Eric Strand, MD, is associate professor, obstetrics and gynecology; and chief of the division of general obstetrics and gynecology. His specialties include obstetrics and gynecology, gynecologic surgery, preventive medicine and minimally invasive surgery.
Dr. Strand sees patients at the Women’s Health Center, in the Center for Advanced Medicine, 4921 Parkview Place, 5th floor, Suite A.
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What happened in the course of schooling to influence you to choose your specialty?
Through the course of schooling, I liked most every rotation and knew choosing one specialty would be difficult. During my ob/gyn rotation, I discovered I enjoyed that specialty on a completely different level. The combination of surgery and medicine was very appealing to me. Treating ob/gyn patients with complicated medical conditions was intellectually challenging, and managing gynecologic disorders provided an opportunity to be active in the operating room. In addition, prenatal care and childbirth was a great opportunity to share a very special time with the patient.
Every day is different – sometimes you are delivering a baby, sometimes you are in the operating room, sometimes you are in the clinic. I like the fact that this specialty is so diverse.
What brought you to Washington University?
I had been the residency program director for a hospital in Indianapolis when I met Dr. Jeffrey Peipert, the Washington University ob/gyn residency program director, at a conference. At that time, my wife and I weren’t looking to move, and our four children were perhaps a little less enthusiastic about the idea.
But it was a great opportunity to be associated with a top notch medical school and community. The fact that my new position would allow me to have more patient contact really appealed to me. While I loved being a residency director and working with the residents, watching them transform over four years into skilled and confident physicians, I missed seeing patients.
Coming here as director of the division would swing the pendulum back towards a more even balance between resident education and treating patients. I’d be more clinically active, but still be able to participate in the residents’ educational process.
Which aspect of your practice do you find most interesting?
I wear two separate hats. I love taking care of patients because there is never a dull moment working in the clinic. Women come to Washington University looking for medical answers and the best treatment. It is very appealing and rewarding to help them.
The other hat I wear is administrative. We are developing the plan for the new Women’s and Infant’s Pavilion, to be built on campus over the next three to four years. It’s very exciting to be on the front edge of this significant project. Since I am new to Washington University, I’m not married to any of the systems currently in place. I hope to bring a fresh set of eyes for transforming the care provided to mothers and babies.
It’s important to keep the high level of all aspects of care-- obstetrics, nursery and newborn intensive care (NICU)-- and combine them with comfortable and appealing facility upgrades for the families during their time in the hospital – including immediate post-delivery recovery or longer stays in the NICU.
What are the advantages of team approach your ob/gyn group takes to patient care?
The team approach is beneficial to the patient and the doctor. The physicians in our practice each have his or her own patients, but if a woman has an emergency and needs to be seen, one of our physicians would always be available to see her. We work hard to make sure the patient meets each of us during the course of her prenatal care.
There are five physicians in our group, so if there are 10-12 prenatal visits for the mom, she has an opportunity to see each doctor at least once. Because babies don’t often come when they are scheduled, we want to make sure the mother has a familiar face to take care of her when she has her baby.
In obstetrics in general, most physicians are practicing in groups. The group practice allows a division of on-call duties, which ensures that a well-rested physician is always available for patient care.
Are there new developments in your field that you are excited about?
There is so much we still don’t know about pregnancy, such as what causes preterm labor or preeclampsia. There are plenty of opportunities for continued research; I don’t think we’ve come to the end of the road in terms of new discoveries.
Technologies for screening pregnancies to detect Down syndrome or other genetic conditions have become less invasive, giving patients an alternative to amniocentesis and other invasive procedures used in the past. By using a combination of blood work and ultrasound, today’s screening tests are able to provide more accurate information, without the risk of the invasive tests (for 100% accuracy, amniocentesis is still the preferred method). These new screening options have changed the way I counsel patients, compared to 10 years ago.
Can you explain the new less invasive options for amniocentesis?
There is a test that magnifies or amplifies cell fetal cell-free DNA in the mother’s blood stream. The mother’s blood is drawn, and the amplification process is able to determine if the baby has Down syndrome or trisomy 18. It’s not 100% accurate, but it is extremely close.
Compared to what we have been using, this test has a lower error rate than all the other tests we’ve had to date -- with very low false positive rates and very low false negative rates. It is also able to detect more babies with Down syndrome than any other screening technique we’ve had.
That technology is relatively new, but it is becoming more common. Right now the screening test is limited to women who are in a high-risk patient population (those older than 35 or those with a prior baby with Down syndrome, for example). But as it is studied further in women who are at lower risk for genetic conditions, we may find it has applications for improved care for those patients, as well.
Where are you from?
I’m from Cincinnati, Ohio. My parents still live in the same house I grew up in, and I have two sisters who live in Cincinnati. I attended college at Vanderbilt in Nashville, Tennessee and medical school at Johns Hopkins in Baltimore. I returned to Nashville for residency, where I met my wife, who was a medical student.
My family really likes St. Louis. Our four boys have adjusted nicely to their new community and there’s plenty for them to do here. My wife also had a very busy transition – she is a neonatologist at St. Louis University, covering Cardinal Glennon and St. Mary’s hospitals.
Is there a particular award or achievement that is most gratifying?
Every year, CREOG, the Counsel on Resident Education in OB/GYN, one of our educational governing bodies, gives an award at each program for the best teacher in that program. I was fortunate enough to win that honor when I was on staff in Cincinnati.
Ten years later, I was given the award again in Indianapolis. It was complete surprise. The residents had “voted” during one of our meetings to give it to another staff, then went behind my back and gave me the honor. It was very gratifying to be chosen as the teacher who meant the most to the residents. To win the award twice, almost a decade apart, was extremely nice and a great reminder of the impact we have as educators on those we teach.
What is the best advice you’ve received?
I was one of five kids. My mom was a teacher and my dad was a pharmaceutical salesman. When I was in kindergarten, my dad started law school. For several years my mom’s teacher’s salary supported our family while dad went to school in the evenings. It might sound trite, but my mom always said, “Don’t sweat the small stuff”. She did a great job of focusing on what was really important. I don’t ever remember seeing my parents argue. I’m sure they would get upset, but they had a way of understanding what was important and what wasn’t. It was the same way with raising the five of us. My parents knew when to let us go, and they knew when they needed to pay closer attention.
At times I try to step back from a frustrating situation and ask, “In the grand scheme of things, what is its significance?” In the end, most problems will get taken care of just fine. The key is understanding which issues matter in the end and which don’t – whether at work, with children or my wife.
If you weren’t a doctor, what would you like to be doing?
I grew up a huge sports fan in Cincinnati, watching the Big Red Machine with Johnny Bench and Joe Morgan. As kids, our lives revolved around baseball and what was happening with the Reds. I remember going to bed and listening to the game on my little transistor radio. I’d watch the Bengal football games on Sunday with my dad. I’m sure I’m more valuable for humanity as a doctor, but I could be completely happy as a sports journalist or working for a sports company or a sports team.
So are you looking forward to your first season as a Cardinals fan?
My older son is a big baseball fan. I took the kids to a Cardinals game at the end of last season when they were playing the Reds. I couldn’t help myself; I still was invested in the Reds and wanted them to win. I’m not sure I’ll ever be able to bleed that out. However, we were happy to cheer for the Cardinals once the Reds were out of the pennant race!