What Are the Invisible Burdens Carried By Physician Moms?

In a recent episode of The Medical Sisterhood podcast, Mona Shahriari, MD, assistant clinical professor of dermatology at the Yale School of Medicine, sat down with Jennifer L. Hsiao, MD, a dermatologist and clinical associate professor of clinical dermatology at Keck Medicine of the University of Southern California, for a candid, clinician-focused discussion on the “invisible load” carried by physician mothers, and how it intersects with high-acuity dermatologic practice.

The conversation moved beyond surface-level work-life balance tips and into the cognitive realities of dual roles: managing complex dermatologic disease while simultaneously running a household. Shahriari opened by naming what many clinician mothers experience but rarely articulate. In addition to diagnosing hidradenitis suppurativa (HS), adjusting biologics, managing portal messages, and keeping clinic flow on track, there is an ever-running mental checklist in the background; school forms, snack logistics, summer camp registration, call schedules, and family appointments.

She noted that physician mothers are often so high-functioning that their exhaustion is invisible to colleagues and patients alike. Hsiao reflected that while she is fully present when inside a patient room, listening intently, formulating management plans, and making therapeutic decisions, it is the transitional moments between patients where cognitive overload surfaces. She likened her brain to an internet browser with multiple open tabs: clinical trial responsibilities, patient care follow-ups, children’s schedules, seasonal planning, and routine medical and dental appointments.

The fragmentation is less about lack of focus and more about relentless context switching. Importantly for practicing clinicians, Hsiao highlighted the activation energy required to move between domains. Once the brain shifts from clinic mode to personal logistics, it can be difficult to recalibrate. Ironically, she noted that back-to-back patient visits sometimes feel easier because there is no opportunity for mental drift. The “lull” moments, when one checks email or text messages, can derail efficiency and compound stress.

The discussion also touched on sleep and anticipatory planning. Shahriari referenced data suggesting that women, particularly mothers, often engage in active next-day planning at bedtime—contrasting with male sleep patterns that may involve less cognitive processing. Both physicians described difficulty fully “shutting off,” frequently waking at night attuned to their children’s needs. The physiological hypervigilance, whether biologically driven or socially conditioned, contributes to chronic fatigue.

A central theme was the persistent sense of underperformance. Hsiao candidly shared that she often feels behind at work, with unanswered emails, administrative tasks, research obligations, while simultaneously describing occasionally not feeling present at home. The tension is particularly acute when children explicitly call attention to divided attention, such as asking a parent to put down a phone. For high-achieving physicians accustomed to excellence, perceived mediocrity in either domain can be psychologically distressing.

Shahriari emphasized that common advice to “be present” lacks actionable guidance. In response, she described implementing structured boundaries: dedicating a protected window from 5 to 7 pm exclusively to her child, limiting phone access to urgent contacts, and deferring noncritical communications. While not flawless, the structure provides psychological containment. However, Shahriari acknowledged the tradeoff: deferred work often encroaches on sleep, illustrating that balance frequently involves redistribution rather than elimination of strain.

For clinician audiences, the exchange underscores several key takeaways: cognitive load management is a professional competency issue; context switching carries efficiency costs; and intentional boundary-setting, though imperfect, may mitigate burnout. The conversation reframes physician-mother stress not as individual inadequacy but as a structural reality of modern medical practice.

Ultimately, Shahriari and Hsiao model transparent dialogue about the dual demands placed on physician mothers, an approach that may help normalize these experiences within academic and clinical dermatology.

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