The doctor-rapper Zubin Dama- nia, MD—otherwise known as ZDoggMD—may soon be advertising for a medication therapy management expert well grounded in collaborative practice to join his primary care team at the newly minted Turntable Health clinic in downtown Las Vegas. “Having a pharmacist can be a real source of patient education,” Damania told Pharmacy Today. “If you allow pharmacists to handle the stuff they’re really good at and practice at the top of their license, they can be a tremendous asset to the team and to care coordination and costs and outcomes.” As an internist with nearly a decade of practice as a hospitalist at Stanford University Medical Center, the physician was speaking from firsthand knowledge. “The role of the inpatient pharmacist as an educator and sort of fail-safe systems person, especially on rounds, is invaluable,” Damania said. “The typical pharmacist knows a lot more about medications and how to take them than a lot of clinicians do, especially in the primary care setting where there is so much to know.” That team role can also be effective in an outpatient wellness setting such as Turntable Health, Damania said. But he is not quite ready to hang out a pharmacist-wanted sign yet. If he had an unlimited budget, he said, that is exactly what he would do, but he doesn’t, so the pharmacist hire will have to wait for the clinic’s membership rolls to reach a more financially viable level. So far, the signs are promising. Turntable Health, in partnership with the Cambridge, MA-based Iora Health, opened its spacious primary care and wellness clinic on December 16, 2013, and within a month had enrolled 200 individuals at the roughly $80 monthly membership fee for unlimited primary care visits plus an array of other wellness services. Several thousand more members are expected through contracts with large local employers and a major health plan. Damania said that the clinic’s eventual complement of primary care physicians, nurses, professional social workers, and personal health coaches will be capable of serving as many as 7,000 members. When that goal is realized, the plan is to immediately roll out several more clinics in various Las Vegas suburbs. “Then as we create a big network and a patient volume large enough to hire our own specialists, we can really transform health care because we’ll bring our culture and our rigorous practice to all phases of the medical interaction.” An onsite pharmacy may also be in the offing, he said. Turntable Health is unlike the vast majority of primary care clinics in the United States today. In addition to clinical consulting rooms, the airy, modernistic 7,000-square-foot street-level clinic contains a yoga studio, a community space with Wi-Fi access, and a live demonstration kitchen where members learn how to prepare healthy meals. As a membership organization, Turntable does not accept fee-for-service insurance payments, Damania said, but it is working with the not-for-profit health plan Nevada Health Co-Op to provide full insurance coverage as well as access to Turntable primary care for one price, potentially subsidized under the Affordable Care Act on the health insurance marketplaces. Damania’s electric online presence as ZDoggMD, the rapping physician with satirical lyrics about the current health care system, was partly what attracted the attention of Zappos CEO Tony Hsieh. Hsieh was looking for a fresh approach to the new health care clinic he envisioned for his Downtown Project, which aims to revive Las Vegas. “Hsieh was a friend,” Damania said, “and because he had gone to school with my wife and had watched my [YouTube] videos, he realized I was not in my right mind and so thought I’d be the perfect person to quit everything and move to Las Vegas to try to start something new.” For the free-spirited Damania, it was an offer he couldn’t refuse.
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