The Medical Sisterhood: Advocacy and Systemic Change, With Kristi Hawley, DO

Welcome to The Medical Sisterhood!

The first episode of The Medical Sisterhood in January 2026 opens with a candid and timely conversation about advocacy, autonomy, and the quiet breaking points many women physicians experience within modern medicine. Hosted by Mona Shahriari, MD, of Yale School of Medicine, the episode features Kristi B. Hawley, DO, founder and owner of The Derm Institute of West Michigan, whose journey as a dermatologist, practice owner, and physician advocate offers a powerful lens into the systemic challenges facing clinicians today.

Rather than framing the new year around resolutions or productivity goals, Shahriari sets the tone by addressing a reality familiar to many women in medicine: the feeling that January simply brings renewed pressure from a system that continues to demand more while offering less control. Hawley shares how her own advocacy journey began not from ambition, but from frustration and moral distress early in her career. After joining a practice where patient care conflicted with her values, she describes the emotional toll of witnessing care that felt misaligned with her ethics, and the sleepless nights that followed.

Opening her own practice in 2019 provided a degree of autonomy, but Hawley quickly realized that independence alone did not shield her from larger systemic forces. Insurance barriers, pharmacy benefit managers, reimbursement cuts, and corporate medicine continued to dictate patient access to care, often leaving physicians blamed for decisions they do not control. This realization marked a turning point, pushing Hawley to move beyond venting privately and toward advocacy at the state and national levels.

Throughout the conversation, Shahriari and Hawley unpack the misconception that physicians are the primary drivers of rising healthcare costs, noting how patients often perceive doctors as gatekeepers rather than allies. Both emphasize the importance of patient advocacy alongside physician advocacy, highlighting how patient voices can resonate more strongly with lawmakers than professional lobbying alone. Their shared experiences working with dermatology advocacy organizations underscore the power of bringing patient stories directly to Capitol Hill.

The episode also explores the gendered dynamics of advocacy. Hawley reflects on how women are often socialized to remain agreeable and quiet, and how speaking assertively, whether in the exam room or legislative settings, can be perceived differently when voiced by women. She candidly discusses the confidence it took to overcome fears of being labeled “too loud” or “difficult,” emphasizing that advocacy does not require aggression, but does require persistence and self-trust.

Importantly, the discussion demystifies advocacy by addressing its “unsexy” realities. Hawley shares how political engagement is often slow, frustrating, and deeply influenced by financial power. Still, she stresses that small actions, joining professional organizations, donating modestly to PACs, responding to advocacy emails, and participating in state-level efforts, can collectively drive meaningful change.

As the episode closes, both physicians underscore that burnout is not always about workload, but about powerlessness. Advocacy, even in small forms, can restore a sense of agency and purpose. Hawley leaves listeners with a resonant message: there is more than one seat at the table, and progress depends on women lifting one another rather than competing. Together, Shahriari and Hawley reaffirm The Medical Sisterhood’s mission—to create space for honest dialogue, shared strength, and collective action among women physicians.

Editor’s note: This summary was edited with the help of AI tools.

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