Interview Summary

Dr. Rechner is a general surgeon who practices medicine in a rural community in Michigan. Alongside her job as a general surgeon, she is also her county’s medical examiner, the trauma program medical director, and is on the administrative team and executive committee for the hospital where she works.
General surgeons essentially take care of all of the surgical operations that are not done by surgeons in specialized fields like orthopedics or neurosurgery. Some of the procedures done by general surgeons include, but are not limited to, colon surgery, bowel surgery, hernia surgery, and breast surgery.
Dr. Rechner describes her love for her patients and working in a rural community. She emphasizes how rewarding it is to be able to care for patients close to home without them needing to travel long distances to get the care they need.
To become a general surgeon, you first have to get an undergraduate degree, followed by four years of medical school. Afterwards, you must complete a five-year residency. Some general surgeons also choose to attend a one-to-three-year fellowship to receive additional training.
Dr. Rechner highlights the importance of talking to medical professionals, shadowing, and keeping an open mind when exploring potential healthcare careers.

General Surgery Interview With Dr. Rechner

What does a day in your life as a general surgeon look like?

What I do throughout the week varies each day. On Mondays, I spend the whole day in the operating room. On Tuesdays, I am in the office in the morning, and then in the afternoon I perform breast biopsies. The ability to do breast biopsies as a general surgeon is kind of unique to being in a rural area because that is a job normally reserved for radiologists who are trained to do them for ladies with abnormal mammograms and ultrasounds. However, in our small community, we don’t have anybody that is able to do a breast biopsy unless the patient wants to travel over an hour to get one done. So, as general surgeons, we are trained to do biopsies on ultrasounds and mammograms so our patients don’t have to travel so far. On Wednesdays, I do lower and upper endoscopies, usually completing around 10-15 a day. Then, I’m in the office all day Thursday and all of Friday morning.

I am also on call for about 7-10 days a month, and this is a job usually shared between however many surgeons you have in the same field. Currently, there are four general surgeons where I work, so the amount of days I am on call varies every month.

When I am operating, I am usually the only surgeon in the room. However, there are also other people in the room like techs who can assist me in surgery. Sometimes I’ll just need an extra pair of hands during surgery, so I’ll call someone in to help me with that. If we have a bigger surgery, then we have a nurse practitioner that will sometimes help. In some cases, we may even call one of the other surgeons to come and help. I’m one of the older surgeons where I work, so I’m usually the one who gets called to help other surgeons.

I think that surgery is the most rewarding, exciting, and slightly terrifying thing you’ll ever do. I feel this way because I always want to make sure I’m doing the best job for my patients. If I ever feel like someone else can do a certain surgery better and I can get the patient there safely, then that person should be performing the surgery. But, if I have the skills to do the surgery, then I am more than happy to take care of the patient. I think it is so rewarding to have the ability to help patients locally so that they don’t have to travel all over to get the care they need. Not only does this help my patients stay close to home, but it also helps them to be near their families. However, you always have to make the decision of whether you are the best person to care for a patient and if our clinic is the best place for them to be. Sometimes, when you have a patient in an emergency situation, you do what you can and then get them to a bigger hospital. Especially if it’s a patient that’s very elderly, someone with heart or lung problems, or a very complex surgical case, I need to use good judgement about whether I should send this patient to a bigger hospital with more resources. This is definitely one of the challenges of working in a rural area because I always want to make sure that my patients are getting the best care and resources.

I typically work about 8-10 hours a day, and I also work on call. However, I also have a couple of other jobs, so I am sometimes working more than my main job as a general surgeon. For example, I am the county medical examiner, so I recently took a call about a patient who died from a police officer and gathered information about the situation.

Another job that I have is that I am the trauma program medical director, which means I have to be certified to take care of trauma patients. In this role, I am the surgeon in our hospital who makes sure that we follow all of the quality rules, have good protocols, and make sure our patients are getting everything they need. I make sure that all of these things are set up and monitor all of the trauma cases that we have here. I usually spend 3-5 hours a week doing this job.

