Meet the Stanford hospitalist-turned-rapper changing healthcare in Las Vegas

There's a new voice adding to the end-of-life care discussion, to the tune of Rihanna and Eminem's hit "Love the Way You Lie." It's the voice of ZDoggMD, a self-described "international icon and man of mild-to-moderate mystery."

ZDoggMD dropped his latest music video "Ain't the Way to Die" at the end of July. It has already garnered 175,000 views on YouTube and 63,000 shares from his website.

He may star in more than 100 music videos, comedies and sketches about healthcare, but ZDoggMD is more than your average Internet sensation. Zubin Damania, MD, was a Stanford hospitalist when he decided to start moonlighting as the "Weird Al" Yankovic of the medical world. Things took off from there.

A musical mid-life crisis
"Ain't the Way to Die" was professionally directed by Michael Shaun Conaway, who plans to feature Dr. Damania in his documentary "Wake UP!" about people who incorporate their passions into their professions.

"I had my midlife crisis early," says Dr. Damania. After about eight years at Stanford, he yearned for some creativity in his career. "I decided I was going to reconnect with my passion, which is being a goofball."

The end-of-life number was co-written by Kaiser Permanente pediatrician Harry Duh, MD, and it was instrumentally and vocally backed up by Devin Moore of the indie-pop quartet Rabbit!. In the video ZDoggMD diverges from his goofy self, and takes a much more somber, emotionally-charged approach to the song.

Dr. Damania said he got a sense that the subject needed to be taken seriously after testing the waters on social media.

"We feel healthcare providers need to be reminded constantly about having this conversation in the outpatient space," said Dr. Damania. "They need to see the torture — it's not glamorous at all if you ignore these conversations."  

Dr. Damania has some musical background — he played guitar in high school and minored in music at University of California, Berkeley — but claims his talent is more comparable to a brute force.

"Weird Al was my idol as a kid, which got me absolutely no street cred, but it's the truth," he said. Dr. Damania began writing and filming videos on his own about everything from ulcers to vaccines to CPR. His biggest hit, "Readmission," has more than 1.1 million views on YouTube.

In addition to his musical pursuits, Dr. Damania continues to practice as adjunct faculty at the University of Nevada on a volunteer basis. He is also disrupting healthcare delivery in downtown Las Vegas. There he launched the primary care clinic Turntable Health as part of Zappos CEO Tony Hsieh's Downtown Project.

Turning the tables on primary care in Las Vegas
The videos led Dr. Damania to Mr. Hsieh, who attended Harvard University with his wife. After incessantly emailing the Zappos CEO, Dr. Damania finally got a response — and an opportunity he couldn't ignore.

Mr. Hsieh told Dr. Damania if he left his job at Stanford, he would give him some resources to redesign healthcare in downtown Las Vegas. But there was a catch. Dr. Damania had to make it work — funding was limited and his project had to be financially feasible right off the bat.

"I never would have thought making videos would have led to this kind of crazy offer," Dr. Damania said. Despite the naysayers, Dr. Damania was compelled to see if he could pull it off. "It was a huge life change and terrifying," he said. "But just making videos wasn't enough."

In partnership with Cambridge, Mass.-based Iora Health, Dr. Damania made Turntable Health ("Primary care, remixed," the website touts) a reality in Las Vegas a year and a half ago. The primary care clinic offers a team-based, membership model of capitated care. According to Dr. Damania, the innovation behind it is three-fold.

First, the payment model is membership-based, so patients pay a flat fee for care at the clinic. There are no copays. Turntable Health takes self-pay patients and patients of member employers and unions, such as the culinary workers union and other local businesses like GoldSpike Hotel & Casino. It also teamed up with Nevada Health CO-OP to offer coverage for the clinic on the federal health exchange.

Second, the care model is driven by team health coaches, who are nonclinicians screened for empathy and trained in motivational interviewing skills. Four health coaches per physician allows providers to practice at the top of their license, according to Dr. Damania. The clinic offers patients 24/7 physician access via text, video chat and email, as well as a host of wellness services, such as yoga classes, which are offered at its downtown location. The clinic has plans to expand to more locations, enough "so that just about anyone [in Las Vegas] can walk or bike to Turntable Health," according to its website.

Third, the clinic uses Iora's purpose-built EHR, which focuses on the narrative of patient stories and issues, rather than episodic, billable transactions. It also includes a population health dashboard to proactively manage chronic conditions. The platform enables care to be more cohesive, and allows patients to access their records, Dr. Damania said.

In addition bringing these innovations to primary care in Las Vegas, one major perk of Dr. Damania's new gig? He can use Turntable Health's facility as a set for more ZDoggMD videos. He continues to put his voice on YouTube airways.

"I hope others in the healthcare space can see the example in our videos and think, 'I am going to do something interesting and creative to help healthcare wake up,' " Dr. Damania said. "If we use our innate passions and creativity, we can do a lot of damage in a good way."


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