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

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

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