Op-Med is a collection of original articles contributed by Doximity members.
Name: Sasha Shillcutt, M.D.
Education: University of Nebraska Medical Center, Omaha; University of Utah, Salt Lake City
Area(s) of Expertise: Cardiac Anesthesiology
Current Position(s): Associate Professor of Cardiac Anesthesiologist, University of Nebraska Medical Center; Vice Chair of Strategy and Clinical Transformation
1. How do you prepare for your workday?
My day starts really early (4:30 AM!) with an hour of exercise, which I find to be vital to set the tone of my day. I learned a while ago I had to put my own health first to be the best physician I can for my patients. My evenings are busy with family activities so I exercise first thing and the rest of my day I feel great knowing I lifted something heavy and got my heart rate up. Exercising early also forces me to go to bed at a decent time, improving my sleep health as well.
2. What area of your specialty is changing most rapidly?
I am a cardiac anesthesiologist and care for patients who have advanced heart disease. In the last 10 years, what my surgical colleagues have been able to do for these patients is quite remarkable. We as anesthesiologists are constantly helping our surgical partners intervene on sicker patients in different ways to try and extend their life and possibly receive a heart transplant. It’s a constant moving machine and definitely a team effort.
3. What is the last journal article or piece of research that significantly changed your practice?
Many of my patients have right heart failure, which is very difficult to treat. I read a lot of literature on right heart failure to try and prevent this in the perioperative arena as it has a post operative mortality of nearly 70% if severe. I read excellent work done by Dr. Tim Lahm and colleagues on right heart failure treatment in critically ill patients and implement his work into my practice.
4. What research are you working on?
I am currently studying the use of echocardiography in vascular surgery patients who have left ventricular diastolic dysfunction to guide their hemodynamics based on their filling pressures. Heart failure post vascular surgery is a common problem. I am also studying how online communities can improve resiliency in women physicians. Both problems are applicable in my day to day life as an anesthesiologist and physician.
5. Outside of your daily practice, do you have any personal or professional projects that you’re passionate about?
A few years ago I experienced pretty severe clinical burnout. This led me to undertake some healthy changes in my own life that I realized I could share with other physicians. I started an online community for female physician that quickly grew to 6,000 attending female physicians and I am passionate about encouraging women to lead in medicine.
6. What is a common misconception that other clinicians have about your specialty?
Other clinicians have very little exposure to the practice of anesthesia, and as such, many think it is a boring job. I can tell you that it is quite the opposite; anesthesiology is the practice of caring for another person’s life — beat to beat. We must know and understand disease processes and physiology in depth to keep patients alive and their organs optimized. I like to say my work is other people’s life. Period.
7. Who are your mentors?
I have had some great mentors. My first mentor was Dr. Ricardo Cardenas, who taught me to love cardiac anesthesiology. My current chair, Dr. Steven Lisco, is a great leader and I have learned a lot from him on how to develop programs. Dr. Julie Silver, who is a leader in the advancement of women in medicine, has become an incredible mentor to me and challenges me to keep asking difficult questions until I find the answers.
8. What’s the best advice you’ve ever received?
To be authentic and to find my niche in medicine. I can tell you those two thing bring personal peace, which is invaluable.
9. What has been your most gratifying moment of being a clinician?
There have been a handful of times I have used my skill of perioperative echocardiography to diagnose complications or diseases that gone unrecognized would have led to a patient’s demise. I know that my instincts led to figuring out what we needed to do to save the patient, and those times are quite rewarding and needed to keep up the work we do in medicine.
10. How do you unwind after a challenging day?
My four children help me unwind. I like to debrief with each of them about our days and they help me remember that my most important role is their mother, not being a physician. They help me bring everything fuzzy into view, so to speak. And I am an avid reader, and I read something for at least 5 minutes prior to bed to unwind.
11. What are your favorite Doximity features and how have they helped your productivity?
I like DocNews. I like seeing quickly what others are reading and what I should stay on top of with regards to literature. I like connecting and reading what is happening in the medical community to feel less isolated and more connected.
12. Are you a part of any groups or advocacy efforts that support women in medicine?
I started an online Facebook Group called StyleMD two years ago for attending female physicians to connect and support each other in self-care and sponsorship. It is an amazing diverse network and promotes friendships, networking, resiliency, promotion and leadership. I blog for women in healthcare at www.becomebraveenough.com and support women as leaders in healthcare.
13. What is the biggest obstacle for women in your specialty?
One of the most difficult things about the practice of anesthesiology is the unpredictable nature of surgery. This can be very stressful on an individual physician, especially those with families. For those who are parents, if our children need us we must physically ask another partner to step in for us, as we cannot leave surgery. We don’t have the ability to change our clinical schedules as other physicians, or work later in the evening if we have to take time off during the afternoon. This can be very stressful on women in anesthesiology.
14. How can women in medicine better support each other?
We can remember women who are capable and experienced but may not be as visible as men when it comes to career opportunities. We can speak up for other women and give them credit in meetings for their great ideas. We can invite them to the table and give them the floor to speak. We can encourage one another and bring visibility to other women around us.
15. What piece of advice would you give to a female physician early in her career?
Do not equate having a family with putting your career on hold. You can do both if you desire. Define your own success, and do not think you must work a specific way to have success. We need women to improve our culture, so please don’t leave the profession!
16. Tag a colleague! Who would you like to see next in this “How I Work” Op-Med series?
Julie Silver, MD (Harvard)