The Rural American Surgeon podcast

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المحتوى المقدم من Randy Lehman. يتم تحميل جميع محتويات البودكاست بما في ذلك الحلقات والرسومات وأوصاف البودكاست وتقديمها مباشرة بواسطة Randy Lehman أو شريك منصة البودكاست الخاص بهم. إذا كنت تعتقد أن شخصًا ما يستخدم عملك المحمي بحقوق الطبع والنشر دون إذنك، فيمكنك اتباع العملية الموضحة هنا https://ar.player.fm/legal.

Species Unite

1
Trevor Ritland: The Golden Toad 34:01

منذ 22 يومًا34:01

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قوائم

إعجاب

احب

34:01

I think you could probably go back and track the stages of grief, probably that is what I went through. But I think if you do it right, you end up at acceptance. And that's where I ended up. And that's not to say that I've fully accepted the idea that the golden toad is extinct. Personally, I do still hold out hope that it could still be out there in those forests." - Trevor Ritland This conversation is with Trevor Ritland, who—along with his twin brother Kyle—authored The Golden Toad . The book chronicles their remarkable journey into Costa Rica’s cloud forest, once home to hundreds of brilliant golden toads that would emerge for just a few weeks each year—until, one day, they vanished without a trace. What began as a search for a lost species soon became something much more profound: a confrontation with ecological grief, a meditation on hope, and a powerful call to protect the natural world while we still can. Links: SpeciesUnite.com Kyle and Trevor: https://kyleandtrevor.com/ Instagram: https://www.instagram.com/adventureterm/ Goodreads - https://www.goodreads.com/book/show/222249677-the-golden-toad Amazon - https://www.amazon.com/Golden-Toad-Ecological-Mystery-Species/dp/163576996…

The Rural American Surgeon

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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.

39 حلقات

#Science #Randy Lehman

The Rural American Surgeon

updated منذ 6 أيام

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39 حلقات

#Science #Randy Lehman

كل الحلقات

The Rural American Surgeon

1
E38: The Colonoscopy Chronicles with Dr. Dan Margo 1:39:01

منذ 6 أيام1:39:01

1:39:01

What happens when you're the only surgeon for hundreds of miles and every decision matters? Host Dr. Randy Lehman welcomes Dr. Dan Margo, a seasoned rural surgeon from northern Minnesota, who has spent decades mastering the art of surgical practice in isolation. Dr. Margo shares hard-won insights from his years serving remote communities, including the unique challenges of being a visiting surgeon and the critical importance of collegiality in rural practice. They dive deep into colonoscopy techniques–including abdominal pressure maneuvers and advanced lesion removal strategies–while exploring everything from Miralax prep protocols to pre-anesthesia evaluation timing. Dr. Margo demonstrates why rural surgeons must be master diagnosticians, skilled technicians, and compassionate caregivers all rolled into one. Tune in for an inspiring episode filled with practical surgical wisdom from the frontlines of rural healthcare, where innovation is born from necessity and every patient interaction truly counts. 0:00 Introduction 2:58 Dr. Margo's Background 5:22 Why Rural Surgery Is Special to You 23:52 How I Do It: The Colonoscopy 1:35:40 Financial Corner 1:37:06 Resources for the Busy Rural Surgeon Resources Mentioned: 🌐 Foregut Disease Foundation course: https://foregutdiseasefoundation.org/2025-course 🌐 North American Rural Surgical Society : https://www.northamericanrss.org/ 🌐 American Society for Gastrointestinal Endoscopy (ASGE) Guidelines: https://www.asge.org/home/resources/publications/guidelines 🌐 Cologuard test (alternative screening method for colorectal cancer): https://www.cologuardtest.com/…

The Rural American Surgeon

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E37: Money Miniseries 1: What's the Point? Why Money Means Nothing Without Purpose 38:07

