Kim Ashayeri, MD, has spent years learning how to make spine surgery more precise. Now, some of her most important work involves convincing surgeons with decades more experience than she has to rethink how they operate.
Dr. Ashayeri, a neurosurgeon at Morristown, N.J.-based Atlantic Brain and Spine, serves as the designated proctor for robotic spine surgery at Atlantic Health System, also based in Morristown. In that role, she teaches established surgeons to incorporate technology that can fundamentally change how they approach familiar procedures. Some have spent entire careers perfecting techniques they must now learn to perform differently.
The challenge is not simply technical. Dr. Ashayeri is a young woman teaching experienced surgeons in a specialty where women have historically been underrepresented, particularly in positions of authority.
“I want to challenge the stereotypes of what leadership, teaching and mentorship look like in spine surgery,” she told Becker’s. Her experience offers a window into two changes unfolding in spine surgery: the growing role of robotics and a reconsideration of who gets to lead the surgeons using it.
When expertise gets in the way of learning
Dr. Ashayeri has used robotic technology since 2018 and completed a fellowship at Johns Hopkins Hospital in Baltimore, where she gained extensive experience with robotic techniques. She has also spent years teaching residents and medical students.
But training surgeons who have already mastered traditional approaches has proved to be a different undertaking. Experienced surgeons bring something residents do not: years of deeply ingrained habits, developed through thousands of decisions in the operating room. Those instincts are valuable, but they can also make it harder to embrace a technique that demands a different way of thinking.
“Sometimes it involves unlearning what you know from the traditional techniques in order to successfully incorporate robotics into your practice,” she said.
The distinction becomes particularly apparent during pedicle screw placement. As Dr. Ashayeri explains it, the transition from traditional open pedicle screw placement to robotic-assisted techniques involves relying less on visual feedback and more on tactile and auditory cues. The shift can be counterintuitive for someone accustomed to relying on direct visualization.
Dr. Ashayeri described the difference this way. “Putting in a traditional pedicle screw is kind of about brute force,” she said. “Putting in a robotic pedicle screw is all about finesse.”
That distinction captures what she sees as one of the central challenges of surgical innovation. Adopting new technology is not always a matter of adding another skill. Sometimes it requires setting aside instincts that have made a surgeon successful.
The problem with saving robotics for difficult cases
Dr. Ashayeri believes one of the biggest mistakes surgeons can make with robotics is treating it as a tool reserved for exceptional circumstances. She sees a role for the technology across procedures involving spinal instrumentation, citing its ability to improve the precision and accuracy of pedicle screw placement compared with traditional freehand techniques.
But she argues that the benefits of robotics depend on more than the capabilities of the equipment. Surgeons and their operating room teams must become proficient enough to use it consistently.
“I find that the people who have the most trouble incorporating robotics into their practice are the people who are only using it as a one-off,” she said.
The problem, as she sees it, is that surgeons who reserve robotics for patients with severely distorted anatomy may be attempting their most technically demanding cases without having developed sufficient familiarity with the technology. Instead, she advocates incorporating robotics into routine cases when spinal hardware is being placed, allowing surgeons to build experience before encountering more complicated anatomy.
“Using robotics consistently helps surgeons move beyond proficiency to true mastery of the technique,” she said.
That mastery extends beyond the surgeon. Operating room staff must also become familiar with the equipment and workflow, allowing the entire team to operate more confidently and efficiently. For Dr. Ashayeri, the promise of robotics lies not simply in its precision, but in the expertise required to make that precision a routine part of patient care.
Challenging the image of authority
The technical lessons are only part of what Dr. Ashayeri has learned from teaching experienced surgeons. She has also encountered resistance that reflects longstanding assumptions about who is expected to occupy positions of authority in spine surgery.
“As a young female coming in and teaching these experienced, well-established surgeons,” she said, the experience is “often met with some resistance.”
Rather than dismissing that resistance, Dr. Ashayeri respects the experience surgeons bring to the operating room. Her goal is not to impose a new technique, but to meet them where they are and demonstrate what robotics can offer.
But she also recognizes that her presence at the front of the operating room carries significance beyond the lesson being taught.
“It’s important to have a female presence and not shy away from leadership positions or speaking up about something you’re passionate about or have expertise in, because representation matters,” she said.
For younger women considering neurosurgery, seeing someone who looks like them teaching established surgeons can make leadership seem less distant.
“The more young female surgeons see me teaching others in the field, the more I hope they’ll feel empowered to pursue neurosurgery or spine surgery themselves,” she said.
She hopes that confidence extends beyond entering the specialty to pursuing leadership roles once there. She hopes younger women recognize “that there is space for them at the top of the field.”
The case for leading with expertise
Dr. Ashayeri encourages young women in neurosurgery to seek supportive mentors, regardless of gender, and build connections with other women in the field. But her strongest advice is to let their work speak for itself.
“Really lead with your expertise,” she said. “When it comes down to it, it’s really about being an expert in the field and getting good outcomes for your patients.”
It is the same philosophy she brings to teaching experienced surgeons: Authority comes not from a title, but from the knowledge and experience behind it.
Her work also reveals a parallel between technological progress and changing expectations of leadership. Just as robotics challenges surgeons to rethink familiar techniques, Dr. Ashayeri is challenging assumptions about who gets to teach them.
For a specialty embracing new ways of operating, she believes it is time to embrace new faces of leadership, too.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
