Zubin Damania, MD, Puts a New Spin on Primary Care
Modern health care has become a monstrous system filled with baggage and regulations, but physicians can turn the tide by experimenting with new models of care that put the focus back on the patient-physician relationship. That's the crux of the message Zubin Damania, MD, will spread when he headlines the General Session at TexMed 2014 in Fort Worth May 2.
"None of us intended to have the system that we have," he said. "Patients all know it's a horribly dysfunctional system."
In his presentation, Redefining the Culture of Medicine, he'll delve into the ethical challenges to delivering excellent care in a troubled health care system while proposing ways to revitalize it. Dr. Damania says he wants to create a new system that will allow doctors to retain their passion for patients, and he plans to share his mission with physicians at the Texas Medical Association's annual conference next month. His keynote speech will examine the everyday strife physicians face in a highly regulated health care system while highlighting ways doctors can bring joy back into the practice of medicine.
Dr. Damania is the founder of Turntable Health, a Las Vegas-based practice that fosters a new type of primary care — one that focuses on prevention by offering nutrition classes and group therapy along with regular patient visits.
What sets Dr. Damania apart from past General Session speakers is his alter ego, "ZDoggMD," a rapper well known in physician circles for his musical antics, dope beats, and fresh lyrics. ZDogg has attracted thousands of Internet viewers by transforming catchy songs by Miley Cyrus, Usher, Notorious B.I.G., and other popular artists into side-splitting music video parodies about infections, first aid, pharmaceuticals, and other health care topics. View some of ZDogg's videos at ZDoggMD.com or on YouTube.
Dr. Damania says the bureaucracy in modern medicine makes TMA important because the organization helps doctors "push back." TexMed attendees can expect a few laughs from Dr. Damania's speech, but he hopes his message will resonate on a more serious level.
"You can find a way to do the right thing," he says. "Once you find it, you reengage with that passion that drove you into medicine in the first place."
Dr. Damania says he's excited to visit Fort Worth and participate in his first TexMed conference.
"And I'm really excited to talk to Texas physicians," he said. "I think Texas has incredible health care and incredible providers, and I can't wait to learn as much as I can while I'm there."
As for whether the audience can also expect a live ZDoggMD performance, Dr. Damania is keeping mum.
"I'm a studio gangster," he said. "If push comes to shove, I'll throw some rhymes down."
Dr. Damania says physicians practicing in traditional settings don't have to take on a hip-hop alter ego to incorporate elements of the Turntable model into their practices. One suggestion he has for physicians involves accepting some direct-pay patients, a move he says frees doctors from the constraints of the traditional insurance model, allowing them to deliver better care.
If doctors feel they have delivered the best care they can give to a patient, some of the joy returns to practicing medicine, Dr. Damania says. He says even though Turntable Health is a company, it empowers doctors to practice autonomously, "the way they've always wanted to practice. We're reconnecting with why we went into medicine."
Fight the Power
Dr. Damania's music videos caught the eye of Tony Hsieh, chief executive officer of Zappos, Inc. He encouraged Dr. Damania to move from his home in the California Bay Area to Las Vegas to create a better health care archetype.
Dr. Damania opened the doors to Turntable Health in December. Its mission is "to fix health care for everyone," he says.
In less than two months, the facility had 250 members. Dr. Damania says he wants his practice to serve as a model for a new wave of health care. Turntable members pay an $80 monthly flat fee for primary care. The practice offers same-day or next-day appointments, 24-7 access to physicians by phone, nutrition classes, yoga, and group therapy.
"You have the ability to impact multiple aspects of people's lives," he said.
The organization's operating partner, Iora Health, based in Cambridge, Mass., has been experimenting with a similar model for several years, Dr. Damania says. Iora has a handful of flat-fee practices, but they cater to individual sponsors, such as unions and colleges.
"We've seen the early pilots," Dr. Damania said. "Now we want to optimize and bring the model to everyone."
Unlike a clinic funded by a union or an employer, Turntable is open to the public.
"We're not the first, but we think we're the more sustainable solution to get it established," he said.
Patient feedback has been positive, he says. Postvisit surveys show a 97-percent satisfaction rating from the first 50 patients.
Many patient members struggled with poor health care in the past and are grateful the facility opened its doors, he says. Turntable Health attracts patients from a broad socioeconomic spectrum but doesn't accept Medicare or Medicaid patients.
Several small businesses and young entrepreneurs in the city provide Turntable Health membership to their employees, including Project 100, a transit service that offers shared electric cars and bicycles, shuttles, and chauffeured vehicles for a flat monthly fee.
"The demographic is younger, but they're not necessarily healthier," Dr. Damania said, adding that these patients often struggle with substance abuse problems and mental health concerns.
He says Turntable Heath focuses on the relationship between the patient and the physician, a critical aspect of health care that he plans to examine in his TexMed presentation.
"If we do the right thing for the patients, they're going to respect that," he said.
Turntable Health is now free for many members of the Nevada Health Co-Op, a state health insurance cooperative created under the Affordable Care Act. Dr. Damania plans to build more Turntable locations — first in the Las Vegas suburbs, then in other states.
"If we could make it work in Las Vegas, we think we could make it work anywhere," he said.
A: Seeing the instruments. I've been hearing about these Texas Instruments since I was a boy. They better be dope.
Zubin Damania, MD
Q: When did your medical career begin?
A: In the womb. My mom was doing her residency when she was pregnant with me.
Q: What is your specialty?
A: Hospital medicine (trained as an internist). I got to routinely see patients who were in the hospital as a result of the lack of access to primary care. Now I'm trying to grow a new model of primary care via our start-up, Turntable Health.
Q: Whom are you trying to reach in your practice?
A: Everyone — patients of all ages and socioeconomic backgrounds, and doctors and nurses excited to practice medicine the way they always hoped it could be practiced.
Q: What or who inspired you to become a doctor?
A: Medicine is a calling that often chooses you, as opposed to the other way around. But I have to say having two physician parents was a huge influence on me in choosing my career.
Q: How do you picture your career developing?
A: My hope is to create a means through which health care professionals can practice at the top of their licenses, free of insurance-related red tape, and instigate grass-roots, bottom-up health care reform led by health professionals.
Q: What aspect of Texas are you most looking forward to?
A: Meeting all the great folks there and experiencing the legendary hospitality firsthand.