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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.

Copyright: © Copyright 2024 All rights reserved.

Latest Episodes:

E08: Rural Robotic Revolution with Dr. John Robertson Oct 31, 2024

In this episode, host Dr. Randy Lehman sits down with Dr. John Robertson, who started his medical career in the big city before transitioning to rural surgery. Dr. Robertson delves into his “modified plug and patch” technique for inguinal hernia repair and his embrace of robotics in the OR, offering valuable insights for both urban and rural practitioners.

[00:00] Introduction

[00:50] Dr. Robertson’s background

[07:07] Collaboration and community in rural practice

[17:00] How I Do It: Open inguinal hernia

[30:12] How I Do It: Robotic surgery techniques

[34:56] Financial Corner

[36:14] Classic rural surgery anecdotes

[41:52] Resources for the busy rural surgeon

E07: Managing Complex Wound Care with Dr. Stephanie Heller Oct 24, 2024

In this episode, Dr. Randy Lehman reunites with his former program director at Mayo Clinic, the accomplished and beloved Dr. Stephanie Heller. Together they discuss Dr. Heller's wealth of experience, from navigating career transitions to mastering complex procedures like skin grafting and managing fistulas. Listen for insights on optimizing wound care, tackling challenging cases, and thriving in acute care surgery.

[00:00] Introduction

[1:18] Dr. Heller’s background

[06:37] Dr. Heller’s surgical group

[13:55] Importance of rural surgery and training

[25:29] How I Do It: Wound care and skin grafting

[48:43] How I Do It: Managing fistulas

[54:50] Financial Corner

[57:03] Resources for the busy rural surgeon

Resources Mentioned:

The American College of Surgeons

North American Rural Surgical Society

E06: PAs and the Power of Collaborative Care Oct 17, 2024

Join us in a special location as your host, Dr. Randy Lehman, sits down with Wisconsin PA Jerry Fushianes to discuss how Physician Assistants and Nurse Practitioners strengthen rural practices. Discover more about the Associate Provider model, where PAs are trained to duplicate physician services across specialties, acting as a conduit between doctors and patients to provide comprehensive care and support for rural surgeons.

[00:00] Introduction

[01:43] Jerry’s background

[08:00] How Dr. Lehman’s rural practice began

[12:50] Advantages of working with a PA

[20:50] The role of advanced practice providers in rural surgery

[26:29] Difference between PAs and nurse practitioners

[34:58] Building trust between doctor and PA/NP

[39:15] Continuing education for PAs/NPs and hiring a team

[48:11] Financial Corner

[53:35] Classic rural surgery anecdotes

Resources Mentioned:

NIFA's RNFA Program

E05: Mastering the Right Colectomy with Dr. Chris Huiras Oct 10, 2024

In this episode, host Dr. Randy Lehman is joined by Dr. Chris Huiras, a general surgeon who has dedicated over 30 years to providing care at Mayo Clinic as well as in rural Wisconsin. In addition to some great stories, Dr. Huiras shares a detailed overview of how he performs a right colectomy. Listen as Dr. Huiras' passion shines through, not just for surgery, but for the rural communities he's been able to serve along the way.

[00:00] Introduction

[01:03] Dr. Huiras’ background

[05:49] The spectrum of rural surgery

[10:44] How I Do It: Right Colectomy

[25:53] Financial Corner

[33:35] Classic rural surgery anecdotes

[38:03] Resources for the busy rural surgeon

Resources Mentioned:

Book: Rural Surgery

E04: Training the Next Generation of Surgeons with Dr. David Farley Oct 05, 2024

In this episode, host Dr. Randy Lehman sits down with former Mayo Clinic program director Dr. David Farley, who offers expertise as a seasoned and respected mentor to hundreds of surgeons. From his rural Wisconsin upbringing to his 31 years of training residents, Dr. Farley shares insights on mastering techniques like TEP inguinal hernia repair and fostering a culture of continuous learning and improvement.

[00:27] Dr. Farley’s background

[06:06] How I Do It: TEP inguinal hernia repair

[17:11] How I Do It: TEP bilateral hernia repair

[31:18] Financial Corner

[41:38] The importance of training and feedback in surgical education

[55:33] Resources for the busy rural surgeon

[1:01:58] How I Do It: J-tube

Resources Mentioned:

Book: Mayo Clinic General Surgery

E03: Navigating Global Rural Surgery with Dr. Lauren Smithson Sep 26, 2024

In this episode, Dr. Lauren Smithson, the Chair of the Advisory Council for Rural Surgery, shares her journey from the Caribbean to the UK to rural Canada, providing valuable insights to those eager to pursue a career in rural surgery. Host Dr. Randy Lehman and Dr. Smithson discuss her wide-ranging scope of work, from complex breast cancer operations to unique trauma cases, and her involvement in advocacy for rural medicine.

[00:58] Dr. Smithson’s background

[05:07] St. Anthony’s resources

[16:51] Rural biopsies and mastectomies

[34:10] Skin-sparing mastectomy technique

[40:59] Financial corner and Dr. Smithson’s unique investment

[45:43] Classic rural surgery anecdotes

[50:27] Resources for the busy rural surgeon

[53:35] Tips for choosing a program

Resources Mentioned:

Advisory Council for Rural Surgery

RagnaRok Brewing

E02: Trailblazing Rural Surgery with Dr. Tyler Hughes Sep 19, 2024

Few understand the wonders and challenges of rural surgery as acutely as the respected Dr. Tyler Hughes. In this episode, host Dr. Randy Lehman sits down with Dr. Hughes to discuss insights and anecdotes from his remarkable career. From being named the first Rural Practitioner of the Year to his instrumental involvement in the American College of Surgeons, Dr. Hughes has invaluable wisdom to share from his exceptional journey.

[00:00] Introduction

[02:41] Dr. Hughes’ transition from operating to teaching

[09:42] Importance of rural surgery

[14:44] Challenges and solutions in rural surgery

[23:05] Dr. Hughes’ detailed surgical technique for right colectomy

[36:42] Hand-sewn anastomosis technique

[46:50] Laparoscopic and Enhanced Recovery After Surgery (ERAS) techniques

[53:53] Financial wisdom for young surgeons

[56:42] Classic rural surgery anecdote

[1:03:37] Resources for the busy rural surgeon

Resources Mentioned:

Advisory Council for Rural Surgery

E01: Life in Rural Surgery Sep 13, 2024

In this introductory episode, Dr. Randy Lehman highlights the unique challenges and rewarding moments that come with practicing surgery in rural America. Tune in and join the community, where each week we'll discuss topics pertinent to the healthcare providers of America’s heartland.

Key Topics:

[0:00] Intro

[3:58] Upcoming segments and episodes

[7:44] Rural lifestyle and unique cases

The Rural American Surgeon Trailer Aug 16, 2024

This is your sneak peek into the world of rural surgery, where we celebrate the profound connections and unique experiences that define this vital field. In the upcoming episodes, we'll feature intimate conversations with leading rural surgeons, breaking down surgical techniques, and shedding light on the challenges faced by those practicing in isolated areas. You'll gain insights into overcoming professional isolation and fostering a supportive community, along with a financial corner featuring practical advice for achieving financial independence in your surgical career. Whether you're a seasoned professional, a resident, or just curious about rural healthcare, this podcast aims to inspire and empower you. Subscribe now to join us on this journey as we connect, learn, and grow together!

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