Zubin Damania, MD—aka ZDoggMD—took RBMA attendees on a hilarious and subversive ride through his career in medicine, employing shock tactics, bathroom humor and family references, all calculated to drive home a deadly serious message: The culture in medicine must change.

“They don't pay you to develop relationships, they don't pay you to get to know the patient, they don't pay you to do things for people,” Damania said. “They pay you to do things to people.”

While he was an internist at Stanford, Damania leveraged music and his alter ego, ZDoggMD (“with two ‘g’s’ because one isn’t sufficiently gansta’”) to teach young men about testicular cancer and build esprit de corp by paying tribute to nurses. Then Tony Hsieh, CEO of Zappos.com came calling, and offered him the opportunity to incubate a healthcare business in Las Vegas, where healthcare outcomes are among the worst in the nation.

Damania founded Turntable Health based on four principles: start with primary care, use a membership model ($80 per month goosed with things like yoga and no co-pays), employ healthcare coaches (four per physician) and leverage technology.

Acknowledging that healthcare reform has created many challenges for healthcare, Damania’s advice is this: “When life gives you Obamacare, make Obamalade.”

Turntable is now on the Nevada state exchange as a primary care narrow network option for Nevada Health Corp’s VIP plan. Damania, whose, wife is a radiologist, discussed the role of local radiology providers in an interview with the RBMA prior to the show.

Following the presentation, Damania took the time to stroll the exhibit floor aisles to meet and greet attendees and exhibitors. He told RadiologyBusiness.com that Turntable made the calculated decision to begin with primary care and partner with not-for-profit insurers, but had a longer-range plan in view.

“Our deal with the insurance companies is we will provide primary care, keep admissions down, create a narrow network,” he said. As Turntable demonstrates its value, it will receive a chunk of cash, much like an ACO would, to build out an “engine mechanism” to manage a multispecialty care network and then hire hospitalists, keeping their census low, perhaps 10 versus the more common 30.

In bringing his talk to a close, Damania viewed his physician father’s world as Health 1.0, and our current environment marked by consolidation, regulation and administration as Health 2.0. “What does Health 3.0 looks like?” he asked. “The doctor–patient relationship is sacred, but it’s no longer patriarchal, it is a team.”