Dr. Jessica Shellock (Courtesy: Texas Back Institute)

Surgery

Overcoming the ‘Locker Room Mentality’: A Conversation with a Spine Surgeon

Dr. Jessica Shellock says the industry still has its fair share of gender issues, but she is hopeful about more diversity.

Despite women comprising more than half of all medical school admissions according to the Association for American Medical colleges — an improvement from years prior — most still steer clear of the operating room. Recent reports suggest women make up less than a quarter of surgeons in ten different specialties and outnumber male surgeons only in obstetrics and gynecology. Orthopedics is the least diverse surgical specialty in terms of gender — only 5.3 percent of orthopedic surgeons are women.

Dr. Jessica Shellock is part of that five percent. A spinal surgeon at Texas Back Institute, Dr. Shellock has had to navigate her fair share of stereotyping and gender differences throughout her medical training and practice. Even now — as she successfully performs minimally invasive disc replacement, motion preservation, and spinal fusion surgeries — her patients often mistake her for a nurse or PA.

Below, we share some of Dr. Shellock’s thoughts on the future of diversity in spinal surgery, the procedures and technology to come, and her experiences as a minority member of a male-dominated field.

You have training from Chapel Hill, University of Florida, and then you did your fellowship at Texas Back Institute. What was your training like as a woman moving through a heavily male-dominated field at those places?

As a female in a field where it is mostly male-dominated, I’ve had the fortunate experience that most of my male colleagues throughout have been just cool people. It really wouldn’t have mattered to me whether they were a guy or girl. I like them. One of the ways where I think it really comes into play is that in a lot of specialties where it’s predominantly male oriented, there’s a certain networking and collegiality amongst the guys — kind of like that locker room mentality — and it’s a little bit different being a female in that arena. It’s not like we’re all going to go hang out and go to the bar together and go play golf together. You definitely feel that you’re a little bit on your own. And that’s not always a bad thing. I think that if you’re challenged, it helps you to grow to become stronger.

On the on the other side of things, as a female I think many women are just really good at multitasking. Right? And it always comes into play [in] the whole life-work balance. I have two young children, there’s always that element of how do you do it all? Right? And I think that as women, we kind of put that pressure on ourselves a little more because it kind of is there — spoken or unspoken. So, I just think that you need perspective to realize that you can do all these things. You might have to give here or there a little bit, but at the end of the day, you can still make it work.”

Have there ever been any moments in particular or any of the environments that you’ve been in during your training where you’ve had to really adapt your approach with a coworker or with a patient because of your gender?

“There’s not one thing that stands out. Ten or twelve years ago, I’d say maybe I looked a bit younger. So, you come out and practice, and you have patients, especially older patients and certainly especially older guys — that still kind of give you that, ‘Oh, hey honey.’ You know, that kind of stuff, which is kind of like ‘Eye roll.’ In the back of my mind, I’m like, ‘Seriously? Aren’t we in 2020?’ I think sometimes it’s hard for older generations to realize that, hey, you know what, I can be your spine surgeon too. I can’t tell you how many times that I’ve sat there and had an entire conversation with a patient in clinic — going over their imaging, talk[ing] about the surgery — and then at the end, they’ll say ‘Well, who is going to do my surgery?’ And I’m like, ‘I’m your surgeon.’ That’s not all the time, but it definitely happens.”

Is there anything really new and revolutionary to the field that Texas Back Institute has taken on?

I wouldn’t say that the approaches are new or revolutionary. We rely heavily and believe heavily in motion preservation. So, I keep coming back to the whole disk replacement [topic], but we have a center for disc replacement and get consults from all around the world to come in to benefit from the expertise that we can provide just because of the breadth of experience and the number of cases that we do. I’ve recently become part of that center, and I am excited about that because it is something that I believe in and I think that future directions are going to make disc replacement even more accepted and common than [spinal] fusion.

Anything else that you see as up and coming?

“I think that there is going to be more awareness, more knowledge of how the properties of the devices that we use and the materials that we put in to try to enhance fusion. I think they’ll be a greater understanding of these properties of what we do to to be able to make us more efficient, to optimize healing, [and] hopefully to decrease the cost of a procedure. There’s lots of different types of surface coatings on implants. There’s different options between metallic implants or metal coated implants that are otherwise plastic. And I think that — as we gather more data, more information, and more patient-outcomes data —over time, we’ll just have more like an algorithmic approach to understand what might be better for certain types of pathologies and in certain types of patients so that we can be, again, more efficient.”

With regards to the gender differences that you have seen in the field, how do you feel? Do you think we’ll see more women joining you in the spinal surgery field in the future?

You know, I hope so. I just want to be able to think that if somebody truly has a passion for
something, that it doesn’t matter what your gender is — or anything other than you just kind of going for your dreams, right? I feel like one of maybe the biggest barriers for women going into medical fields and thinking about surgery is again, coming back to that whole [thought of] ‘Well can I have a family and still do this?’ And, I hope that people will be able to look out there and see people like myself and other women who are out there in surgical specialties and making that life-work balance work to where it’s encouraging and not discouraging to get other women interested.

This interview has been edited for length and clarity. 

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