Dr. Levi Smucker joins host Dr. Randy Lehman on The Rural American Surgeon to discuss his path to rural general surgery, from growing up in Pennsylvania and training at Bassett Healthcare in Cooperstown to building his practice in Goshen, Indiana.

He shares how a close knit group of six surgeons has given him strong mentorship, broad operative experience, and the opportunity to develop his own areas of expertise while serving multiple hospitals.

Dr. Smucker also takes a practical look at pilonidal disease, walking through patient presentation, conservative management, the Gips procedure, excision, wound healing, and the Bascom cleft lift.

The conversation explores how he approaches recurrent and complex cases, technical considerations for different procedures, and the importance of choosing treatment based on the individual patient.

They also discuss cost sharing within local Plain Church communities, an unusual rural surgery case involving an esophageal food bolus, preparing for challenging cases without letting anxiety take over, and why mentorship remains so important for the next generation of rural surgeons.

Key Takeaways

00:38 Meet Rural General Surgeon Dr. Levi Smucker

01:20 From Pennsylvania to Rural Surgery in Indiana

02:18 Why Bassett Healthcare Was the Right Place to Train

02:52 Building a Career in a Supportive Rural Surgery Practice

04:21 Resources and Capabilities Across Three Hospitals

05:09 Finding a Surgical Niche in Rural Practice

05:52 Bringing Vascular Surgery Into General Surgery Practice

06:25 The Broad Spectrum of Rural General Surgery

08:30 Why Rural Surgery Still Matters

09:15 Understanding Pilonidal Disease

11:27 Evaluating Patients After a Pilonidal Abscess

12:09 Treatment Options for Pilonidal Disease

13:05 How the Gips Procedure Works

15:02 The Bascom Cleft Lift Procedure

16:43 Technical Approach to the Gips Procedure

18:13 Choosing the Right Treatment for Complex Cases

20:48 Performing the Bascom Cleft Lift

24:52 Creating an Off Midline Closure

26:03 Coding Considerations for Pilonidal Surgery

27:42 Lessons From Plain Church Communities and Cost Sharing

29:10 A Classic Rural Surgery Case

30:06 Preparing for Difficult Cases Without Burning Out

32:46 Why a Culture of Mentorship Must Be Passed On

Resources Mentioned

Bassett Healthcare

https://www.bassett.org/

Gehrig Surgical Associates

https://www.gerigsurgical.com/

Critical Access Hospitals

https://www.cms.gov/medicare/health-safety-standards/certification-compliance/critical-access-hospitals