The Rural American Surgeon
Welcome to ”The Rural American Surgeon,” a podcast series dedicated to providing insights, resources, and a community for the surgeons of rural America. Your host, Randy Lehman, is an established authority on the multifaceted aspects of rural surgery—from the unique professional benefits and challenges, rural surgical training paradigms, current reimbursement landscape, and how to create triple win opportunities for sustainable rural surgery in partnerships with hospitals and rural communities. This podcast is designed for both rural general surgeons and rural surgical specialists who are seeking not just advice and guidance on practicing in rural areas, but also inspiration to foster valuable partnerships across our great land. Each episode is a deep dive into topics such as mastery of rural surgery, the rural lifestyle, fighting professional isolation, building a system to ensure surgical services are offered at a high level, using scarce resources wisely, achieving personal financial freedom, accessing a wealth of outside surgical resources, and inspiration at a high level of why what we do is important.
Episodes
Introducing a new miniseries on money—starting with the question beneath the dollars: What’s the point?
Before we talk finance, we’re digging into foundations. In this episode, Dr. Randy Lehman shares an unexpected conversation with ChatGPT about evolution, intelligent design, and the meaning of existence—revealing why, for him, the evidence points to faith over chance.
But this isn’t just about science. It’s about worldview—ho...
What happens when a rural hospital loses its only surgeon and faces closure?
Host Dr. Randy Lehman welcomes Dr. Manu Kaushik, who stepped in to save a dying critical access hospital in Greenville, Alabama. After 40 years of service, the hospital's longtime surgeon retired, COVID hit, and the OR shut down completely - threatening the entire community's access to care.
Dr. Kaushik shares his incredible journey of rebuilding surg...
How do you perform a carotid endarterectomy with confidence while ensuring patient safety in a rural setting?
Host Dr. Randy Lehman welcomes Dr. Michael Roskos, his former program director for the rural surgery track at Mayo Clinic, to dive deep into this critical procedure. They explore patient selection criteria, detailed surgical techniques, and the evolution of vascular surgery practice over the decades.
Dr. Roskos shares ...
What does it take to bring advanced foregut surgery to a rural hospital?
Host Dr. Randy Lehman sits down with Dr. Greg Gerrish, a third-generation surgeon practicing in South Dakota, to talk shop on the real-world challenges and wins of rural surgical care. From Barrett’s esophagus to emergency thoracotomies, Dr. Gerrish brings both technical depth and day-to-day experience to the conversation.
They cover Dr. Gerrish’s approach to ...
What happens when Mayo Clinic precision meets small-town grit?
Dr. Randy Lehman sits down with Dr. Kabir Mehta, who never expected to land in Hazard, Kentucky–population 5,000–but now finds deep purpose in bringing advanced bariatric care to a region where patients used to drive hours for a specialist.
This honest doctor's lounge conversation covers the real stuff: Dr. Mehta’s surgical strategies for handling bariatric emergencies...
What does it take to thrive as a rural surgeon for over four decades?
Host Dr. Randy Lehman welcomes Dr. P.J. Reddy, a most adaptable and resourceful rural surgeon who shares his journey from India to settling in Kansas, where he practiced for 41 years.
Dr. Reddy discusses his experience with colonoscopies, offers financial insight for medical students, and emphasizes the importance of a broad skill set for rural surgeons.
Tune i...
What makes rural surgery uniquely rewarding and challenging?
Host Dr. Randy Lehman welcomes one of the greats–Dr. Gary Timmerman, a distinguished surgeon from South Dakota–to share his journey and insights into rural surgical practice.
Dr. Timmerman discusses his career path, the role his faith has played throughout his many years of surgery, and offers a detailed exploration of esophagectomy techniques and feeding tube placement...
How can rural surgeons navigate the complexities of modern surgical techniques while maintaining financial stability?
Host Dr. Randy Lehman welcomes back Dr. Eugene Shively, a retired general surgeon from Campbellsville, Kentucky, to explore this question. They discuss the critical role of rural surgery, delve into common bile duct exploration techniques, and examine the growing presence of robotic surgery in rural hospitals. Dr. ...
A family emergency gave Dr. Randy Lehman an unexpected perspective—from the waiting room instead of the operating room.
In this episode, he shares the story of his grandfather’s emergency gallbladder surgery and how that experience reshaped his approach to rural surgical care.