منذ 13 يومًا38:07

38:07

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—how what you believe about life shapes how you handle money. Dr. Lehman pushes back on the pursuit of wealth for its own sake, arguing that without a higher purpose, money is meaningless. He challenges listeners to redefine what it truly means to be “rich”—and why, in the end, the means are the ends. This episode sets the stage for the entire series: exploring money as a tool for freedom, purpose, and lasting impact. 0:00 Introduction 2:15 The Most Important Question 3:30 A Conversation with ChatGPT About Evolution and Design 15:40 Why Darwin's Finches Don't Prove Macroevolution 18:55 The Cultural Fallout of Teaching We're Cosmic Accidents 25:30 ChatGPT's Stunning Response 31:20 From Utilitarian Thinking to Faith-Based Purpose 34:10 Money as Freedom vs. Monument Building 36:05 Redefining “Rich”…

The Rural American Surgeon

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E36: Saving a Dying Hospital with Dr. Manu Kaushik 1:28:41

منذ 20 يومًا1:28:41

1:28:41

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 surgical services from scratch, training staff, fixing broken equipment, and literally buying his own instruments to keep patients from having to travel hours for basic care. They dive deep into his innovative modified Smead-Jones hernia repair technique, discuss IPOM and component separation procedures, explore the transition from laparoscopic to robotic surgery, and cover everything from inguinal repairs to emergency trauma management. Tune in for an inspiring episode filled with practical surgical techniques and unforgettable stories from the frontlines of rural healthcare. 0:00 Intro 1:54 Dr. Kaushik's Background 6:43 Why Rural Surgery Is Special to You 11:00 How I Do It: Ventral Hernia Repair 20:22 How I Do It: Smead-Jones Stitch 28:23 How I Do It: IPOM Technique 35:13 How I Do It: Robotic Inguinal Focus 43:51 How I Do It: Mesh Placement in Hernia Repair 55:48 Financial corner 1:06:06 Classic Rural Surgery Stories 1:23:18 Resources for the Busy Rural Surgeon Resources Mentioned 🌐 American College of Surgeons (ACS) Rural Trauma Development Course: https://www.facs.org/quality-programs/trauma/education/ 🌐 ACS Stop the Bleed Program: https://www.stopthebleed.org/ 🌐 ACS Rural Surgery Resources: https://www.facs.org/for-medical-professionals/education/programs/so-you-want-to-be-a-surgeon/section-iii-surgical-specialties/rural-surgery-program/ 🌐 MGMA (Medical Group Management Association) Data: https://www.mgma.com/mgmadata…

The Rural American Surgeon

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E35: Carotid Endarterectomy Mastery with Dr. Michael Roskos 45:36

منذ 27 يومًا45:36

45:36

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 his experience practicing in La Crosse, Wisconsin, and his weekly surgeries in the small town of Arcadia, where he operated on patients whose families he'd known for generations. Tune in for an in-depth discussion where technical mastery intersects with the unique demands of rural healthcare. 0:00 Introduction 1:52 Dr. Roskos’ Background and Path to Rural Surgery 4:11 Why Rural Surgery Is Special to You 6:08 How I Do It: Carotid Endarterectomy 29:30 Financial Corner 33:49 Classic Rural Surgery Story 39:30 Finding The Right Surgical Volume Balance 43:21 Resources for The Busy Rural Surgeon 45:03 Outro Resources Mentioned 🌐 Rural surgery listserv: https://gaggle.email/join/distribution-list@rural-surgery.ca 🌐 National Comprehensive Cancer Network Guidelines (NCCN): https://www.nccn.org/guidelines/ 🌐 UpToDate - Medical Resource recommended by Dr. Rosko: https://www.uptodate.com/…

The Rural American Surgeon

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E34: Rural Surgery on the Cutting Edge with Dr. Greg Gerrish 1:13:20

