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October 1, 2014

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Joe Downtown: New-to-downtown doctor sets out to demystify medicine

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Joe Schoenmann

Dr. Zubin Damania poses for a picture on Thursday, Jan. 10, 2013. Recruited to the city by Zappos CEO Tony Hsieh, Dr. Damania is opening a clinic in Downtown Las Vegas.

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The logo from Zubin Damania's website, ZDoggMD.com, where he produced videos to demystify and make more tangible medicine

There may be no one better suited to configure a new way to practice medicine in Las Vegas than Zubin Damania, a Stanford-trained doctor who last year uprooted from the Bay Area and moved his family to Las Vegas.

Joining an army of people lured downtown to try something new, Damania is dead serious about medicine — and he embodies a streak of witty silliness displayed on his website, zdoggmd.com.

If you happened upon the videos first — which are both instructive and off-the-wall, with ZDogg playing the part of a “word-up”-spewing, off-white (he’s Indian) rapper — you might think a screw or two needs tightening.

Of course, that’s what he wants. ZDogg demystifies medicine, or at least makes it more tangible, by having fun with it.

It all seems part of a humanist strain in Damania, who shuns assembly-line medicine for a more one-on-one approach. He might put it in terms of a favorite movie and say he simply is looking beyond “The Matrix” to craft a clinic that puts people first.

“The current system is blind to the truth that in order to take care of people, we must prevent disease and promote wellness,” he said. “The hope is to get people really engaged with health and fitness more than their current system, where they have 10 minutes with a doctor and they’re out the door.”

Damania and his wife, Margaret, both physicians, moved to Las Vegas last spring, drawn here by the siren call of Zappos CEO Tony Hsieh, who met Margaret Damania at Harvard University about 20 years ago.

Before moving here, Margaret Damania was on the radiology faculty at Stanford University School of Medicine; Zubin Damania practiced internal medicine. Both had successful careers.

Zubin Damania, though, wasn’t happy.

“I like dealing with people, talking to them, helping them work through things, but I didn’t really have the time to do that anymore,” he said. “I felt like I was a cog in the machine. I could be replaced at any time.”

After moving into the Ogden with his wife and two young children (they have since moved to Summerlin to be closer to their daughter’s school), Zubin Damania has conducted dozens of meetings with health care experts, insurance representatives, doctors, group managers and potential customers.

Over months of meetings, he chose a model of care that represents a different approach to primary care in Las Vegas.

Clinic patients, Zubin Damania said, will pay a flat fee that entitles them to a series of services. Those will include unlimited primary care access, access to health coaches and classes for nutrition, cooking and yoga. He also is considering other wellness-related amenities, such as a gym.

Prices haven’t been set, but he said the per-month cost would vary depending on services used.

Zubin Damania speculates that 80 percent of health care can be delivered at the primary care level. Improving care at that level can cut into the cost of more expensive chronic and catastrophic care, saving money for patients and employers.

In turn, he said, employers might pass savings onto employees by cutting the cost of their insurance premiums.

Here’s how it might work: You pay a “membership” fee likely under $100 per month, which gives you access to all the clinic’s services. The clinic provides primary care; if specialists are needed, the clinic coordinates referrals and, Zubin Damania said, “maintains an active supervisory role." Typically, high-deductible insurance covers the specialty and hospital care if needed.

So the clinic wouldn’t eliminate the need for traditional insurance, but it is expected to bend the cost curve downwards and decrease the cost of backup insurance plans.

Self-insured companies like Zappos or government agencies would be a perfect fit because they would be able to reduce their expenses for downstream specialty and hospital care.

“If (employers) look at their metrics and see health care costs are going down, they can create a hybrid plan — maybe cutting premiums as they see health expenses dwindle — that melds our flat fee/primary care plan with a catastrophic plan,” Zubin Damania said. “It puts primary care at the apex of care; primary care physicians are then accountable for the welfare of the customer, and if customers are unhappy, they’re going to walk.”

Another important aspect to this clinic, he said, is that “it keeps the money for insurance premiums here in the community instead of going out to some national insurance company,” he said. “Normally, insurance is taking a piece of the action as the middleman.”

The clinic is expected to open in a few months in a building purchased by Downtown Project partners at Bridger Avenue and Seventh Street.

He hasn’t chosen a name for the clinic, but jokes on one video that maybe it will be “the Bellagio Clinic.”

“You go in with a sore throat. Do I have strep? Do I not have strep? Do I need antibiotics? Then FWEEEESH!” he says, raising his hands to emulate the famous fountains of the Bellagio resort on the Strip as he begins la-la-ing “Time To Say Goodbye,” the Andrea Bocelli song associated with the fountains.

Zubin Damania, 39, characterizes the years of cajoling by Hsieh to get him to move to Las Vegas as “a gift.”

“He’s given us a chance to potentially revolutionize how we see health care in this country, and, frankly, we couldn’t do this anywhere else but in downtown Las Vegas,” he said. “We have Zappos, real estate, and all the young and enthusiastic people who want to be part of it. So all the ingredients are here to do something fantastic.”

Maybe as fantastic, even, as his ZDoggMD videos.

Joe Schoenmann doesn’t just cover downtown, he lives and works there. Schoenmann is Greenspun Media Group’s embedded downtown journalist, working from an office in the Emergency Arts building.

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