"I can't believe that this little show that we wrote and thought was a lot of fun in the beginning has turned out to be this thing that has really taught people," creator Rhimes says of her medical drama, which brought Meredith and McDreamy to life (and "vajayjay" into the vernacular), as she and partner Betsy Beers reveal their favorites and frustrations over 14 seasons.

When Grey's Anatomy premiered in March 2005, Shonda Rhimes was a newbie writer, Netflix was a DVD-by-mail delivery service and ABC was in the midst of a reinvention with Desperate Housewives and Lost. Now, 14 seasons later, Rhimes, 47, has built an empire that includes an estimated $100 million deal to create originals for Netflix and a full night of programming — ABC's Thank God It's Thursday — with a second Grey's spinoff (the first, Private Practice, lasted six seasons) coming in 2018. "Shonda and the team have done a fantastic job of keeping the storylines and the characters fresh by replenishing the cast over the years," says ABC Studios president Patrick Moran. The pop culture juggernaut and worldwide phenomenon (it airs in 220 territories) is ABC's No. 2 drama (behind only freshman breakout The Good Doctor), with 11.7 million total viewers and a 3.2 rating among adults 18-to-49 — not too shabby for a show about to see its 300th episode (airing Nov. 9). "Mothers who were pregnant during season one are now watching the show with their daughters," says ABC Entertainment president Channing Dungey of the new audiences discovering Grey's on Netflix. To celebrate their milestone, Rhimes and longtime producing partner Betsy Beers, 59, spoke with THR in their cozy Shondaland offices at Sunset Gower Studios about how far the show has come, the road ahead, characters they'd like to revive (literally) and — why not? — shoes.

If you could go back in time knowing what you know now, what would you each do differently?

RHIMES I probably would have had better contracts to start with. The show has made $2 billion or so, and these are not $2 billion shoes.

BEERS If we had known this was going to happen, we might have been more aggressive initially in our approach.

RHIMES We'd both be laying on a beach in Zanzibar somewhere. No, we'd probably still be working, that's the problem. Every choice we've made, it's why the show works the way it does. Every time the interns were learning, we were learning.

BEERS We've both grown up; Shonda has written books about her changes. We really matured into our jobs.

RHIMES And have become more confident.

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Several actors have come and gone over the years, from Patrick Dempsey to Sara Ramirez. If you could bring someone back, who would you want to have another chance to write for?

RHIMES I'm always going to say Sandra Oh [Cristina] because for me, she's the most fun to write for. But if Kyle Chandler [who guest-starred as a bomb squad leader] showed up unexploded, I'd enjoy writing for him.

BEERS Denny [a patient who died, played by Jeffrey Dean Morgan].

You get a lot of feedback from fans about how medical storylines have helped them diagnose themselves or a family member. What stands out?

RHIMES What is significant is how many there are. I can't believe that this little show that we wrote and thought was a lot of fun in the beginning has turned out to be this thing that has really taught people. And the number of people who have gone to medical school because they want to be like those doctors is also incredible.

BEERS Somebody we knew realized they had breast cancer from watching LaTanya Richardson's storyline [as a woman with breast cancer]. The one that sticks out to me was, many years ago a kid in Canada saved his parent by doing CPR because he'd seen it on Grey's.

What's the most interesting note you've received from Standards and Practices over the years?

RHIMES Over the course of this many seasons, what you start to understand is that it's not necessarily about what has happened before; it's about what the climate is politically, because things roll forward and roll back and roll forward again, and that's always surprising. As often as we said "vagina" on the show, to suddenly be told, "I don't know if you can say 'vagina' this time" is hilarious, but also frustrating.

Is that where the term "vajayjay" came from?

RHIMES Years ago, yes. I used that because it was Bailey [Chandra Wilson] in a personal situation. My standard is always: These are medical people trained to be doctors; they are not going to use some weird name for body parts. It's terrible to teach women that they should use weird names for their body parts. But it was funny and worked in that moment.

Grey's was poised to tackle abortion in season two with Oh's character, who wound up having an ectopic pregnancy instead. Was that network pushback?

RHIMES I had been planning for Cristina to have an abortion, and nobody said we couldn't do it. They were like, "It just is not done very often and it sometimes causes a lot of controversy." We hadn't been on the air long, and I wasn't brave enough to just say, "Screw it, we're doing it." I held back. I remember Sandra being like, "Come on!" Years later when we did it [with Oh in season eight], I got more pushback about that than I did when we were going to do it the first time.

