Zubin Damania is a Stanford-trained physician working to develop a new model for primary care clinics. But if you cared to, you could also find him on YouTube, rapping as ZDoggMD.
Damania, assuming the persona of ZDoggMD, began making music videos in 2010. He parodied songs by Notorious B.I.G and the Black Eyed Peas, in so doing addressing some of the serious problems he noticed while treating patients in the hospital. He has since made more than 60 PSA-style videos that have amassed close to 1.2 million YouTube views—from “Immunize: the Vaccine Anthem,”—which plays off the Travie McCoy and Bruno Mars song, “Billionaire,” and urges vaccine deniers to “get your shot on”—to “Pull and Pray,” which explains “ST to the Ds” and other dangers of unsafe sex in graphic detail.
With ZDoggMD at the mic, Damania says he was able to be more vocal about the problems of the healthcare system than he would as “just a regular doc.” One of his most widely watched videos is a take on Jay-Z’s “Hard-Knock Life.” In it, ZDoggMD and his sidekick, Dr. Harry, a pediatrician in Redwood City, California, break it down from hospitalists’ perspective:
“It’s the hard doc’s life for us/Hospital doc’s life for us/Specialists, they got it made/We do the work while they get paid.”
Damania’s humor is grounded in deep frustration over a “devastatingly dysfunctional” healthcare system that, he says, “fails miserably at prevention and focuses instead on the treatment of disease.” The costs of treating chronic diseases like diabetes, heart cancer and cancer represent 75 percent of the staggering $2 trillion spent annually in the U.S. on health care according to a 2012 Institute of Medicine report. Most chronic disease can be prevented.
According to Damania, this approach reduces medicine to “doing something to patients instead of for patients.” This is particularly true, he says, in fee-for-service models—the foundation of most private insurance and public entitlement programs in the U.S.—that reward physicians for quantity of care over quality of care. He estimates that most primary care physicians’ salaries depend on them seeing as many as 30-40 patients each day. “You can’t treat a patient in 10 minutes so you refer them out and probably never see them again,” Damania says.
In a TEDMED talk he delivered earlier this year, “Are zombie doctors taking over America?” Damania made the case that patients are not the only victims of the episodic and fragmented nature of healthcare in the U.S. Pointing to the sobering statistic that fewer than half of all doctors would choose medicine again if given a chance, Damania compares primary care physicians to the undead—their lives devoid of the very interactions that inspired them to become doctors in the first place. What’s worse, he says, is “they feel powerless to do anything about it.”
“The frustration patients have about not getting enough time with their doctor is the same frustration doctors have with not having enough time to spend with their patients,” he explains. “Spending hours on the phone haggling with insurance companies and buried in a crushing amount of paperwork is not why we got into medicine.” According to a recent study by personal finance site NerdWallet, an estimated 25 percent of a doctor’s day is spent on administrative tasks.
Damania’s outspoken views on the healthcare system attracted the attention of Tony Hsieh, CEO of the online shoes and clothing emporium, Zappos.com, who offered him an opportunity to transform his critique info action. In 2012, Hsieh recruited Damania to head up healthcare development of his Downtown Project. Damania’s charge: changing the way medicine is practiced in Las Vegas, a city that the Commonwealth Fund ranked 268 out of 306 localities for its quality of healthcare.
“Zubin is a great communicator and passionate about getting healthcare right. But most importantly, he believes that to get healthcare right, you first have to get the culture right,” Hsieh says.