منذ 5 weeks1:13:20

1:13:20

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 laparoscopic hiatal hernia repair, his reasons for avoiding bougie-assisted intubation, and how he selects patients for LINX procedures. He also walks through a high-stakes trauma case that required fast thinking and decisive action. This episode offers a look into the kind of surgical work being done far from academic centers—but with no less precision or purpose. 0:00 Intro 3:23 Dr. Gerrish's Background 10:25 Why Rural Surgery Is Special To You 13:46 How I Do It: Laparoscopic Foregut 1:03:48 Financial Corner 1:04:49 Classic Rural Surgery Story 1:12:21 Closing Thoughts Resources Mentioned: 🌐 Foregut Disease Foundation course: https://www.forgutdiseasefoundation.org/ 🌐 Comprehensive General Surgery Review Course (Mayo Clinic): https://ce.mayo.edu/surgery/content/comprehensive-general-surgery-review-course-2024…

The Rural American Surgeon

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E33: Bariatric Breakthroughs in Rural America with Dr. Kabir Mehta 1:11:08

منذ 6 weeks1:11:08

1:11:08

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, how he earned trust in a town where everyone knows everyone, and what it takes to not just survive but thrive in rural practice. They dig into technical hurdles, financial realities, and those 2 AM moments when you’re the only one on call. But it’s not all struggle–there’s something powerful about practicing medicine where you know your patients’ stories and see the difference you're making every day. 0:00 Intro 5:11 Dr. Mehta's Background and Practice 14:42 How I Do It: Bariatric Emergencies 26:28 Managing Internal Hernias in Bariatric Patients 48:13 Embracing Failure and Learning from It 59:30 Missed Shuttle Story 1:08:48 Closing Thoughts Resources Mentioned: 🌐 White Coat Investor: https://www.whitecoatinvestor.com/ ▶️ Dr. Kabir Mehta's YouTube channel: @KabirMehtaMD…

The Rural American Surgeon

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E32: The Art of Adaptability in Rural Surgery with Dr. P.J. Reddy 41:02

منذ 7 weeks41:02

41:02

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 in for an episode packed with wisdom and inspiration for every medical professional committed to excellence in rural healthcare. 0:00 Intro 5:11 Dr. Reddy's Background 12:32 Why Rural Surgery Is Special to Dr. Reddy 14:47 How I Do It: Colonoscopy 25:12 Financial Corner 32:24 Classic Rural Surgery Stories 35:44 Resources for the Busy Rural Surgeon 39:16 Closing Thoughts Resources Mentioned: 🌐 Rural surgery listserv: https://gaggle.email/join/distribution-list@rural-surgery.ca 📚 Atlas of Color Human Anatomy by McMinn and Hutchings…

The Rural American Surgeon

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E31: The Privilege of Practicing Back at Home with Dr. Gary Timmerman 1:11:25

منذ 8 weeks1:11:25

1:11:25

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. Tune in for an episode packed with wisdom and inspiration for every medical professional committed to excellence in rural healthcare. 0:00 Intro 5:57 Dr. Timmerman's Background 9:19 Why Rural Surgery Is Special to Dr. Timmerman 12:46 How I Do It: Esophagectomy Techniques 24:02 Tips for Diagnosing Esophageal Cancer 38:45 Colonic Conduit and Anastomosis Techniques 53:24 Financial Corner 55:45 Faith's Role in Dr. Timmerman's Practice 58:33 Classic Rural Surgery Stories 1:02:40 Resources for the Busy Rural Surgeon 1:07:34 Sanford Health Residency Programs Resources Mentioned: 🌐 American College of Surgeons (ACS): https://www.facs.org/ 🌐 North American Rural Surgical Society: https://www.northamericanrss.org/ 🌐 Sanford Health: https://www.sanfordhealth.org/ 🌐 Sanford Medical Education division: https://www.sanfordhealth.org/initiatives/medical-education 🌐 South Dakota and North Dakota Chapter of the American College of Surgeons: https://www.sdsma.org/event-5616925…

The Rural American Surgeon

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E30: Innovations in Rural Surgery with Dr. Eugene Shively 56:59

