The Rural American Surgeon

E11: The Value of Surgical Mentorship with Dr. Eugene Shively

Host Dr. Randy Lehman sits down with friend, mentor, and "godfather" of rural surgery, Dr. Eugene Shively to discuss his impressive 46-year career. From the comfort of Dr. Shively's 200-year-old cabin (listen for the full story!), the two discuss the evolution of surgical techniques, Dr. Shively's approach to common bile duct exploration, and invaluable advice for residents who plan to pursue a career in rural surgery.
 
[0:00] Introduction
[0:48] Dr. Shively’s Background
[10:25] How I Do It: Common Bile Duct Exploration
[25:50] Financial Corner
[31:51] Classic Rural Surgery
[39:13] Resources for the Busy Rural Surgeon
[45:45] How I Do It: Perianal Procedures
[59:08] Importance of Having a Mentor
Resources Mentioned:
Podcast: Single Payer Health Care

E10: Purpose, Practicing, and Publishing with Dr. Michael Sarap

In part two of their conversation, Dr. Randy Lehman welcomes back Dr. Michael Sarap to dive deeper into his 37 years as a rural surgeon. Building on their earlier insights into financial strategies for young surgeons, Dr. Sarap shares intense and captivating stories from rural practice. Listeners will come away inspired and equipped with resources for building a strong network of specialist colleagues. With a wealth of experience and a deep passion for small-town healthcare, Dr. Sarap makes this episode a must-listen for any provider dedicated to rural communities.
[00:00] Introduction
[01:05] Financial Corner
[10:55] Happiness and greater purpose
[15:15] Classic rural surgery anecdotes
[25:24] Resources for the busy rural surgeon
[31:23] Publishing papers while practicing
 
Resources Mentioned:
Book: Man's Search for Meaning
Book: Ikigai
Article: Ripples: One Trauma Case, Three Generations of Lives Saved
North American Rural Surgical Society
ACS Chapters

E09: Laparoscopic Surgery Insights with Dr. Michael Sarap

In this episode, host Dr. Randy Lehman sits down with Dr. Michael Sarap, a seasoned rural surgeon with 37 years of experience. Dr. Sarap shares the rewards and challenges of his career, offering invaluable insights into building a successful rural surgery practice. From mastering advanced endoscopic techniques to performing complex procedures like laparoscopic common bile duct exploration, join us for an engaging discussion that underscores the impact of dedicated rural surgeons in their communities.
[0:00] Intro[0:48] Dr. Sarap's background[5:48] Building a rural surgery practice[33:44] How I Do It: Laparoscopic Common Bile Duct Exploration
 
Resources Mentioned:
ACS Stop the Bleed

E08: Rural Robotic Revolution with Dr. John Robertson

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

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

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

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
UpToDate

E04: Training the Next Generation of Surgeons with Dr. David Farley

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

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

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