The question is not how Zubin Damania, M.D., morphed into ZDoggMD, but why — and what one physician's transformation into a comic rapper and medical innovator says about U.S. healthcare.
Damania — whose ZDoggMD credits include "Diarrhea: The Musical" and "Manhood in the Mirror" (the latter a tribute to testicular self-examination performed to a popular Michael Jackson tune) — told a crowd of 1,800 at TEDMED in Washington, D.C., last week that his humor is grounded in deep frustration over a health system that, he says, grinds away at doctors' ability to truly care for patients. "It's a story that the public doesn't understand," Damania says. "We're a victim of the system as much as anyone else."
TEDMED, held annually, has a lofty if vague mission, billing itself as "a multi-disciplinary community of innovators and leaders who share a common determination to create a better future in health and medicine." This year's conference, held last week at the the Kennedy Center, was also streamed live to 100,000 participants at 2,700 hospitals, universities and other locations worldwide. A few of the out-of-the-box thinkers whose insights into technology, entertainment and design (the TED in TEDMED) have led or could lead to high-tech innovations included Smart Patients, a social-networking site to connect engaged patients, launched by Roni Zeiger, a physician and Google's former health strategist; a low-cost optical scope developed by MIT Media Lab's Ramesh Raskar that can be attached to a smartphone and used to conduct eye exams; and the Nutrition Science Initiative, founded by Peter Attia to understand the inter-relationship of obesity and diabetes, which he says is more complex than many doctors recognize.
This year's conference was edgier than most. Damania and other speakers blasted a health system that, they said, dehumanizes doctors and patients, fails miserably at prevention and squanders valuable data that could streamline and improve patient care. Jonathan Bush, CEO of athenahealth, a Watertown, Mass., provider of practice management, electronic records and care management services, charged that American healthcare eats up 18 percent to 20 percent of everyone's "life work" because of the lack of transparency and competition. Attia, a physician, castigated himself and the training that led him to behave contemptuously toward an obese patient seven years ago because he assumed, he now believes wrongly, that it was her poor health habits that led to her diabetes. "There's nothing more powerful than a preconceived notion," he said.
"What got us here isn't going to get us where we need to go," Jay Walker, TEDMED's chairman, told those watching. Damania's dissection of the system's failings was scalpel-sharp, at once discomfiting and comic. A former hospitalist who spent a decade at Stanford Hospital & Clinics, he showed a YouTube video and offered a mix of zany and melancholy reflections about an increasingly high-pressure job that made him weep in the shower, wondering whether his fleeting encounters with patients were putting them in danger. He cried in the shower, he explained, because it was the one place his daughters couldn't surprise him.
"I was a cog in a machine that was seeing diseases that should have been prevented," he told me after his 18-minute presentation. He began making comic videos as an outlet, assuming ZDoggMD as an alias, fearful that his sideline would threaten his job. When his videos began drawing hundreds of thousands of viewers on YouTube, he dropped the disguise. He left Stanford in 2012 to take on a new role as director of healthcare development for Las Vegas's Downtown Project, launched by Zappos.com CEO Tony Hsieh, which has invested $350 million in real estate, education and tech start-ups to bolster the city's sense of community. "The doctors are going to be the ones to fix it, to reboot the system," says Damania. "But first they have to overcome the powerlessness they feel."