The Rural American Surgeon

E15: Rural Surgery Research with Dr. Dorothy Hughes

As part of this new miniseries, "The Children of Rural Surgeons," host Dr. Randy Lehman welcomes Dr. Dorothy Hughes, daughter of esteemed rural surgeon, Dr. Tyler Hughes. Their conversation delves into her experiences growing up with a small-town surgeon for a father and how that impacted her upbringing. And ultimately, how Dr. Dorothy Hughes came full circle to rural surgery from an academic perspective, including some of the compelling research she's done in this field. 
 
0:00 Intro
1:10 Dr. Dorothy Hughes’ Background
5:55 Growing Up as the Child of a Rural Surgeon
15:37 How I Do It: Rural Surgery Research
19:43 Financial Corner
23:01 Classic Rural Surgery Anecdotes
25:01 Resources for the Busy Rural Surgeon
 
Resources Mentioned:
 
Trailblazing Rural Surgery with Dr. Tyler Hughes
North American Rural Surgical Society
Selected Readings in General Surgery
Dr. Dorothy Hughes’ Google Scholar account

E14: "My Dad's a Rural Surgeon!" with Charlotte Lehman

In this heartfelt episode, Dr. Randy Lehman is joined by two very special guests, his daughter Charlotte and a surprise appearance by his wife, Brittaney. Together they reflect on the demanding days of residency in Minnesota, and how the transition to rural practice in Indiana has impacted their family life and balance.
 
Charlotte describes her dad’s work as candidly and charmingly as only an 8-year-old can (“lots of gross surgeries!”) and reflects on how much more she gets to see her dad now compared to the days of residency. This fun and lighthearted episode not only provides insights into the professional life of a rural surgeon with small children, but also underscores the personal aspects of being present with family throughout a demanding career. 

E13: GI Bleeds in Rural Canada with Dr. Emily Mitic

Explore surgical care in rural Canada through the perspective of host Dr. Randy Lehman as he sits down with Canadian general surgeon, Dr. Emily Mitic. Dr. Mitic is dedicated to serving rural Alberta, practicing in a small city uniquely positioned between two major urban centers, which means her hospital serves a greater population of about 425,000 people. Tune in for a detailed walkthrough of Dr. Mitic’s approach to GI bleeds, a discussion of some distinctions between American and Canadian healthcare, and a lively rural surgery anecdote!
[00:00] Introduction
[00:55] Dr. Mitic’s Background
[07:42] How I Do It: GI Bleed 
[30:43] Financial Corner: Canadian Healthcare
[37:57] Classic Rural Surgery
[42:12] Resources for the Busy Rural Surgeon
Resources Mentioned:
Huber Ag Equipment
American College of Colorectal Surgeons Guidelines

E12: From Residency to Rural with Dr. Ben Mundell

Host Dr. Randy Lehman sits down with Dr. Ben Mundell, a newly minted general surgeon carving out his path in the Eastern Sierras of California. Together they discuss what it takes to thrive as a rural surgeon, especially in those crucial early months out of residency. Tune in for practical advice, invaluable insights, and must-know resources for making a successful transition from residency to rural practice.
 
0:00 - Introduction 4:16 - Challenges Facing Rural Hospitals09:00 - Dr. Lehman's Early Career Insights 13:00 - Handling Complex Cases in Rural Practice18:40 - Expanding Surgical Scope in Rural Hospitals26:30 - How I Do It: Laparoscopic Inguinal Hernia Repair44:00 - Resources for the Busy Rural Surgeon 
 
Resources Mentioned:
UpToDate
North American Rural Surgical Society

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