15 Questions and 1 Wild Birth: Sheila Chhutani, MD, MBA, OB/GYN

Sheila Chhutani, M.D., M.B.A., is originally from Chicago, Illinois. She received her Bachelor of Science degree in Biology from Truman State University in Kirksville, Missouri in 1995 and graduated from St. Louis University School of Medicine in 1999, where she was active on the admissions board. In 2003, Dr. Chhutani completed her training in Obstetrics and Gynecology at Rush University Medical Center in Chicago. She was chief resident during her last year. She moved to Dallas in 2004 for a fellowship in Advanced Pelvic Surgery. She began practicing medicine with Gyn/Ob Associates in January 2007. Dr. Chhutani focuses on minimally invasive gynecological procedures, including laparoscopy using the DaVinci robot and vaginal procedures. She also offers obstetric and general gynecology services with a focus on fibroids and menopause. In her free time, she enjoys serving on various committees in the hospital, traveling and spending time with family.

1025 Healthy Living#27F7F77.jpg

When did you first decide to become an OBGYN?

It wasn’t until I was actually in medical school doing my rotations. I never thought that I would want to deal with women all the time, or look at vaginas all the time. I’m like “oh my God, that’s gross,” but once I was actually doing the rotations and seeing patients, I realized it’s not what people think it is. It’s not just looking at vaginas all day. What I really enjoy about it is the relationships that I’m able to have with my patients. I like being able to follow them out for long periods of time and see their life progress. I’m there for some of the most joyous and memorable times of their lives in delivering their babies, but the part that I like the most is probably the surgery part, whether it’s something minor like taking a polyp off the cervix or doing a full hysterectomy, or anything in between. I enjoy making women feel better and educating them about their bodies and empowering them with that education and that knowledge.

What role do you currently have and what does it entail?

I am a partner in a four person practice, so we are independant. We are not hospital owned or anything like that. We have our own business and I see obstetrics and gynecology patients and then the four of us also participate in a medicaid only obstetrics clinic, so we will deliver patients and take care of them and do prenatal care for women that have medicaid out of the specific clinic that we work with.

What does a typical day look like?

Well, I guess that’s part of the reason why I went into OB– there is no set typical day. Today I was seeing patients in my office. Over lunch I was doing surgery. This afternoon I was in the medicaid office. On any given day there may or may not be a delivery that might happen between patients. There are certain days that I may be doing surgery all day or half the day. Every day is a little bit different. There’s no rhyme or reason to it and it’s not a set schedule to what every day looks like because babies come when they want to come.

How do you manage with such an unstructured schedule?

Our schedules are pretty fluid and having a practice with multiple people allows us time because then there is somebody that’s on call everyday and that person has the most fluid schedule. If a patient of mine goes into labor, that means I probably wasn’t the person on call and that there is somebody that’s there to deliver them but I’m still able to juggle and do things and if I miss the delivery because one of my partners is going to take care of it, so be it. But if I can do both, I try to do both. Having partners helps make it so that we don’t keep patients in the office waiting forever. It also allows us to be able to take care of their patients in labor and delivery and when spontaneous things happen.

So you have a pretty strong team?

We all work very well together. I think that we all have similar– not the same, but similar philosophies when it comes to caring for our patients and similar work ethics and so I don’t think any of us feel like one of us is ever going to drop the ball or leave extra work for other people. I think everybody pulls their own load, which works well for us. I’m the youngest person within our practice and I’ve been here now nine years and so we’ve been working here a long time, which I think really helps.

What do your work environments look like?