I also have been involved in our administrative team and executive committee for about 22 of the years I have been working here. One of the things that has always interested me is making sure that we offer high quality care and are able to maintain high standards to meet the needs of patients close to home. I am currently the vice president of medical affairs, and that job allows me to work as a bridge between the administrative team of our health system and our local administrative team. I work to connect these teams with our executive committee, which is the governing body of our local hospital. Together, we set up all of our rules, regulations, bylaws, and we also credential and privilege all of the providers in the hospital. My job is to make sure that we have a quality healthcare team for all of the medical cases we encounter. I do this by ensuring that all of the providers in our hospital have the right privileges (the right skills to perform their job well), and by intervening when issues arise to make improvements and positive changes. This is a really interesting part of my job because I get to impact more patients than just the ones I see by raising the quality of our healthcare system.

As a mom, I would say that my career made it difficult to have a good work-life balance. In fact, if you ask my kids, they would say that my work-life balance was horrible when they were little. However, I do think that it has gotten better over the years. In 2025, I think it’s possible for parents of either sex to be able to create a better work-life balance and to be able to define their career. This means that if you wanted to be a 0.5 (half-time doctor) or a 0.75 (three-fourths-time doctor), there are opportunities to be able to set some boundaries and say that you are only going to work a certain amount of hours a week. Historically, that wasn’t easily done, and as a female, I got more scrutiny that I was not going to fulfill my job as a surgeon. This put me under a lot of pressure to make sure that I was pulling my weight in my job. However, this has become better now, and you can definitely have a good work-life balance if you choose to be a general surgeon. Compared to when I was becoming a doctor, there are a lot better choices now to be able to set some boundaries and have more time for yourself. There are also now laws that govern doctors having protected time off, either for maternity or paternity leave, which allows them to have time to spend with a baby either during residency or medical school. My son is 29 and my twins are 26, so this was not available for me when I was in school. At the time, if I hadn’t been in a really good program, I honestly would have probably been kicked out of my residency because I had three babies during it.

What does general surgery mean to you?

There are lots of different types of surgeons, and oftentimes when you hear the word surgeon you will think of orthopedic surgeons, heart surgeons, neurosurgeons, spine surgeons, gynecologist surgeons, etc.

When thinking of all of these different surgical specialties, general surgery essentially consists of all of the other surgical operations left over. In my job, I perform breast surgeries, colon surgery, bowel surgery, and hernia surgery. I also remove gallbladders, help patients with diverticulitis, remove skin abscesses, and perform trauma surgery. In rural areas, general surgeons are oftentimes trained in endoscopy (the upper and lower scopes used when looking for ulcers in a patient’s stomach or with colon cancer), and some general surgeons are even trained to do thyroid surgery. I spend about half of my time in the operating room and performing endoscopy, and the other half in the office seeing patients. While in the office, I sometimes perform procedures for patients who have conditions like skin cancer, abscesses, or skin lesions.

To be honest, I was quite naive about all the different types of surgery until I went to medical school. When I first started medical school, I thought that maybe I wanted to be a plastic surgeon or an orthopedic surgeon. At the time, I didn’t realize that there were surgeons who took care of the inside organs, which is similar to what general surgery does. When I eventually did my general surgery rotation, I found it fascinating that the surgeons not only got to see a patient and give them a diagnosis, but also that they got to treat the problem. This ability to not only be a problem solver but to also be able to use surgery to help a patient was really what drew me into general surgery.

Can you tell us about yourself?

My name is Paula Rechner, and I am a general surgeon. I went to undergrad at Northern Michigan University, which is in Marquette where I grew up. Afterwards, I attended the upper peninsula program at Michigan State, which is a really cool rural track program that helps train physicians to be better prepared to work in a rural area. This program was great and aligned with my goal of eventually coming back to work in a smaller town. During this program, I first went to Lansing for two years, then spent about eight months in a small town called Escanaba, and then finished off my last year and a half of medical school in Marquette. Once I graduated from medical school, I completed my residency at Gundersen in La Crosse, Wisconsin. This program was very focused on training surgeons to become competent and able to work in rural areas.

Once I completed my training at Gundersen, I moved to Sault St. Marie, a rural community far on the eastern end of the upper peninsula of Michigan. I have been living here for 25 years. There aren’t a lot of people who are interested in working in rural areas in any capacity, whether that is surgery, primary care, anesthesia, or any of the other healthcare professions that small towns are in need of. It is for this reason that healthcare providers who are from rural areas or have an interest in working in these areas are so appreciated and have very fulfilling careers.