Do you regret not going through with that in season two?

RHIMES No. We didn't know the characters well enough. What I have come to understand and love about our show is, the more you get to know those characters, the more powerful things are. When Cristina chose to have the abortion, she had a perfectly good guy beside her, a great career and she is a person who was very clear about the fact that she did not want to have children. There is something wrong with our society in that it does not support a woman's choice to not want to have children. On TV, that is never portrayed as: You're watching a woman whom you respect make a choice that feels like a really strong, powerful choice that a lot of women make, and we pretend that nobody does.

BEERS And that's an incredibly liberating moment.

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Would you ever take on a timely issue, like the debate over universal health care?

RHIMES We've done the "people who have no insurance and we're going to give them the surgery anyway" stories. I don't know what the universal health care story would be yet, so it would be about figuring out what that is. I don't ever approach anything from the issue first, so I can't tell you that I've thought about tackling universal health care. I'd have to have some great story I'd want to tell, and then universal health care would become part of the way to tell that story.

BEERS Issues have emerged from the stories and the characters and the storylines.

RHIMES It's the only way to tell stories.

What's the casting or pilot story that still stands out?

RHIMES Isaiah Washington came in for the role of Derek Shepherd, and Patrick Dempsey was there. And then we had Sandra come in for the role of Bailey. I looked at her and thought she could be Cristina, and everyone was like, "What?! That's totally different from what we thought she was going to be like." Chandra Wilson came in, and she was not the Bailey we imagined, but the best Bailey ever. Jim Pickens was the only person who ever read for the Chief. There were a million guys who came in for George, but we just fell in love with T.R. Knight. Picking the actors was simple.

BEERS In comparison to the way it is to cast a pilot now, where there are 4 billion TV shows and you're slaughtering people in the road to try to get to somebody … this was, in retrospect, a cakewalk.

How much input does Ellen Pompeo (Meredith Grey) have on the show?

RHIMES Her opinion is very important. I have said to her that we're in this together, and that's important because it doesn't feel right that she be some sort of soldier on a field just taking orders. She also has some really beautiful, smart insights and some amazing character choices. When the character was steeped in grief [after the death of her husband Derek, played by Dempsey], we had some amazing conversations about what that would mean and where the character would go and how she would handle it.

Does Grey's Anatomy exist without Ellen?

RHIMES Not as far as I'm concerned.

Have there been any talks about how much longer Ellen is interested in doing the show?

RHIMES No comment.

As you've gone from intern to chief, what's your biggest change?

RHIMES It's about having gone from being two kids in a candy store to being leaders. A lot of people think that they are leaders just because they have been placed in charge of something — and you're not.

BEERS The learning process is sort of a baptism by fire, too, because you learn on the way. I hopefully have an easier time figuring out what's really a problem because everything seems to be the same when you start. The great thing about getting to be on a show this long and becoming a leader through it is it helps you prioritize, and that knowledge helps you enjoy the job a lot more.

RHIMES You're less afraid to make decisions. It's easier to look at the landscape and pick out the mistakes. Before, everything looked the same and so you were terrified that you were going to step on a land mine before you knew it. I was always terrified that if I stopped working, none of this would work. I only started to think that maybe this would actually last in season seven or eight. You start to enjoy yourself and get comfortable and you're not afraid to make decisions, and if the decision is a bad one, then you're not afraid to take the heat.

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Looking ahead, you're launching a firefighter spinoff come midseason on ABC as the flagship's second offshoot. Have you considered others over time?

RHIMES We think about it a lot. There's always different spinoff ideas that come up all the time. It's too easy almost.

BEERS If something is really interesting then immediately maybe that could be a spinoff.

Do you have a title yet for the firefighter spinoff?

RHIMES I like to tell people that it's called Fire Place and say it really seriously and see their faces, because that's the worst title ever!

BEERS The Fire Place. (Laughter.) We were saying that on set, and every 10 minutes it was just a different one: "Tonight on Feel the Burn!" (Laughter.)

What are some of the ideas you've discussed in the past? What made firefighters the right idea?

RHIMES I'm not going to tell you because maybe one day we'll make them. The firefighter spinoff was interesting because that was an idea that wasn't an idea. The idea that we were going to put Jason George [who plays Dr. Ben Warren on the flagship] in it was not part of the idea. In a weird way, we kind of wrote the [season 13] finale as a firefighter thing —

BEERS — without knowing that we were doing it …

RHIMES … because we weren't doing a firefighter spinoff. We talked about firefighters being really cool and everybody was obsessed with them, so we were like, "Let's do a big, giant fire!" But it wasn't anything until after, when we were like, "We really have to have a spinoff topic." Then [Grey's writer-EP] Stacy McKee pitched this beautiful thing.