From the weight of urgent decisions to the strain of limited resources, Dr. Lehman reflects on how these events transformed his approach to pre-op communicat...
For Dr. Randy Lehman, “rushing to surgery” sometimes means taking to the skies.
In this episode, he shares how aviation became an unexpected solution to some of rural healthcare’s biggest hurdles: time, distance, and access.
From unforgettable landings to the real-world logistics of owning and flying a helicopter, Dr. Lehman gives us a front-row seat to how this unconventional approach is transforming his surgical practice in India...
Join host Dr. Randy Lehman as he welcomes Dr. Rebekah Wever, a passionate young rural surgeon who returned to her Appalachia, Ohio roots after training in South Dakota.
In this episode, Dr. Wever shares candid reflections on her first independent cases while delivering a masterclass on the innovative Transversus Abdominis Release (TAR) technique for complex hernia repairs. She reveals how her dedication to building healthcare re...
After a week of medical missions in rural Honduras, host Dr. Randy Lehman sits down with Dr. John Haeberlin to reflect on their experience and discuss laparoscopic cholecystectomy techniques.
Dr. Haeberlin shares insights on robotics and breaks down an excellent "How I Do It" segment on a gallbladder case. Dr. Lehman also recounts a compelling case from their time in Honduras, offering a firsthand look at the challenges and decisio...
Host Dr. Randy Lehman sits down with Iowa rural surgeon and former Navy doctor, Dr. Dave Kermode, for a gripping deep dive into an emergency C-section case. Together, they explore the key differences between elective and emergency C-sections in a rural setting, offering valuable insights for general surgery residents. Beyond medicine, they also discuss the intersections of finance, marriage, and faith, making this an episode packed...
Welcome back for this Part Two conversation with host Dr. Randy Lehman and distinguished breast surgeon, Dr. Mel Johnson. Listen for a technical walkthrough on sentinel lymph node biopsy, plus a very unique bonus “How I Do It” section involving surgery on a farm! Stay through the end for Dr. Johnson’s powerful encouragement for the new resident who might wonder what life looks like ahead.
00:00 Introduction
02:39 How I Do It: Sen...
Host Dr. Randy Lehman welcomes Dr. Mel Johnson, President of the North American Rural Surgical Society and Program Director at Gundersen Lutheran in La Crosse, Wisconsin. This Part One conversation highlights breast cancer treatment, focusing on sentinel lymph node biopsy and the decision-making process for prophylactic mastectomy. Tune in for Dr. Johnson’s insights into implementing comprehensive breast cancer care in rural settin...
In this Part Two episode, host Dr. Randy Lehman returns with PA Dan Leman—who flips the script and takes on the role of interviewer! Together, they explore the balance between technological resources and human connection, the complexities of ethical decision-making, and the role of humility in a surgeon’s journey. Don’t miss this insightful conversation packed with thought-provoking perspectives and real-world experience.
0:00 In...
Host Dr. Randy Lehman welcomes Dan Leman, a Physician Assistant with a notable background in telehealth innovation. Together, they explore the transformative role of telehealth technology in rural healthcare, highlighting Dan's pioneering work in developing remote medical solutions for underserved communities. The conversation also delves into the financial hurdles faced by healthcare startups and the profound experiences gained fr...
Host Dr. Randy Lehman welcomes Dr. Konstantin Grigoryan, dermatologist and Mohs surgeon, to uncover his unique journey toward becoming a surgeon and explore the intricacies of skin cancer management. With skin cancer being a prevalent challenge in rural surgery settings, Dr. Grigoryan highlights the precision and benefits of the Mohs technique. Whether you're a surgeon seeking to refine your understanding of this specialized approa...
Host Dr. Randy Lehman welcomes Dr. Shannon Gulley, a seasoned general surgeon with 20 years in practice, including the last decade operating in Alaska. She shares practical insights on personal finances as well as codes and modifiers, with an overall emphasis on maximizing your efforts and your income as a surgeon. With experience both as an employed surgeon and a practice owner, Dr. Gulley shares her thoughts on the two and dives ...
Looking ahead to the upcoming NARSS conference on January 17-18 in Denver, Dr. Randy Lehman explores the pivotal role of the North American Rural Surgical Society in supporting rural surgeons. He delves into the society's rich history and traces its evolution from the Northern Plains Vascular Society to its current form. He shares his personal experiences at the annual NARSS conference, highlighting its significance as a hub for pr...
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