A peculiar thing happens to Zubin Damania, MD, when he does rounds at University Medical Center in his hometown of Las Vegas. To his patients, he’s mild-mannered Dr. Damania, hospitalist physician — the guy checking into their diabetes or broken hip. But to some of the physicians and other staff, he’s kind of a rock star.
“Patients often don’t recognize me,” he said. “But I can’t get through the hospital without people wanting a selfie. A lot of the nurses [and other staff] recognize me from the videos. And that’s true of almost any hospital I go to in the country, which is still weird to me.”
That’s because in his other life, Dr. Damania assumes the persona of ZDoggMD, a sometimes acerbic, sometimes goofy, and always outspoken champion of fixing the problems physicians live with daily. Since 2010, the Stanford-trained physician has used humorous music video parodies, podcasts, speeches, and just about every other forum to promote what he calls “Health 3.0” — a reimagining of modern medicine. (Visit his website at ZDoggMD.com).
Dr. Damania first started making parody music videos in 2010 as way to shake off professional burnout. As a music minor in college, he had just enough training to pull it off. But he freely admits to having bad aim when he selected his original target audience.
“I thought I was doing it for patients, what I call muggles — the non-medical folk,” he said. “They were my audience, I thought. And I was absolutely wrong because even when I did a piece that was aimed at educating non-medical people, it was medical people who watched it and shared it and enjoyed it.”
Dr. Damania’s early videos were mostly seat-of-the-pants productions, but over time their production values have risen dramatically. He says he has about 1 million followers on Facebook, YouTube, podcasts, and other media, and the biggest single chunk of them work as medical professionals in Texas.
“For some reason, the people of Texas resonate with our no-BS, un-PC way of talking about medicine,” he said.
Dr. Damania is making a repeat appearance at the Texas Medical Association’s annual meeting this year, following his debut performance at TexMed 2014. He said the past four years have taught him lot about what works and what doesn’t. And that’s what he’s going to discuss — always with some humor, but always with a serious message.
“I’d really like to talk about how we as a group, physicians, can actually effect transformative change,” he said. “Because we all know what’s wrong. … But how can we actually do something transformative?”
Texas Medicine asked him about all of that … and more.
You got into entertainment in part because of your frustration with medicine. How did that start?
It was kind of death by a thousand paper cuts. … I think initially my job was very flexible and allowed me to be more me than I expected. We had time to spend with our patients, we were a partnership of physicians, we had a lot of autonomy to do the right thing.
So what changed?
We became more corporate in structure as this pressure to deliver volume over value sort of hit. As [electronic health records] came on line and made us stare at a computer instead of talking to each other, as residency work hour rules came along and pulled back our coverage. All those things started to make you feel like, wow, this really is kind of like living in The Matrix. It’s been developing and we don’t even know it’s there, and we’ve become enslaved to the system.
Doing music videos isn’t an obvious way to deal with frustration at work. How did you get into it?
When I was in the depths of despair over my burnout, I decided consciously one day, I woke up in the morning and I was like, “This is not who I am to sit here quietly and suffer. It is who I am to be a smart-aleck, to loudly make jokes about what’s wrong with it in hopes of subversively triggering change, and to do it partially in a musical way. So I am going to go to YouTube, and I am going to put videos on there that are who I am.”
Surveys show that a lot of physicians feel the way you do. Why do you think they don’t speak up like you do?
The culture of medicine is to kind of defer to authority and grumble about it, instead of actually trying to stand up and do something or questioning everything. You really can’t do that in medicine because in your training you really can’t question everything because the idea is you [anger] the attending physician and they’re the boss. So you’re conditioned from day one of medical school to kind of go with the flow of the hierarchy and that sort of thing, and that’s very damaging when we’re now placed in a system that all of us know is dysfunctional.
Is there stuff you wish you could take back?
Everything before 2015 is sort of like, whoa! But even in that group I kind of look and go, “Some of this stuff is [not bad].” … We did a parody of a [Les Misérables] piece about an ER doc in a hospital battling [with another doctor] and it was so cheesy and so corny and so amazing at the same time. I still have people who email me and go, “This video doesn’t have that many views, but it’s my favorite video you’ve ever done because you totally captured the experience of two doctors really pushing back on each other and not understanding each other until the very end of the song.” (See the video at tma.tips/LesMisVideo)
If you could wave a magic wand, what would you change about the U.S. medical system?