منذ 9 weeks56:59

56:59

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. Shively also brings up the debate about government-subsidized insurance and recounts a memorable case from his career. Tune in for a compelling episode packed with practical notes and inspiring stories for every medical professional. 0:00 Intro 5:18 Why Rural Surgery is Special to You 16:44 How I Do It: Laparoscopic common bile duct exploration 24:09 Volumes and equipment for common bile duct exploration 29:45 Open common bile duct exploration techniques 32:03 Dr. Shively's thoughts on robotic surgery in rural locations 38:11 Case discussion: Sigmoid colon polyp management 49:27 Financial Corner: Hospital employment for surgeons 51:17 Classic Rural Surgery Story: 1989 case 54:17 Resources for the Busy Rural Surgeon 56:12 Outro…

The Rural American Surgeon

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E29: The Case That Changed Me 39:13

منذ 10 weeks39:13

39:13

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 communication and deepened his commitment to compassionate, patient-centered care. 0:00 Intro 5:28 Grandpa's emergency 11:26 Resource limitations in small hospitals 18:30 Unexpected turn of events post-surgery 24:38 Lessons learned 38:13 Importance of rural surgeons…

The Rural American Surgeon

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E28: Flying My Helicopter to Surgery 54:38

منذ 12 weeks54:38

54:38

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 Indiana. ...and let’s be honest, flying is just plain awesome! 0:00 Introduction 1:58 Family Aviation Roots and Grandpa's Flying Legacy 12:47 Trading Long Drives for Short Flights During Residency 19:51 The Real Economics of Maintaining Three Aircraft 25:31 Robinson R44 Operations and Beating the Air into Submission 29:23 Why a Helicopter Provides Crucial Direct Hospital Access 34:03 Getting a Helicopter License in Just 54 Days 38:17 Landing at Hospitals, Schools and Family Farms 41:53 Transforming Friends Through Rural Peace After City Chaos 47:03 Weather Limitations and Always Having a Safety Plan B 52:24 When $400 Per Hour Flying Actually Makes Financial Sense 54:08 Small Minds vs. Creative Rural Transportation Solutions 59:09 Designing an Intentional Rural Surgical Practice Resources Mentioned: Cleveland Helicopters https://clevelandhelicopters.com/ One Six Right https://www.onesixright.com/…

The Rural American Surgeon

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E27: Bringing Complex Procedures Back to Rural Roots with Dr. Rebekah Wever 46:33

منذ 14 weeks46:33

46:33

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 resilience in her underserved Appalachian hometown means the difference between life-threatening transfers and keeping critical care local. Whether you're a healthcare provider considering rural practice or simply curious about delivering exceptional surgical care in underserved communities, discover why Dr. Wever believes returning home might be the most rewarding decision a surgeon can make. 0:00 Introduction 1:26 Dr. Wever's Background 7:01 Why Rural Surgery is Special to You 8:49 How I Do It: Ventral Hernia Repair - Transversus Abdominis Release 37:55 Resources for the Busy Rural Surgeon 39:27 Financial Corner 42:01 Classic Rural Surgery Story Resources Mentioned: Book: Hernia Surgery: Current Principles by Yuri W. Novitsky…

The Rural American Surgeon

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E26: Honduras Medical Missions & Gallbladder Cases with Dr. John Haeberlin 51:35

منذ 15 weeks51:35

51:35

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 decisions they faced in the field. 0:00 Introduction 1:41 Dr. Haeberlin's Background 3:26 Why Rural Surgery Is Special To You 8:10 How I Do It: Laparoscopic Cholecystectomy 38:47 Classic Rural Surgery Story 45:26 Financial Corner 47:04 Resources for the Busy Rural Surgeon…

The Rural American Surgeon

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E25: Rural Emergency C-Sections with Dr. Dave Kermode 1:17:57

منذ 18 weeks1:17:57

1:17:57

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 with wisdom both in and out of the operating room. 0:00 Introduction 0:48 Dr. Kermode's background 4:08 Why Rural Surgery Is Special To You 7:55 C-Sections as a Rural Surgeon 16:59 OB Department Closures 29:01 How I Do It: Emergency C-Section 52:24 Technical Differences: Elective vs. Emergency C-Sections 1:03:02 Financial Corner 1:11:22 Classic Rural Surgery Stories 1:13:21 Resources for the Busy Rural Surgeon Resources mentioned: North American Rural Surgical Society Really Rural Surgery Podcast Rural Medical Training Collaborative…