BEERS It was super organic. We just reverse engineered something that was already there.

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Is the larger goal to build a world similar to what Dick Wolf has done with NBC's Chicago franchise, where all the shows are connected?

BEERS The primary determinant continues to be if we really want to watch it and we really want to see it and we really want to work on it, then we do it.

RHIMES Because that ends up being what's good. I'm flummoxed by Dick Wolf. While I'll watch Law & Order until the cows come home, when [Grey's] was first on the air, it would never occur to me to go, "Let's franchise this; let's make Grey's Anatomy: Chicago," or whatever those people do.

BEERS Very early on, somebody had said we should do that.

RHIMES We didn't even know what that meant. It was like, "So there's just another Meredith?"

BEERS Should we call her Meredith? She's in another city; she'd be called Meredith Flay? (Laughter.)

RHIMES Flay's Anatomy?! That's super weird. So no, I don't think that's ever occurred to us in that way.

BEERS We're excited about this because I want to see something that is fun to do, to work in a different space that we've never been in before. We have a stage that you burn stuff on. It's insane.

RHIMES It pretty much goes with [the thinking of], wouldn't it be really cool to have an Oval Office? Wouldn't it be cool to have an OR?

Krista Vernoff returned as co-showrunner this season. Why is it important to bring her back?

RHIMES The only way I was going to be able to allow myself to step back a bit was to have somebody there whom I knew had this. Krista understands my sense of humor, and she can write. She is just as passionate about the show now as she was in year one. I needed somebody that I knew would care that much, and that is not an easy thing to find, especially when you're saying, "I'm going to hand off my baby to somebody to look after." I have never been able to hand it off before, so I wouldn't be able to hand it off if I didn't have somebody who was going to do a really great job.

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Ben Sherwood recently said 2 million people per month watch the Grey's pilot on Netflix. How has new viewers finding the show helped Grey's sustain itself over the years?

RHIMES The beauty of Netflix is it continues to make new audiences for us. Our fans can give birth to our fans. Grey's has this universal, global thing to it. It works all over the world.

BEERS There is a timeless quality to the show. The stories are emotional, the medicine is always relevant. Nothing is outdated because it's all based in real emotions and caring about people.

How will the Netflix deal impact your involvement with Grey's and the spinoff going forward?

RHIMES Pretty much be exactly what it is now since we are in the middle of the Netflix deal right now.

You wrote in your welcome essay on Shondaland.com, your media site, about "too much change" and ending Scandal when you wanted to. Have there been times when you've wanted to end Grey's?

RHIMES Yes. Season two, season three, season four, season five … it was an exhausting show until I really got the hang of doing 22 to 24 episodes a season. I learned how to write TV by writing Grey's Anatomy. It was about getting the hang of being a leader, being a boss and then doing two shows at a time [with Private Practice], and then three shows at a time [with Scandal]. But it was more about, "Can I do this?" That's how I discovered the art of reinvention: I'd write a season ending and be like, "That's it, we're done." And then I'd have to come up with something else. That got really fun.

All three shows that you've created (Grey's, Private Practice and Scandal) have run for more than 100 episodes — you're the first female showrunner to accomplish that feat. Given the challenges with cutting through in an era of 500 shows, do you think there will be other showrunners with three 100-episode shows to come?

RHIMES I have no idea. Honestly, you can look at network television and say that you can't quite tell what's coming. But I hope so.

Do you have an ultimate goal of what the end of Grey's Anatomy is? Is that something you think about?

RHIMES No, not anymore. When we realized that Netflix was reinfusing the show with a whole new audience and that it didn't seem to be going anywhere — and the ratings were going up and not down — that's when I had to get really Zen with myself and say, "What do we want? How do I feel about this?" It's been maddening and amazing to discover that you can reinvent it every year and it still works. I heard [Disney-ABC Television Group president] Ben Sherwood said something about [Grey's running for 40 years like] General Hospital. That's not the plan. But the idea that we are going to go until it feels like we're done is great.

Will that decision ultimately be yours to make?

RHIMES Yes. I don't know why the end of Grey's wouldn't be my decision. Who would close the chocolate factory but me?

A version of this story first appeared in the Nov. 8 issue of The Hollywood Reporter magazine. To receive the magazine, click here to subscribe.