Zubin Damania, MD ’99 : Transforming health care, one laugh at a time

His aims: educate patients in a unique, entertaining way and coalesce and rally a tribe of healthcare providers who, like himself, felt demoralized by what he perceived as a broken healthcare system. In 2013, he started Turntable Health clinic in Las Vegas, NV, to replace the traditional fee-for-service model of healthcare with a monthly capitation-based “wellness ecosystem” model emphasizing prevention and the patient-doctor-care team relationship.

What motivated you to create ZDoggMD and start Turntable Health?

Taking risk and stepping out of a conditioned inertia is very difficult, and it often happens incrementally. In healthcare we're very conditioned not to transform the system, or question authority, or question the way things are, but rather to adapt to the system that is given to us.

Initially my goal [with ZDoggMD] was to educate and entertain patients, so that I could focus on a big problem I saw in the hospital, which is most of what we saw was preventable. Since we were failing to prevent, what I was doing in the hospital was taking care of the failures of our healthcare system.

What I found got the most traction were videos about our healthcare system itself aimed at other healthcare providers. Many people suffer in our healthcare system in silence, not knowing that others are suffering the same thing. By communalizing pain publicly through these videos, whether they're a parody about the EHR, or whether it's a song about end of life and how we don't do it right and we don't talk about it, I found that this engaged this huge tribe of healthcare professionals.

[Tony Hsieh, CEO of Zappos] reached out after having seen some of my videos online and said, "You're a doctor that makes these crazy videos, and you're UCSF and Stanford trained? Like, what is going on?”

I said, "I want to build a clinic that actually puts these precepts of what I call Health 3.0 into action." That's when we started Turntable Health.

What ended up happening is after three years of seeing thousands of patients and changing a lot of lives, not just the patients but the caregivers, we had to close because our biggest partner insurance company went out of business.

It was devastating, but at the same time, it begged the point that being this idea of re-personalized healthcare that's driven in teams and really funds prevention and social determinants, it's a high priority.

Would you call yourself a public health practitioner? Entertainer? Evangelist?

I would say we are evangelists for healthcare transformation at both an individual and collective level. What we often miss is the individual level, so the idea that we can understand our own psychology and the psychology of others in a way that we can actually be more persuasive, and more transformative, and listen to what this unconscious part of our mind, that really already understands what needs to happen. We kind of ignore it at our peril, so just waking people up is kind of what it is; it's an evangelical kind of thing. A digital sage is what we're trying to be, but at the same time, with practical tools that people can use.

Can you talk about the value of partnership and mentors in innovation?

I'm a firm believer that human beings only succeed because they are able to collaborate in loose, flexible, large networks across distances, in unique ways.

That collaborative, team-based approach is key, and that's also what we see in our social media enterprises. It's really the network of people across the world that power, and are going to power, transformation.

What do you hope to achieve in the next 20 years?

My hope in the next 20 years is that we start to see a tipping point, because we're already seeing it, where Health 3.0 is going to start emerging in fits and starts. Where we really start to value prevention and stop medicalizing our social problems.

Where we really start to see that the social determinants of health are 90 percent and that zip code, genetic code, those things are much more important than we do in that 10 percent that patients are interfaced directly with our healthcare system.

Reconnecting with tools that help our minds work better can reduce suffering and improve the lives of lots of people. I want to be involved in that, and continuing to teach, and continuing to learn from everybody that's involved in our project.

How did your time at UCSF School of Medicine influence your current trajectory?

UCSF was absolutely formative in turning me into who I ultimately became. Even in the '90s when I was training, [UCSF was] 5, 10 years ahead in terms of how they thought about social determinants, how they talked about the mind body connection, and how we were exposed to lots of great different mentors who really, really, really were fantastic teachers, tremendous clinicians.

Is there anything else you’d like to say?

The main thing I would say is how we're blessed to be able to do what we do now. I get to see patients at our county hospital, I get to teach on a massive scale that was unprecedented in the past due to the ability of social media to connect people across vast geographies and even countries.

The training that I got so that I have the credibility to do those things would never have happened if I hadn't had my experience at UCSF. Still to this day, my best friends in the world were met and cultivated at UCSF. I have a huge debt to UCSF that I'll never be able to fully repay.

Dr. Damania took home a 2019 UCSF Campaign Alumni Award in "The Innovators" category. The award recognizes those whose work has led to unexpected outcomes that resulted in positive changes for science or healthcare communities.