The Rural American Surgeon

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E24: Sentinel Node Biopsy with Dr. Mel Johnson - Part 2 32:50

منذ 19 weeks32:50

32:50

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: Sentinel Lymph Node Biopsy 05:43 Ongoing Trials in Breast Cancer Surgery 13:27 How I Do It: Patient Prep 20:54 Resources for the Busy Rural Surgeon 21:57 How I Do It: Piglet Hernia Repair 26:52 Financial Corner 28:43 Classic Rural Surgery Story Resources Mentioned: NCCN Guidelines CoC Guidelines New England Journal of Medicine article: "Sentinel Lymph Node Biopsy in Early Stage Breast Cancer: Is It Obsolete?" by Monica Morrow (December 2024) INSEMA trial - Ongoing clinical trial on sentinel lymph node biopsy in breast cancer SOUND trial - Ongoing clinical trial on sentinel lymph node biopsy in breast cancer…

The Rural American Surgeon

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E23: Sentinel Node Biopsy with Dr. Mel Johnson - Part 1 39:55

منذ 20 weeks39:55

39:55

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 settings, emphasizing the importance of multidisciplinary approaches and overcoming barriers. 0:00 Introduction 1:43 Dr. Johnson's Background 8:33 Residency Program Updates 14:54 How I Do It: Sentinel Lymph Node Biopsy (Patient Prep and Anecdotes) 25:40 How I Do It: Sentinel Lymph Node Biopsy (Technical Details) 34:33 Overcoming Obstacles in Rural…

The Rural American Surgeon

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E22: Technology Disruptors in Rural Medicine with Dan Leman - Part 2 35:33

منذ 22 weeks35:33

35:33

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 Intro 5:03 Unexpected rectal cancer during surgery 11:19 Importance of humility in practice 17:41 Culture of humility among rural surgeons 22:37 Critical access dollars and healthcare policy 29:26 Investing in rural communities Resources mentioned: UpToDate Rural American Surgeon Facebook page Critical Access Hospital program…

The Rural American Surgeon

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E21: Technology Disruptors in Rural Medicine with Dan Leman - Part 1 33:21

منذ 24 weeks33:21

33:21

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 from international medical missions. 0:00 Intro 1:30 Dan Leman's Background 5:47 Telehealth Technology 12:25 Inventing Medical Technology 17:17 Surgical experience in Haiti Resources mentioned: PAACS BMDMI When Helping Hurts book…

The Rural American Surgeon

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E20: Mohs Surgery and Skin Grafts with Dr. Konstantin Grigoryan 49:49

منذ 25 weeks49:49

49:49

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 approach or simply interested in the art and science of dermatologic surgery, this episode offers valuable insights and practical takeaways. 0:00 Intro 1:37 Dr. Grigoryan’s Background 5:51 How I Do It: Mohs Surgery 17:09 How I Do It: Skin Grafts 34:12 Financial Corner 35:20 Classic Rural Surgery Stories 45:23 Resources for the Busy Rural Surgeon 45:58 How I Do It: Benign Skin Cyst Resources mentioned: DermNet NZ…

The Rural American Surgeon

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E19: General Surgery in the Last Frontier with Dr. Shannon Gulley 45:48

منذ 26 weeks45:48

45:48

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 into thyroidectomy and anterior spine exposure in a bonus “How I Do It” segment. 0:00 Intro 6:15 Dr. Gulley’s Background 21:31 How I Do It: FNA and Thyroidectomy 36:41 Financial Corner 38:18 Classic Rural Surgery Anecdotes 39:45 Resources for the Busy Rural Surgeon 40:30 How I Do It: Anterior Spine Exposure Resources mentioned: American College of Surgeons American Society of Breast Surgeons Mayo Clinic QuickBooks…

