Tiffany Mayo, MD, FAAD

Leadership in medicine rarely comes with a manual for what happens outside the clinic. In this segment of the 

, Tiffany Mayo, MD, associate professor at the University of Alabama at Birmingham who will soon join UT Southwestern in Dallas, joined host Mona Shahriari, MD, associate clinical professor of 

 at Yale University, to discuss 2 of those unspoken challenges: protecting personal boundaries and navigating what it means to represent more than yourself.

How Women of Color in Medicine Navigate Representation Pressure

Shahriari and Mayo discussed how expectations around availability have shifted in medical education, with mentees increasingly expecting immediate responses regardless of personal or professional demands on a mentor's time. Mayo said she has learned to communicate response-time expectations clearly to trainees, recognizing that other people's sense of urgency does not have to become her own. She said failing to set these boundaries can compromise a mentor's ability to meet their own professional goals while supporting others.

Does Representation Pressure Feel Different for Women of Color in Medicine?

Shahriari asked Mayo whether pressure to conform feels heightened for women of color, given concerns about losing standing in professional spaces. Mayo said that pressure is real, since women of color in medicine often feel they represent broader communities and organizations rather than only themselves. She said she has come to view her presence in leadership spaces as an opportunity to contribute a distinct perspective rather than default to agreement, citing dermatologist Steve Daveluy, MD, whose own textured hair experience shapes how he approaches patients with similarly textured hair, as an example of how lived experience adds irreplaceable value.

How Does Authenticity Intersect With Professional Expectations?

Mayo also reflected on adapting her appearance, including straightening her hair for residency interviews, to align with perceptions of professionalism at the time. She said such adjustments do not necessarily compromise authenticity, but reflect cultural norms placed on those outside a profession's dominant group. Mayo said that while some adaptation may occur, staying true to one's core values and voice once seated at the table remains non-negotiable.

Editor’s note: Neither speaker had any relevant disclosures of note. This episode was summarized with the help of AI tools.

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Shahriari M, Mayo T. The Medical Sisterhood: The Pressure of Representation, With Tiffany Mayo, MD. HCPLive. August 13, 2026. Accessed August 21, 2026. 

https://www.hcplive.com/view/medical-sisterhood-pressure-representation-tiffany-mayo-md

Videos

This segment of The Medical Sisterhood podcast highlights setting boundaries in mentorship and the pressure of representation for women of color in medicine.

Mayo said different versions of oneself naturally emerge across settings, but they become unsustainable if they stop feeling authentic to core values.

Growing visibility as a leader can bring added self-consciousness, even for physicians who don't yet feel ready for that level of influence.

Mayo said boundary-setting becomes essential as expectations rise with visibility, and that leaders who stay committed to their purpose tend to be extended grace.

Tiffany Mayo, MD, associate professor at the University of Alabama at Birmingham who will soon join UT Southwestern in Dallas, discussed the pressure of visibility that comes with leadership in medicine during a segment of her conversation with host Mona Shahriari, MD, associate clinical professor of 

 at Yale University, on the latest episode of 

Shahriari opened the discussion by reflecting on a moment after giving a national conference talk when attendees approached her with personal career questions rather than questions about her presentation topic. She said the experience made her realize that physicians have something to offer others at every career stage, even when they do not yet feel ready for that responsibility, and that growing visibility can also bring added self-consciousness about how one is perceived.

How Boundary-Setting as a Physician Leader Can Be Challenging, With Tiffany Mayo, MD

Do Physician Leaders Present Different Versions of Themselves in Different Settings?

Mayo agreed that leadership often comes with an awareness of being watched, and said this pressure has evolved for her over time. She explained that presenting an inauthentic version of oneself on stage or on camera becomes unsustainable, and that different versions of a person naturally emerge depending on the setting rather than representing a performed character. Mayo said the key is ensuring that every version stays grounded in the same core values, mission, and morals, which prevents leadership from feeling like role-playing.

Why Is Setting Boundaries Difficult for Visible Physician Leaders?

Shahriari and Mayo also discussed how visibility can make physicians feel they are not permitted ordinary human moments, such as having an off day or declining a request. Mayo said rising expectations that accompany leadership make boundary-setting essential, describing it as an ongoing area of personal growth. She said advocating for her own needs, just as she would advocate for patients, can feel risky, but noted that people tend to extend grace to leaders who remain visibly committed to their broader purpose, even when they occasionally fall short.

Shahriari M, Mayo T. The Medical Sisterhood: The Pressure of Representation, With Tiffany Mayo, MD. HCPLive. August 13, 2026. Accessed August 18, 2026. 

Tiffany Mayo, MD, reflects on the pressure of visibility in medical leadership and why boundary-setting becomes essential.

Tiffany Mayo, MD, associate professor at the University of Alabama at Birmingham who will soon join UT Southwestern in Dallas, joined host Mona Shahriari, MD, associate clinical professor of 

 podcast to discuss what she called the pressure of representation that comes after becoming a leader in medicine.

, said she initially envisioned herself as a mentor for nontraditional medical students, but was surprised when established colleagues began reaching out to admire her work. She said the experience felt intimidating because she had not yet reached what she once imagined leadership should look like, before realizing that mentorship is rooted in the ongoing process of growth rather than a fixed destination.

The Medical Sisterhood: The Pressure of Representation, With Tiffany Mayo, MD

How Does Leadership Change the Way Physicians Present Themselves?

