims include expanding membership to staff and trainees, gaining financial support to help facilitate faculty development and community, establishing local affinity group collaborations, and increasing national networking. We believe that these will help sustain our group moving forward. We expect that during a growth phase we will not only encounter differences in management styles and preferences but also we can use those challenges to elevate us into norming and performing.

While formal feedback has not been elicited, many members have noted that this group has created a safe space. Safety was established by having meetings outside of work, discussing confidentiality, and offering multiple ways to share ideas (e.g., by email or text, during meetings, one-on-one between members). When DEI efforts in the department have arisen, faculty have felt that this group was a place to discuss them openly without fear of negative consequences. In the future, we anticipate eliciting more formal feedback. Additionally, we hope that our group can serve as a model for other groups both within and outside of our institution. Thus, we have been connecting with members of the larger Georgetown University AAPI community and national-level organizations.

Humans are social creatures, and psychiatrists and psychologists think about socialization routinely. As academic psychiatrists and psychologists, we are optimally positioned among health care workers to promote wellness through social belonging. Creating a space through affinity groups for the element of community and collectivism can be a monumental step toward what all people need: to be known, heard, and validated. In this way, we can help pave the path toward a more understanding and equitable system and healthier future. So how do we tackle a problem so monumental? Proverbial wisdom suggests, “If you want to go fast, go alone; if you want to go far, go together.”