We work at Texas Health Dallas. Within our department for obstetrics and gynecology there’s probably about fifty to sixty OB/GYNs on staff. Our practice consists of four of those. We do share call with two other solo practitioners– both are females. They didn’t want to be in a group but it’s nice to have that call covered so that they will help us on weekends and some weeknights so that alleviates us also as far as the amount of call that we have to take on nights that we have to work. We offer a full scope of obstetrics and gynecology. We handle high risk pregnancies in conjunction with our maternal fetal medicine doctors, which are the high risk doctors that work here. We do a lot of minimally invasive surgery, whether it is laparoscopically, vaginally, or using the [DaVinci] robot, we really try to do things that are minimally invasive so that patients will get back to work quickly, have less pain, and not have to stay in the hospital for prolonged periods of time. Our practice has definitely evolved as far as that is concerned; it has basically evolved with the times.

You mentioned surgery was your favorite part of OB/GYN. Why is that?

I did a pelvic surgery fellowship. It was a non accredited fellowship but I did it for a year between 2004 and 2005, after I finished my residency. Basically I just spent a full year in the operating room working on procedures and honing my skills. I really like that surgery part because I like being able to fix something. As much as I like surgery I don’t want to perform on somebody who, when they come out of surgery, is going to say, “oh my God, I feel so much worse than I did going into it,” I want them to say, “oh my God, why didn’t I do this sooner?” or, “oh my God, I feel so much better,” because I know I can do that for people.

Do you ever get squeamish during procedures?

The thing in the operating room that makes me the queasiest is when the anesthesiologist starts suctioning out saliva from the mouth. I have to walk out of the room. It is the grossest thing to me. I can handle all of the blood and the guts and vaginal secretions and even smells but the sound of the sucking up of all the saliva– it drives me nuts.

What is the most challenging part?

As far as surgery is concerned, it is making sure to stay humble. No matter how many years of experience that I have or I will have in the future, I think I have a healthy respect, as far as surgery is concerned, of going into it thinking about exactly how am I going to perform this procedure, what are the possible complications, what can go wrong, and how do I fix those things if they do go wrong? Thinking about those things prior to every surgery as far as, “if  this, then that,” is something that I think the majority of surgeons do, you just kind of role play in your head and kind of keep on your toes, and keep aware. When you bring it to your forefront and start thinking about those things, if something did happen, then you are ready and you are prepared. And so, I think that surgery is just a humbling experience.

Is this prepared mindset something you have always had?

I think it’s something that I’ve always had, but I have noticed that I have honed it a lot more and I’m a lot more deliberate with surgery.

How much time do you spend in the operating room in a given week?

Most of our surgeries aren’t that long. Today I was in the operating room for thirty minutes. I took off a fibroid and burned the lining of somebody’s uterus who was having bad bleeding, but it took thirty minutes, so probably I’m in the operating room for an hour and a half to two hours a week. A C-section, even if it’s a complicated one with a lot of adhesions and scar tissue, then that can take up to an hour, but usually the straightforward C-section is thirty minutes. The longest time I spend in the operating room is probably doing a hysterectomy, especially if they are laparoscopically and that might be a two to three hour case, and I’m not doing those every week. Between C-sections and some more minor surgeries and everything else, probably a good two and a half hours a week in the operating room.

In your position now, knowing what you do – what would you say to yourself when you were beginning your career?

I think I would probably go back to medical school and say, “do dermatology.” I was on call this weekend and I had a cold, and so the delivery was at 10:30 at night, I’m getting phone calls in the middle of the night, and I can’t breathe, so I’m not sleeping well, when I do sleep, I wake up coughing, I do another C-section at 5:30 in the morning, and then I’ve got ten people to see in the hospital, and then I’ve got two other people in labor, and once I’ve got those delivered by four in the afternoon, then the rest of the weekend is ok, but it is draining. It is tiring. After year after year of that, my forty two year old body is not like my thirty two year old body, where I could do that and I could snap back and say, “ok, now let’s go out and have fun,” with the other part of my life. So I just feel more tired. So I wonder, “why didn’t I do a different specialty that has a better quality of life?” So that’s the hard part, but I tell myself that staying in obstetrics and gynecology, there’s going to be good days and bad days and overall, I don’t think that I would necessarily trade the relationships that I have with my patients. I think that is the one thing to treasure. I have to tell myself not to take things personally, because as much as patients get attached to their doctors, we get attached to patients, too.

