The Medical Sisterhood: The Hidden Cost of Being the Compassionate Doctor, With Lisa Swanson MD

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In this May episode of The Medical Sisterhood podcast, host Mona Shahriari, MD, associate clinical professor of dermatology at Yale University and practicing dermatologist in Connecticut, is joined by Lisa Swanson, MD, a dual board-certified dermatologist and pediatric dermatologist at Ada West Dermatology and St. Luke’s Children’s Hospital in Boise, Idaho, for a candid discussion on representation, emotional labor, physician identity, and the unique interpersonal dynamics of pediatric dermatology.

Framed around both Mental Health Awareness Month and Women’s Health Month, the conversation explores the impact female physicians can have on young girls simply through visibility and leadership. Swanson reflects on growing up surrounded by women in medicine, including her aunt, a pediatrician, and her own female physicians, whom she credits as early inspirations for her career path. She and Shahriari discuss the importance of representation in shaping what young women perceive as possible for themselves, particularly in medicine.

Swanson also recounts her unexpected path into pediatric dermatology, explaining that she discovered the specialty during residency and quickly realized she felt happiest while working in pediatric dermatology clinics. The discussion highlights how exposure and mentorship within training environments can significantly influence career trajectories, especially given that many dermatology residency programs still lack dedicated pediatric dermatology exposure.

A major focus of the episode centers on the emotional complexity of pediatric dermatology. Swanson discusses the profound psychosocial burden associated with chronic pediatric skin diseases such as atopic dermatitis and alopecia areata, emphasizing that these conditions affect not only children but entire families. She describes the sleep disruption, guilt, anxiety, and uncertainty many parents experience, particularly when confronting visible conditions that may affect a child’s self-esteem and future social experiences. Shahriari and Swanson underscore the importance of allowing sufficient time during visits to address not only clinical management but also emotional support and counseling.

The conversation then shifts toward the broader expectations placed on women physicians. Shahriari and Swanson discuss the double standards female clinicians often navigate, particularly the expectation to remain endlessly empathetic and emotionally available while simultaneously maintaining authority and expertise. Swanson reflects on the difficulty of advocating strongly for patients or professional goals without being labeled negatively, contrasting these perceptions with how similar behaviors are often interpreted in male colleagues.

Both physicians also discuss the internal pressures many women physicians place upon themselves, including perfectionism, overcommitment, and the challenge of balancing professional ambition with personal wellbeing. Swanson introduces the concept of “eldest daughter syndrome,” describing how early family dynamics may contribute to high-achieving tendencies, emotional caretaking, and anxiety among many women in medicine.

Throughout the discussion, the two physicians repeatedly return to the joy and perspective children bring into clinical practice. Swanson shares how pediatric patients often remind physicians to appreciate humor, curiosity, and presence in everyday life, even amid difficult diagnoses. The episode concludes with reflections on the lasting impact physicians can have on young patients, with Swanson recalling a pediatric alopecia areata patient who later asked whether she, too, could become a dermatologist one day.

Editor’s note: This episode was produced with the help of AI tools.

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