From the Editor-in-Chief

Microaggressions, Accountability, and Our Commitment to Doing Better

Author and Disclosure Information

© 2021 Society of Hospital Medicine

We recently published an article in our Leadership & Professional Development series titled “Tribalism: The Good, the Bad, and the Future.” Despite pre- and post-acceptance manuscript review and discussion by a diverse and thoughtful team of editors, we did not appreciate how particular language in this article would be hurtful to some communities. We also promoted the article using the hashtag “tribalism” in a journal tweet. Shortly after we posted the tweet, several readers on social media reached out with constructive feedback on the prejudicial nature of this terminology. Within hours of receiving this feedback, our editorial team met to better understand our error, and we made the decision to immediately retract the manuscript. We also deleted the tweet and issued an apology referencing a screenshot of the original tweet.1,2 We have republished the original article with appropriate language.3 Tweets promoting the new article will incorporate this new language.

From this experience, we learned that the words “tribe” and “tribalism” have no consistent meaning, are associated with negative historical and cultural assumptions, and can promote misleading stereotypes.4 The term “tribe” became popular as a colonial construct to describe forms of social organization considered ”uncivilized” or ”primitive.“5 In using the term “tribe” to describe members of medical communities, we ignored the complex and dynamic identities of Native American, African, and other Indigenous Peoples and the history of their oppression.

The intent of the original article was to highlight how being part of a distinct medical discipline, such as hospital medicine or emergency medicine, conferred benefits, such as shared identity and social support structure, and caution how this group identity could also lead to nonconstructive partisan behaviors that might not best serve our patients. We recognize that other words more accurately convey our intent and do not cause harm. We used “tribe” when we meant “group,” “discipline,” or “specialty.” We used “tribalism” when we meant “siloed” or “factional.”

This misstep underscores how, even with the best intentions and diverse teams, microaggressions can happen. We accept responsibility for this mistake, and we will continue to do the work of respecting and advocating for all members of our community. To minimize the likelihood of future errors, we are developing a systematic process to identify language within manuscripts accepted for publication that may be racist, sexist, ableist, homophobic, or otherwise harmful. As we embrace a growth mindset, we vow to remain transparent, responsive, and welcoming of feedback. We are grateful to our readers for helping us learn.


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