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Vegas, baby!
A hospitalist dives into urban planning

Keywords: A hospital physician finds a new career in urban planning





Published in the November 2012 issue of Today's Hospitalist

IF YOU'VE BEEN MISSING the unique voice of ZDoggMD, hospital medicine's premier video rap satirist, there's a good reason why his stream of new videos has slowed down: He's busy building an empire.

At the very least, he's mapping out a new health care approach for an audacious urban renewal project. That's despite the fact that, as he puts it, "I didn't know squat about health care reform or the financial infrastructure of medicine."

Earlier this year, ZDoggMD—a.k.a. Zubin Damania, MD—stepped away from his hospitalist career in Palo Alto, Calif., and moved his
The first clinic—housed in a construction trailer—should open next year.

family to downtown Las Vegas.

That decision grew out of his friendship with Tony Hsieh, one of his wife's undergraduate suite mates. Since college, Mr. Hsieh has sold one company to Microsoft for $265 million (LinkExchange) and another company he still runs to Amazon for $800 million (Zappos).

Mr. Hsieh also became fascinated with the science of cities, particularly the idea that cities, unlike companies, become more productive as they become more dense.

Acting on that notion, he leased downtown Las Vegas' former city hall, where he intends to move Zappos' 1,400 employees next year from the city's suburbs. That became the first step in the Downtown Project, with Mr. Hsieh planning to invest $350 million in residential development, education and technology start-ups to transform a declining downtown that's miles from the Strip into a vibrant community.

It's ZDogg's job to figure out how to provide medical care to that downtown. Right now, he explains, medical care—particularly primary care—there is fragmented and demoralized because of "really low" reimbursements and the (undeserved) stigma that Vegas is no place to raise a family.

So how to fix primary care? ZDogg plans to approach individuals and self-insured companies like Zappos with a variation on a membership model. "An employer might pay a capitated fee per employee to get unlimited primary care at this medical home," he says. Companies would carry catastrophic coverage for hospitalizations, and the model could be scaled up to include specialists.

The first clinic—housed in a construction trailer—should open next year. In the meantime, ZDogg is recruiting doctors, working start-up hours and loving it. "It's Tony's method to hire people who are not experts, but who are passionate and can learn," he says. What's helping him get over that learning curve? "One advantage of working with Tony is that you get access to really smart people."

More information is online at zdoggmd.com and downtownproject.com.


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