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Session 29
In this episode, I talk with Dr. Zubin Damania, a.k.a. ZDoggMD, a hospitalist, healthcare visionary and internet personality. We talk about his path to medicine, his struggles, and the exciting Downtown Project in Las Vegas, Nevada.
When ZDoggMD knew he wanted to become a doctor:
- Born to parents who are doctors
- Doing medicine as a rebellion to spite his parents but liking science at the same time
- Having idealism at the back of his mind to make a difference by helping people
- Finding the actual practice to be disconcerting
The negative side of medicine:
As a physician, you have the stress of running your own business when you're not trained to do that.Click To TweetHis medical school years:
- Going to UC Berkeley as an undergrad in 3 years
- Nothing was conceptually too difficult
- Not getting prepared for his first clinical year during the third year: Pass-Fail-Honors
- Faking his way through the process as he was getting incredibly depressed
- Finding the importance of getting support from colleagues
- The haphazard system of having varying degrees of experience
[Related episode: A Burnout Story and What You Can Do to Avoid It]
His three-year undergrad experience at Berkeley:
- Major in biology and minor in music
- Starting to get tired of college by his second year
- Spending his fourth year at a Berkeley lab doing genetics research that he liked
- Realizing research wasn’t something he wanted to do and reaffirming that going to medical school was the right answer
- Describing his Berkeley experience as the most brutal in terms of competition
- The ultimate goal as better patient care
Choosing his specialty:
- Being influenced by a GI doc he knew
- Entering an internal medicine residency with the intent of doing a GI fellowship
- Realizing he didn’t like GI and the primary care setup
- Not having a job plan after residency, taking time off, and going back to clinical medicine
- Taking a hospitalist job at Stanford
The trends he’s seeing in medicine:
- The super-specialization as a reaction to high debt loads and salary differences
- Reimbursement, level of respect, and basic job structure as the main drivers for people staying away from primary care
His ideas for fixing primary care:
- Fair compensation with a job structure where they could help people
- More precision functions taken over by other entities like nurse practitioners or health coaches
- Taking insurance out of primary care and basing it on a flat-fee membership model
Ways to motivate patients to go to a doctor:
- Taking away any transactional barrier
- Paying for the overall relationship with the team rather than a transactional, episodic visit
- Fixing the current service fees system and replace it with a more sensible one for both providers and patients
ZDoggMD describes the Downtown Project in Las Vegas
- Starting with a 7,000-sq.ft. clinic in downtown Las Vegas.
- First piece: Financial disruption: Get insurance out!
- Funding through the flat-fee membership of patients
- Second piece: The care team: The village-type scenario
- Other community programs like yoga, meditation, and nutrition classes as part of the membership to tie together all the clinic members and the patients with the community they’re in.
- Third piece: Proprietary EMR they’re developing with their partner
Links and Other Resources:
- ZDoggMD YouTube Channel
- Downtown Project Homepage
- Free Will (book by Sam Harris)
- My article on Tiger Woods and the Premed Gunner Mentality (at KevinMD.com)
- Related episode: What I Wish Every Premed Student Would Know
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