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Randy Lehman Podcasts

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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 communiti ...
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A family doc taking on surgery in rural America? That’s what Dr. Brogan Bahler is doing as a rural family physician who has carved out a full-scope OBGYN practice, including C-sections, D&Cs, hysteroscopies, and more. In today’s conversation, Dr. Bahler and Dr. Randy Lehman discuss: How residency moonlighting helped prepare him for surgical OB Why …
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What does it really mean to be efficient? In this fifth installment of the Money Miniseries, Dr. Randy Lehman takes us deep into the philosophy and practical tactics of operating with maximum efficiency–whether you’re in the OR, clinic, or managing investments. From streamlining surgical workflows to understanding your personal dollar-per-hour, thi…
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What do you do when the gallbladder just won’t behave—and the duct isn't clear? In Part 2 of our conversation, Dr. Randy Lehman and Dr. Seung Gwon get deep into advanced gallbladder surgery, rural surgical reality, and the wisdom behind bailout decisions. From fenestrated cholecystectomies to lost stones, lost nights of sleep, and lost support staf…
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What if you could design your own job out of residency…and make it stick for 20 years? In Part 1 of this two-part episode, Dr. Randy Lehman sits down with Dr. Seung Gwon, a general surgeon from El Centro, California, to explore what it takes to build—and keep—a solo rural practice. They dive deep into income guarantees, sign-on bonuses, practice mo…
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In this episode of the Money Miniseries, Dr. Randy Lehman sits down with a very special guest—his wife, Brittaney—to share the tax strategy that’s become a cornerstone of their financial plan: Real Estate Professional Status (REPS). They walk through what REPS is, why it’s so powerful for high-income households, and how Brittaney’s role as a full-t…
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What happens when you're learning one of surgery's most technical procedures from a living legend? Dr. Benji Smith, an advanced endoscopy fellow training under the renowned Dr. Vitale in Louisville, joins host Dr. Randy Lehman to share his journey from general surgery residency to mastering ERCP. The two discover a surprising connection to the same…
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What if the biggest ROI isn’t measured in dollars, but in freedom? In this third installment of his finance miniseries, Dr. Randy Lehman unpacks what it really means to invest—beyond the usual “just put it in a 401(k)” advice. From real estate and business ownership to tax liens and even cattle, Dr. Lehman pulls back the curtain on investment oppor…
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What happens when you bring cutting-edge robotic surgery to one of the poorest regions in America? Host Dr. Randy Lehman welcomes Dr. Quince Gibson, a UAB-trained general surgeon serving rural Alabama's Black Belt region. Born in Jamaica and shaped by a life-changing encounter with poverty in inner-city Baltimore, Dr. Gibson made the bold decision …
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Beyond the 'why' of money lies the 'how'—and it starts with a practical paradox most doctors never hear: the less you need, the richer you become. What if the secret to true wealth isn't earning more, but spending less? In episode two of his finance miniseries, host Dr. Randy Lehman reveals why frugality is the unsung hero of wealth building. This …
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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…
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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…
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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 communit…
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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…
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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…
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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 cover…
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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 stud…
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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 o…
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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 tech…
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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, …
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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 se…
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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 fo…
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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…
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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 dis…
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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…
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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. …
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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 convers…
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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 …
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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. Whe…
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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 employ…
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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 expe…
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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 app…
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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 hospita…
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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 …
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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’…
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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 …
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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 ma…
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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 inval…
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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 …
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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 …
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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 practi…
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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 c…
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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 doct…
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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 …
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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…
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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 operatio…
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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 S…
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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…
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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 iso…
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