Do you feel like you have a good work/life balance?

I think I do have a good work/life balance. I think being in the group that I am in and working with the partners that I have, because everyone wants to have a good work/life balance, nobody is leaving work for anyone else. Everyone really pulls their own weight, because we all want to spend time with our families, we all want to travel, we all want to enjoy the fruits of our labor from working and get out and have some fun. Overall I think I do have a good work/life balance, and over the years I have definitely made it to make sure that I have that.

From your perspective, what is the biggest problem in healthcare today?

Oh gosh, where do we begin? I think the biggest problem is going to be access to care. Where I see that is in the medicaid population that I take care of in obstetrics, so any woman who is pregnant and makes a certain amount of money is going to qualify for medicaid to help them during their pregnancy, but the thing is that six weeks after their pregnancy, it’s gone. So when it comes to the time for the follow up and different things like that, especially in poverty stricken areas, the access to care is still very poor. Then you start not preventing problems, but just feeding and putting bandaids on problems, and so increasing that access to care is still really important.

Where do you see gynecology in five-ten years?

As the new doctors are coming up, they are really focused more on work/life balance. Where I see that changing for obstetrics and gynecology is work hour limits. When I was a resident, there were no work hour limits. There were weeks where if somebody was on vacation, I would be at the hospital for one hundred hours that week. When I left residency is when the implementation of an eighty hour work week came in, and that just seems ridiculous that you have to limit someone to work eighty hours per week and that that could even be difficult, but it is, when you are in residency training. Now, this new group of doctors coming out are used to that. That’s not what my life is now. In seeing changes like that for private practices, you are going to be seeing a lot more hospital lists, meaning people who work shift work, that there might be people who see patients in the office, even for obstetrics, and then have somebody else do your delivery, in order to have that work/life balance, and I see that changing probably in the next five to ten years. It may not be that call for twenty four hours at a time or a whole weekend at a time. It’s going to be divided up into shift work. You already see that even with your internal medicine doctor. You go to see them and you get hospitalized; they are not going to be the ones to see you in the hospital. Whereas in the past, your doctor would be the one to see you in the hospital, and I think that’s going to start to move towards obstetrics and gynecology, too.

What is the craziest thing you have seen in the operating room?  

A patient walked in and she was in labor. She had only had one prenatal visit and had never had an ultrasound and she delivers a baby. The baby was small, but the baby comes out, the placenta comes out, we clean her up, and then she says that she is starting to have more pain. We’re like, “oh, it’s normal for your uterus to contract afterwards,” but she was in a lot more pain than what we expected and then another baby came out. She was pregnant with twins, and nobody knew. That was probably one of the wildest things.

What about delivery? Is it something you have gotten used to?

I don’t think you ever get used to it. It’s the whole miracle of life– watching this baby come out of somebody, wondering what they are going to look like. For me the most fun is when they don’t find out the sex, finding out whether it is a boy or a girl at the time of delivery. And so, it’s still exciting, even more so when you are watching patients experience their joy and excitement. I get to see this everyday, versus one, two, maybe three times in their lifetime. It gives you this excitement, especially when you see bad things happen with pregnancy, and miscarriages or babies that don’t survive, you just really have an appreciation when you have a nice, normal, live little baby, and I don’t think that ever goes away. You never get tired of it, it never becomes “whatever.” It is always a miracle.

About the Author: Sarah Lisovich

Sarah Lisovich is a Chicago based writer, editor, and content strategist at CIA Medical. The young author has published writing on multiple print and online publications and has received the Marion and David Stocking Prize for nonfiction writing. With creative writing, communications and marketing, and public relations experience, the up and coming creative thrives in multimedia publications and looks forward to applying her skills to learn, explore, and write about the wonderful world of medicine.