The first thing I’d do is get rid of most of the measurement stuff that we do now because it really doesn’t affect real outcomes. The second thing I would do is mandate that medical school is free so that you no longer have to worry about paying off $250,000 in loans, and then you’ll promote more physicians to choose preventative medicine and primary care options. I would then provide some sort of universal catastrophic insurance coverage so that there’s no medical bankruptcies in the U.S. I would then encourage medical groups to compete and allow the private sector to shine in terms of innovating around outcomes that matter, which is the prevention of disease. And when you actually have to treat something, making sure that you’re as optimized for that particular outcome as possible.
You think that would put U.S. health care on the road to recovery?
Well, the other thing I’d do — and a lot of doctors might not like this — is that I’d take some of that 3 trillion in health care dollars and I’d shift it into social services that actually address the 90 percent of peoples’ lives where the health care system isn’t the issue; it’s everything else — it’s lifestyle, it’s education, it’s community. Right now we’re trying to provide those services within a health care model, and it doesn’t really work.
How do you think all this would help physicians practice medicine?
Part of the mandate to pay for medical school would be that medical education would have to be transformed. So it has to be focused on systems thinking, collaboration, as well as training physician leaders — because we are the ones who have to lead. We’re the only ones on the spectrum who can do the leadership role in the way that’s going to actually improve outcomes for patients. We have to groom the leaders from the very beginning, and that hasn’t really been done.
How is this year’s talk going to be different from the one you gave at TexMed 2014?
Back then, the talk I gave was one of the earliest that I’d done publicly. So it was new to me. I’d done TEDMED and I kind of adapted that message to TexMed, and if I looked at that video from four years ago, I’d probably cringe at how lame and awkward it was. … The best part is that now I’ve performed a lot of our bigger music videos live, and they illustrate and imbue the talk with a certain emotion and fun that didn’t exist in my message four years ago.
What’s your main message?
Every video that I make, every live show that I do, every speaking engagement that I take has a mission: We’re trying to catalyze the emergence of what we call Health 3.0. It’s reconnected, re-humanized, outcomes-driven, technology-enabled care where we work as a team. We still have autonomy, we retake physician leadership. We sort of take health care back, and what emerges is bigger than the sum of what came before. We’re not trying to claw back [to] the good old days. We’re trying create vastly better days to come.
SIDEBAR
Why should you come to TexMed 2018?
TexMed 2018 is your chance to meet up with fellow Texas physicians from a wide variety of specialties, to further your personal and continuing medical education (CME), and to be an active participant in the house of medicine.
But it’s not all business at our giant annual meeting, which is scheduled for May 18-19 at the JW Marriott San Antonio Hill Country Resort.
The TMA Alliance (TMAA) will celebrate 100 years as one of the state’s premier political, community, and service organizations with a Centennial Celebration on Thursday, May 17. Five-time Grammy winner Marcia Ball will be part of the festivities, that will also feature dinner and a welcome reception.
That’s not the only big party planned. The TMA Foundation will hold its 25th anniversary gala that same evening. More than 500 physicians and friends of medicine will enjoy cocktails, a seated dinner, auctions, and live music. Proceeds from the gala will support TMA’s charitable programs.
On Friday, May 18, don’t miss the TMA/TMAA Presidents’ Reception from 6 to 7 p.m. for a chance to meet incoming TMA President Douglas Curran, MD, and incoming TMAA President Sunshine Moore.
TexMed 2018 also offers more than 80 hours of free CME opportunities, including new sessions on “Population Health and Your Practice,” “Professional Development and Leadership,” and “Wound Care.”
There also will be more than 100 vendors in the Expo Hall, including representatives from banks, practice management providers, insurance companies, and medical equipment providers.
For more information, go to www.texmed.org/TexMed/.
Photo courtesy of ZDoggMD
Tex Med. 2018;114(4):30-35
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