Family Medicine for America's Health chose the AAFP's 2016 National Conference of Family Medicine Residents and Medical Students as the setting for its Health is Primary(healthisprimary.org) campaign's message of primary care advocacy. A high-energy panel that opened the three-day event drove home the point that choosing and supporting primary care specialties is critical to changing the health care system and improving the health of all Americans.
Zubin Damania, M.D., (also known as ZDogg M.D., far left) jokes with other members of a Health is Primary panel (from left: Jennifer Brull, M.D., Natasha Bhuyan, M.D., and moderator T.R. Reid) that opened the 2016 National Conference of Family Medicine Residents and Medical Students.
Moderated by author and journalist T.R. Reid, the panel featured Natasha Bhuyan, M.D., of Phoenix; Jennifer Brull, M.D., of Plainville, Kan.; and surprise special guest Zubin Damania, M.D., of Las Vegas, who might be better known as ZDogg M.D.
"We know that primary care is one of the best buys in health care," said Glen Stream, M.D., M.B.I., of La Quinta, Calif., president and board chair of Family Medicine for America's Health, in a news release.(healthisprimary.org) "Unfortunately, too often students who start out planning to work in primary care end up going into a subspecialty instead. We urgently need to redesign our system to encourage students to select and stay with primary care specialties if we are going to meet the needs of society and improve the nation's health care system.
"The good news is there are innovative programs emerging across the country -- including here in the greater Kansas City area -- to do just that."
Reid opened the session by telling a story about a family physician friend in King County, Washington, who is 72 years old and still practicing. Reid asked his friend why he continued to work when other professionals his age had long since retired.
- During a July 28 Health is Primary panel event at the National Conference of Family Medicine Residents and Medical Students, panelists discussed the importance of advocating for family medicine.
- Moderated by author and journalist T.R. Reid, the panel featured Natasha Bhuyan, M.D., of Phoenix; Jennifer Brull, M.D., of Plainville, Kan.; and surprise special guest Zubin Damania, M.D., of Las Vegas, who might be better known as ZDogg M.D.
- The session also included the premier of a new music video by ZDogg M.D. that described his journey through medical school and the effect caring for patients has had on his life.
"People come into my office every day, and I know a lot of them," Reid's friend told him. "They hurt or they're scared or something's happened in their body that they can't understand. They have a problem with their kids or their parents that they can't handle. … I can't solve them all. But most of the time, those people leave my office feeling better than when they came in. Why would I retire?"
Reid told the residents and students in attendance, "I think this is your future; this is what you are going to see."
The other panelists then shared their perspectives on how they became primary care champions and how attendees -- the future of family medicine -- can help shape the role of primary care in a rapidly evolving health care system.
Show Up, Speak Out, Make Change
Bhuyan addressed the culture in medical school that discourages students from choosing primary care as a specialty, saying that students can change this culture by showing up, speaking out and making actual change.
"For me, three years ago, I showed up for National Conference, I ran for a board of directors position for the Association of Family Medicine Residency Directors, and that led to a role in Family Medicine for America's Health as an adviser. Showing up makes a huge difference."
According to Bhuyan, speaking out can mean reaching out to political leaders about the importance of family medicine, or it can mean blogging or using social media to promote the cause.
"I currently serve as an advocate for family medicine as a medical correspondent for local news stations, and I speak about evidence-based care," she explained. "But more importantly, I get to say I can do multiple segments; you don't need a GI specialist or a dermatologist. As family physicians, we can manage 95 percent of the conditions that we see."
Panelist Natasha Bhuyan, M.D., of One Medical Group, says the culture of discouraging students from choosing primary care can be changed by students showing up, speaking out and making actual change.
As for shaping the culture in medical school, Bhuyan said it may take many people to create seismic change and follow it through, but it only takes one person to ignite the spark.
For example, while in medical school 10 years ago, she'd seen a comment on a listserv from a student who said he was willing to treat lesbian, gay, bisexual and transgender patients but didn't want his kids to interact with gay people. This sparked Bhuyan to start a "No Hate" campaign on her medical school campus, posting photos of med students, teachers and administrators with duct tape over their mouths and "No Hate" written on their faces.
