By Lauren Gelman, Content Marketing Manager, Editorial at Zocdoc
The drive is the worst. For Kandis Daroski, a mom of three in the rural Midwest, it’s a minimum 30-minute slog each way for every well visit, dental check-up, and sudden toddler sickness. And she finds herself dealing with this (multiplied by five people!) several times a month.
Welcome to healthkeeping: the invisible project management of household healthcare.
“Healthkeeping is the physical, mental, and emotional labor required to make sure people are getting the care they need,” says Megan Ranney, MD, MPH, FACEP, an emergency physician and Dean of the Yale School of Public Health. “Keeping track of appointments, medications, vaccinations: All of it has to be held in someone’s brain, and for many reasons, it’s usually a woman’s.”
On the Zocdoc platform, three in four appointments made for someone else were booked by women. A separate Zocdoc research survey also found that 74% of caregivers feel that they’re the main person responsible for medical decisions in their household.
Even when care is routine, the logistics suck up a lot of time and energy. And basic friction in the process — from chasing follow-up calls to confirming insurance approval — can quickly boost the frustration factor. In other words, healthkeeping hits different from other chores and tasks.
“The control is out of your hands,” Kandis told Zocdoc. “You’re constantly calculating in your head: Is this going to resolve itself, or do I spend four hours driving and waiting just to be told it’s viral? As a mom, you feel guilty for even feeling burdened by it.”
Caught in the middle of everyone else’s care
It’s not surprising that women often handle pediatric visits or gentle-parent their partners into booking basic check-ups. But the sheer scale of healthkeeping today looks different than it used to.
More than ever, Gen X, millennial, and Gen Z women find themselves squeezed in the “sandwich generation,” managing the complex, overlapping medical needs of young children and aging parents at once.
Zocdoc research found that 37% of healthkeepers say managing others’ healthcare takes significant time. One-third of people feel overwhelmed by caring for more than one person.
Healthkeeping operates across three spaces. First is caring for children, where parental leave policies and broader societal norms not-so-subtly position mothers as the default health manager from day one. This establishes a lasting trajectory in which school nurses dial mom first, pediatric portals text her flu shot reminders, and 75% of mothers attend pediatric specialty visits compared to just 44% of fathers, according to the American Medical Women’s Association.
Second comes partner health. Zocdoc platform data shows that women book a whopping 82% of all medical appointments made for men. It’s a mental load thing, too. Women tend to do more of the invisible future mental planning known as prospective memory: the anticipating and planning of medical care, like booking check-ups months in advance.
As Oklahoma State University researcher and Associate Professor of Psychology Lucia Ciciolla, PhD, has found in her research, men report receiving far more of this cognitive planning support from female partners than they return. “Feeling like you are alone in remembering and planning for the household,” Dr. Ciciolla explains, “is what drives distress, frustration, and burnout.”
And third is eldercare. AARP reports women comprise 61% of unpaid caregivers for older adults, juggling the complex care needs of aging parents alongside their own households.
“I once heard a terrible expression that your best eldercare insurance is having a daughter,” says Lucy McBride, MD, a Harvard-trained primary care doctor and author of the book Beyond the Prescription. “It’s cringeworthy, but it’s true.”
The second job you never applied for
Healthcare tech was supposed to make things easier, but disconnected systems often do the exact opposite. Juggling separate patient portals or waiting on hold to schedule appointments or deal with insurance can make healthkeeping feel like an unpaid second shift.
Hollie Mechak, a mom of two middle schoolers, tries to get ahead by scheduling preventive care months in advance, but finds rescheduling a nightmare. “If you try calling the office, you rarely get a person at the front desk,” she says, noting she far prefers to book online when available. “You get routed to an automated call center that feels separate from the practice.”
While many healthkeeping challenges often start at the front door to care, they rarely end there.
“Primary care is meant to be your medical home that collates all your information in one place,” says Dr. McBride. But unfortunately, she told Zocdoc, most people still have to coordinate their own records, referrals, imaging and more because everything is siloed. “The system forces people to act as their own administrative coordinator. It’s not healthy at all.”
Bottom of your own to-do list
When healthkeeping eats all the bandwidth, the first appointments to fall off the calendar are largely women’s own. Indeed, Zocdoc research shows that 61% of healthkeepers say they put someone else’s health first.
Kandis recalls skipping dental visits when her kids were younger, ending up with a cavity that required even more time and money to fix. When she does see a doctor for an acute issue, follow-up care gets dropped. “I’m not always going back,” she says. “It doesn’t feel like a priority.”
Healthkeeping stress often shows up in the exam room as headaches, insomnia, stomach issues, or high blood pressure. “Not a day goes by in my practice where I don’t talk to a patient, usually a woman, whose physical or emotional symptoms stem from caregiving responsibilities,” Dr. McBride told Zocdoc. “They can overtake a person’s entire life and, therefore, health.”
Sharing the work of staying healthy
The solution isn’t more self-care or better time management. It requires structural fixes in how systems support whole-family care. “There is so much we can do to reduce that administrative tax to make it easier and simpler,” says Dr. Ranney, “and ensure that the act of healthkeeping does not impair the health of those who are doing that essential work.”
Workflow changes can challenge default assumptions, such as updating electronic health records so both parents/guardians are automatically listed for appointment scheduling and portal messaging.
Modern booking systems (powered by online self-scheduling or 24/7 AI phone assistants) eliminate annoying phone tag so healthkeepers can secure care whenever they have a free window, whether that’s at 5 a.m. before the kids wake up or late at night while scrolling in bed.
Sometimes, though, easing the burden may come down to simply finding a provider who gets what you’re going through.
A patient recently saw Dr. McBride seeking help for chronic insomnia coupled with anxiety. As they talked, it turned out she was overwhelmed by caring for her elderly father: feeling sad that she couldn’t do more, angry at the constant demands, and then guilty for feeling angry.
Dr. McBride pulled out her prescription pad, wrote down a single phrase, tore it off, and handed it over. The treatment? Self-compassion.
The patient immediately burst into tears, Dr. McBride recalls. Not from sadness, but from the relief of being validated.
“I think she just needed someone to say, ‘you are doing the best you can in a system that wasn’t built for you,’” Dr. McBride says. Sometimes the best care we can give a healthkeeper is simply acknowledging the load.