Typically, when medical providers work in urban settings, they work in highly specialized areas. On the other hand, when they work in a small rural area, they have a much broader scope of practice. For example, if I was a general surgeon in a big city, I would probably be more focused on a certain area of general surgery or even sub-specialized into one of the fellowships like colorectal surgery, endocrine surgery, or breast surgery. This would really limit my practice to a specific area, which is nice if you want to focus on one thing. However, if you want to see a more broad range of patients and have more variety in what you do, then working in a rural community could be really exciting for you. I also just find my career in medicine to be extremely rewarding.

Full Q&A With Paula Rechner

What is the career outlook for a general surgeon?

We need general surgeons very badly, especially because the general surgeon with a broad set of skills has become a dying breed. I think that part of the reason behind this is the amount of subspecialties available. I also think that when students come out as a resident in general surgery, they sometimes do not feel completely comfortable to go out and practice and want more training to be really good at one thing. With general surgery, the uncertainty of needing to be good at a number of things isn’t very appealing to a lot of people and makes them nervous. As a result, general surgery is one of those things that will always be needed, giving anyone interested in the career a lot of job opportunities for them anywhere in the country, especially in rural areas.

I have really enjoyed working in a rural area because there is almost never a day when I don’t already know half of my patients. People often have many medical problems, and when you are a general surgeon in a small town, you get to know your patients and their families really well. This is extremely rewarding to me and one of the things that I love so much about my job.

How much education is required to become a general surgeon?

You have to complete four years of undergrad, four years of medical school, and then residency. You can pretty much major in anything in undergrad as long as you have the core curriculum for your MCAT. There are a few general education courses that you’ll need to take, such as biology, chemistry, and physics. Personally, I majored in biology, and that worked out for me. Initially, I was going to major in biochem, but I discovered that if I changed a few things around and took a couple of summer classes, then I could graduate in three and a half years. This was a great opportunity because it allowed me to have a semester to earn money for medical school. By changing my major to biology, it gave me the ability to stack my classes more efficiently to graduate early. Once I graduated in December, I worked until I went to medical school in June so I wouldn’t have as much student loans.

After you graduate medical school, you must complete your residency. For general surgery, my residency was five years long, but I could have extended this residency a year or two if I had chosen to do some research. Also, if you want to do a fellowship after residency in a certain specialty, then that would be an additional one to three years of education.

How did you become interested in general surgery?

My mom was a nurse, and when I was a little kid, she had all of her nursing books on the shelf underneath our TV. I was a very curious child and we didn’t have Google at the time, so anytime I would have a question my dad would point me toward the encyclopedias and make me look it up. When I eventually became curious about medicine, I would just thumb through those books, which I always found so interesting. I was always curious about surgery, but I wasn’t exactly sure what area of medicine I wanted to pursue.

When I was 14, I became a volunteer at my local hospital. At the hospital, I worked in the OB unit, snuggling babies while their moms were recovering, and bringing water and snacks to the moms. This was my first experience in the hospital, but I knew that it was where I wanted to be in my future. My passion for medicine just grew from there. Although I wasn’t sure exactly what I wanted to pursue in medicine initially, I just kept trying for the hardest thing, and was fortunate enough to be able to become a general surgeon.

What advice would you give to someone who is interested in the healthcare field and is trying to figure out what profession is best for them?

It is extremely important to talk to healthcare professionals and ask questions, shadow many different providers, and explore things with an open mind. You might think there is something you really want to do, but then find out about something you didn’t know about and think it is very interesting. Always be open to new things in medicine because you never know if you will learn about something that really excites you.

What is the biggest challenge of being a general surgeon?

While having a broad scope of medicine to practice is very appealing, it’s also the biggest challenge because it means that you have to stay current in many areas of medicine. For example, if I am going to continue to do breast surgery, which changes more rapidly than any of the other things that I do, then I have to make sure to stay up to date on current surgical interventions and all of the things that change with breast surgery. While it can be challenging to stay up to date on so many surgical areas, it is also exciting. I never get bored because I always have to read, go to conferences, and make sure that I’m being educated so that I don’t fall behind. For some people, this might not be very exciting because they have to keep learning. However, I enjoy learning, so this is not a problem for me and actually makes my job a better fit.

What is your favorite part of being a general surgeon?

I love having the ability to develop good relationships with my patients and being able to offer them care close to home. I also get to form long-term relationships with my patients, which is extremely rewarding. In fact, I have been with some of my patients for the whole 25 years that I have been living in Sault St. Marie. Lastly, I think that having such a broad range of medicine to practice is great.