"I felt that next Monday, when everyone came back to medical school, there was a shift in the culture," she said. "All change takes is a little bit of courage; this is something all of you can do."
Brull, who practices with four partners in her rural Post Rock Family Medicine clinic, told attendees she wasn't very involved in advocacy while in medical school or residency. It wasn't until the Kansas AFP asked her to go to what's now known as the National Conference of Constituency Leaders that she found herself caught up in the action.
While attending the event, she said Mike Sevilla, M.D., of Salem, Ohio, encouraged her to run for a leadership position; she did so, got elected and hasn't missed the conference since.
Zdogg M.D. Premiers Video During National Conference
During the Health is Primary panel event July 28 at the National Conference of Family Medicine Residents and Medical Students, surprise special guest and panelist Zubin Damania, M.D., of Las Vegas -- also known as ZDogg M.D. -- premiered his new music video(zdoggmd.com) that describes his journey through medical school and the effect caring for patients has had on his life. The video, which highlights the importance of working together to produce a "Health Care 3.0" that values primary care and patients, drew a standing ovation from excited students and residents.
To share the video, click on "Share This" under the video window on the ZDogg M.D. page and choose which platform to share it on.
"I am so on fire about what family physicians are doing not just to improve our specialty, but also the health of our patients," she said. "Natasha said to say yes and show up and that is something I have always done. If you have opportunities to say yes along the way and do these things that engage you with other family physicians, you can become an energizer."
Individualism and Innovation
When asked by Reid which came first -- physician or rapper -- Damania said the question is tough to answer because he was raised by two physician parents, but he also loved "Weird Al" Yankovic and his parody songs.
Damania started Turntable Health, a partner of Iora Health, two years ago because as a hospitalist at Stanford University, he saw that providing better preventive care through family medicine could help shrink the 50 percent of patients admitted to hospitals who don't need to be there.
"For me, waking up was saying, 'This is not OK,'" he said. "I started making videos (about contemporary medical issues) as a cry for help, putting them on YouTube and risking my career almost intentionally. Family physicians are the solution to our problems."
Turntable Health -- tagline: "Primary Care, Re-Mixed" -- uses a model in which patients, their employers, unions or insurers pay a monthly fee for comprehensive care. As to the future of his young practice, Damania said, "Who knows what's going to happen? But if this inspires others to try to create health care in other states from the ground up in a grassroots way, then we've done our job."
When Reid asked Bhuyan what she didn't learn as a student or resident that physicians need to know, she said it's important for new physicians to explore different models of care.
"I think we don't talk enough about innovation in health care because innovation in primary care is so slow," she said. "I've found that there are all these models of care that are emerging and some levels of care that are working in the fee-for-service world. Other models of care are working in capitated markets with totally new models.
Zubin Damania, M.D. -- a.k.a. ZDogg M.D. -- discusses the new music video he premiered at the Health is Primary event that chronicles his journey through medical school and the effect caring for patients has had on his life.
"These efforts are attracting venture capital funding, so this tells me there is a lot of excitement and potential for primary care to be the solution for our health care woes."
Bhuyan asked attendees to think about how they can be innovative in the greater health care system.
Finally, Reid asked Damania -- who has a large social media following -- how family physicians can best spread the word about the benefits of primary care to Americans.
"One of our big problems in medicine is we've been trained to be so conservative about how we speak publicly," Damania said. "And medical institutions and schools are terrified about social media unless it's really controlled. But the rest of the country isn't terrified of social media and that is where they are."
If family physicians want to advocate for and highlight how family medicine can make health care better, they should consider doing so in an edgy and catchy way.
"It doesn't have to be rap videos; it might be speaking at a town hall meeting or speaking at your kid's school to inspire future physicians," Damania said. "But we need to collectively get together and say, 'Let's stand up and be someone who is excited and passionate about the thing we've been called to do -- primary care."
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