Mayo and Shahriari discussed how visibility changes self-presentation, describing different professional versions of themselves that emerge depending on the setting. Mayo said these versions only become unsustainable when they stop feeling authentic, and that staying grounded in core values across situations prevents leadership from feeling like a performance.

Why Do Physician Leaders Struggle to Set Boundaries?

The conversation turned to boundaries, with both physicians acknowledging the discomfort of saying no as expectations grow alongside visibility. Mayo said protecting personal time is an ongoing challenge, particularly when mentees treat their own urgency as universal, and stressed the importance of communicating response-time expectations clearly.

How Does Representation Pressure Differ for Women of Color in Medicine?

As women of color active in the Skin of Color Society (SOCS), Mayo and Shahriari discussed the added pressure of representing broader communities, not just themselves, in professional spaces. Mayo said she has learned to view her presence at decision-making tables as an opportunity to offer a distinct perspective rather than conform, adding that authenticity, including physical self-presentation, becomes a marker of genuine comfort in leadership.

Mayo T, et al. Skin of Color Savvy: HS Management in Skin of Color, with Tiffany Mayo, MD, Steven Daveluy, MD, Jasmine Ivanna Espy. HCPLive. May 12, 2025. Accessed August 13, 2026. 

https://www.hcplive.com/view/skin-of-color-savvy-hs-management-skin-of-color-tiffany-mayo-md-steven-daveluy-md-jasmine-ivanna-espy

Podcasts

Tiffany Mayo, MD, discusses the pressure of representation in medical leadership, setting boundaries, and staying authentic as a woman of color.

Skin of Color Savvy: The Art and Science of Treating Patients of Color

Skin of Color Savvy: Live at RAD 2025 with Tiffany Mayo, MD, and Raj Chovatiya, MD, PhD

In this special on-site episode of Skin of Color Savvy: The Art and Science of Treating Patients of Color, by the 

, dermatologists Raj Chovatiya, MD, PhD, and Tiffany Mayo, MD, engage in a wide-ranging discussion on atopic dermatitis in skin of color, recorded live from the 

2025 Revolutionizing Atopic Dermatitis (RAD) Conference

 in Nashville, Tennessee. Together, the 2 leading voices in dermatology examine diagnostic challenges, patient communication, and the future of topical therapy—offering both clinical insights and actionable strategies for improving care across diverse skin tones.

The conversation begins with an exploration of diagnostic disparities in atopic dermatitis. Mayo highlights how historical underrepresentation of skin of color in dermatologic imagery, along with erythema being a primary clinical feature, contributes to delayed diagnosis in patients with richly pigmented skin. Chovatiya echoes this, noting the visual bias in dermatology and the importance of rethinking severity grading in atopic dermatitis, which often relies on erythema not easily visible in darker skin. Both clinicians emphasize that postinflammatory pigment alteration—especially hyperpigmentation—is not only common in patients of color but often more distressing to patients than the disease itself.

The episode stresses the importance of eliciting patient priorities during consultation. Mayo urges clinicians to directly ask, “What bothers you most?” as pigment changes may be more concerning to patients than active eczema. She also outlines counseling strategies to clarify that medications aren’t the cause of pigment alteration, but rather the disease itself, helping to maintain treatment trust and adherence.

The discussion transitions into clinical pearls for differentiating atopic dermatitis from its mimickers—particularly in darker skin tones. Mayo shares her use of dermoscopy to enhance diagnostic accuracy in cases where morphology is subtle, while Chovatiya recommends palpation as a basic but powerful tool. Both caution against under-recognizing active disease in richly pigmented skin and recommend incorporating validated patient-reported outcome measures like POEM scores to capture disease burden when visual cues are misleading.

As the discussion turns to treatment, the hosts spotlight the growing role of targeted, nonsteroidal topical therapies. Mayo outlines her real-world use of agents such as tapinarof, roflumilast, and ruxolitinib, citing their long-term safety, tolerability, and usefulness across diverse presentations. She emphasizes that simple regimens, monotherapy when possible, and flexible formulations (such as foams) are key to promoting adherence, especially among patients with textured hair, facial involvement, or sensitive skin.

Chovatiya highlights the inclusivity of recent clinical trials, particularly for tapinarof, noting their deliberate enrollment of racially diverse participants and design parameters that more closely mimic real-world behavior. Data from long-term extension studies show that even with intermittent use, patients can maintain control of their disease—an important message for busy individuals who struggle with daily application. Roflumilast and ruxolitinib offer similarly flexible maintenance strategies, supporting proactive or as-needed regimens that match the heterogeneity of atopic dermatitis in the real world.

The episode closes with a mutual call for “intentionality” in atopic dermatitis care: in diagnosis, treatment selection, trial design, and patient communication. Mayo reminds listeners that patients of color may not exhibit textbook signs, making it essential to gather layered diagnostic data and engage patients around their lived experiences. Chovatiya reinforces that clinicians must recognize the multidimensional nature of atopic dermatitis—its signs, symptoms, comorbidities, and psychosocial burden—and approach every patient with individualized, culturally responsive care.

To learn more about SOCS’s mentorship programs and initiatives, visit 

Editor’s note: This podcast summary was edited through the use of artificial intelligence tools.

Leading experts discuss managing atopic dermatitis in skin of color in a live recording from the 2025 Revolutionizing Atopic Dermatitis Conference. 

Tiffany Mayo, MD, FAAD

Articles