Today Dr. Lehman sits down with the most special guest, his daughter Charlotte.

And this time, she’s in the host seat asking the hard-hitting questions!

She covers everything from fear in the operating room to money, parenting, and of course, the grossest thing dad’s ever seen in surgery.

🌐 Connect with The Rural American Surgeon:https://www.theruralamericansurgeon.com/

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Locums surgery is often treated as temporary coverage, but many rural hospitals rely on it to maintain consistent access to care. Surgeons step in without relocating, often filling roles that cannot support full time hires.

Megan Hoot, a physician recruiter at CompHealth, has spent over eight years placing surgeons into roles that often become long-term solutions. She has worked closely with Dr. Randy Lehman across multiple assignments and brings a clear view of how these arrangements develop.

In this episode, Megan and Dr. Hoot break down how locums works in practice, including licensing, privileges, malpractice coverage, and how surgeons are selected and paid. They also address common misconceptions about ease and competition.

For rural surgeons, locums becomes a way to maintain coverage while building flexibility without sacrificing continuity.

0:00 Intro

01:54 Megan Hoot’s Background

11:14 Why Rural Surgery?

16:31 How I Do It: Locums Setup and Entry

39:44 Financial Corner: Locums Rates

58:55 Resources for the Busy Rural Surgeon

Resources Mentioned:

Book a call with Megan:

https://snshqsc.co/uVf0y3

CompHealth:

https://www.comphealth.com/

🌐 Connect with The Rural American Surgeon:

https://www.theruralamericansurgeon.com/

Join us on Facebook:

https://www.facebook.com/profile.php?id=61564305936854

In rural surgery, there’s no “waiting until you feel ready.” There’s only action, because sometimes you’re the only one.

Dr. Scott Nelson, a colorectal surgeon in Grants Pass, Oregon, built a solo practice after losing his partner early in his career. What followed was years of figuring it out in real time, often without backup.

In this episode, Dr. Randy Lehman and Dr. Nelson break down what it actually looks like to grow into responsibility: managing cases outside your training, making decisions without a safety net, and learning through repetition, not confidence.

They also walk through practical approaches to common perianal disease, including hemorrhoids, fistulas, abscesses, and fissures in a rural setting.

From handling GI bleeds without formal training to building a full colorectal practice in isolation, this conversation highlights a core reality of rural medicine:

Competence often comes after you accept responsibility.

If you’re early in your career (or stepping into situations where you feel unprepared) this episode will shift how you interpret that feeling.

0:00 Intro

01:54 Dr. Nelson’s Background

04:23 Why Rural Surgery Is Special to You

14:26 How I Do It: Managing Perianal Disease

48:03 Financial Corner

53:31 Resources for the Busy Rural Surgeon

Resources Mentioned:

North American Rural Surgical Society:

https://www.northamericanrss.org/

🌐 Connect with The Rural American Surgeon:

https://www.theruralamericansurgeon.com/

Join us on Facebook:

https://www.facebook.com/profile.php?id=61564305936854