The Rural American Surgeon

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E18: Evolution of the North American Rural Surgical Society 8:17

منذ 27 weeks8:17

8:17

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 practical learning and networking and how it has impacted his rural practice for the better. 0:00 Intro 0:51 North American Rural Surgical Society 6:01 Upcoming conference details Resources Mentioned: North American Rural Surgical Society (NARSS)…

The Rural American Surgeon

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E17: Robotic Ventral Hernia Repair with Dr. Jeremy Stoller 43:37

منذ 28 weeks43:37

43:37

Host Dr. Randy Lehman welcomes Dr. Jeremy "Bud" Stoller, a distinguished rural surgeon from Van Wert, Ohio. Known for his expertise in hernia repair and his commitment to rural healthcare, Dr. Stoller shares his journey from training at The Ohio State University and the University of Toledo to practicing in his hometown. Dr. Stoller details his approach to ventral hernia repair and his excitement for utilizing robotics in his small-town hospital setting. 0:00 Intro 5:10 Dr. Stoller’s Background 12:29 How I Do It: Ventral Hernia Repair 37:02 Financial Corner 39:01 Classic Rural Surgery Anecdotes 43:06 Resources for the Busy Rural Surgeon Resources Mentioned: International Hernia Collaboration SurgeOn app General Surgery News American College of Surgeons (ACS) forums…

The Rural American Surgeon

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E16: Big Impact in Small Town Family Medicine with Dr. Tod Stillson 46:28

منذ 29 weeks46:28

46:28

Host Dr. Randy Lehman and Dr. Tod Stillson have a heartwarming conversation about the importance of transparency and trust when it comes to small town healthcare–especially in family medicine when you have the opportunity to serve families through many stages of life. In addition to discussing the impact of closing obstetrics units in rural hospitals, Dr. Stillson shares insights on achieving financial independence and introduces his “Employment Lite” model, which combines the benefits of traditional employment with private practice. This episode might just save a rural surgeon a few hundreds of thousands of dollars over the years! 0:00 Intro 3:43 Dr. Stillson’s Background 7:51 Rural Maternity Unit Closures 9:12 Financial Corner 31:45 Resources for the Busy Rural Surgeon 36:17 Classic Rural Surgery Anecdotes 41:28 Resources for the Busy Rural Surgeon Resources mentioned in this episode: Doctor Incorporated book Donor Advised Funds SimpliMD…

The Rural American Surgeon

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E15: Rural Surgery Research with Dr. Dorothy Hughes 27:45

منذ 30 weeks27:45

27:45

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…

The Rural American Surgeon

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E14: "My Dad's a Rural Surgeon!" with Charlotte Lehman 9:53

منذ 31 weeks9:53

9:53

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.…

The Rural American Surgeon

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E13: GI Bleeds in Rural Canada with Dr. Emily Mitic 43:58

منذ 32 weeks43:58

43:58

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…

The Rural American Surgeon

1
E12: From Residency to Rural with Dr. Ben Mundell 45:30

منذ 33 weeks45:30

45:30

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 Hospitals 09:00 - Dr. Lehman's Early Career Insights 13:00 - Handling Complex Cases in Rural Practice 18:40 - Expanding Surgical Scope in Rural Hospitals 26:30 - How I Do It: Laparoscopic Inguinal Hernia Repair 44:00 - Resources for the Busy Rural Surgeon Resources Mentioned: UpToDate North American Rural Surgical Society…

The Rural American Surgeon

1
E11: The Value of Surgical Mentorship with Dr. Eugene Shively 1:08:11

منذ 34 weeks1:08:11

1:08:11

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…

The Rural American Surgeon

1
E10: Purpose, Practicing, and Publishing with Dr. Michael Sarap 42:18

منذ 35 weeks42:18

42:18

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…

The Rural American Surgeon

1
E09: Laparoscopic Surgery Insights with Dr. Michael Sarap 1:00:04

منذ 35 weeks1:00:04

1:00:04

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…

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The Rural American Surgeon

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مرحبًا بك في مشغل أف ام!

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