You may have heard of ZDoggMD—the rapping doctor whose parody music videos on medical topics like electronic health records (EHR), re-admission and sepsis have acquired millions of views. But who is the physician behind the persona?
Primary care physician Michael Rakotz, MD, director of chronic disease prevention with the AMA’s Improving Health Outcomes initiative, sat down with Zubin Damania, MD, to talk about burnout, discuss EHRs and find out how he came to be the YouTube rapping sensation ZDoggMD.
The burnout story that started it all
Dr. Rakotz: “When did you first realize that you were facing burnout?”
Dr. Damania: “For me it was really a slow creep. I started my career in hospital medicine …. I had a wonderful hospital job with mentorship with interns, medical students, residents.”
“We had an electronic record, but [it was used] only [for] reading … the labs, and everything else was on paper. It was this beautiful collusion of being able to help people, like I intended when I went to medical school …. They tolerated me making jokes and using humor as a way to bring people together; it worked really well. But what started happening is … what we see in most of health care, which is increasing pressure on a financial level to produce to perform.”
Dr. Rakotz: “So you experienced the hospital’s EHR transition first hand?”
Dr. Damania: “I was on call the night our first EHR went live …. Say what you will about EHRs, they’re wonderful at storing data and potentially improving outcomes, but the fact is—from a ground-level experience—suddenly my day got so long and so complicated just clicking boxes. And with those boxes came an increased requirement to click more boxes.”
“It became increasingly difficult. The productivity requirements went up, so we had less house staff coverage. Suddenly I was overwhelmed with the number of patients. And what really snapped for me is … I realized I wasn’t able to spend the time with the patient that actually obtained an outcome that was something other than some knee-jerk nonsense that would have them bounce back in 30 days.”
Dr. Rakotz: “What was the last straw that took you in the direction that led you to where you are today?”
Dr. Damania: “There was a patient in his 30s who had cancer. He was one of 30 patients I had in the hospital at the time. It was signed out to me like [he] was a difficult patient, doesn’t take their medications, multiple rounds of chemotherapy but still wants more, totally irrational. And I’m looking at this going this is an engineer, I don’t think irrational is necessarily part of the deal here, so what’s going on?”
“I get in the room, and I feel this wave. [As a physician] you build a wall around yourself to function, but for the first time this wall was wobbling. I did something I had no business doing: I sat down in the room instead of doing my five minute U-turn … and an hour went by.”
“No one was coordinating their care. He wanted … to be home with his kids, but he couldn’t because his pain wasn’t controlled. What the wife really wanted was some balance, but he said, ‘If I get admitted for another round of chemotherapy since the visiting hours are so crappy, my family, my kids won’t see me … and I’ll die in the hospital.” … Luckily, we were able to have a great outcome with him by getting him home because I was able to get the team together. But that was an exception.”
“Finally, I felt so disempowered. There were so many pressures on our time struggling between the record and the regulations and the patient volume, and it just broke me.”
“When I really started getting burned out, I started to reconnect with who I was. YouTube was a thing all of a sudden, [and] I said I’m going to make these silly videos … in a way to reach patients, educate them and also satirize the system that is so dysfunctional.”
“I kept doing it. Suddenly awakened in me was this idea that this is who I am.”
“We did a Michael Jackson parody about testicular self-exam, and I was getting these messages from student health clinics playing it in their waiting room, and kids were catching early testicular tumors. I asked, ‘How is it that I’m more empowered to prevent disease in this way than I was in the hospital?’ … That opened the door.”
Enter … ZDoggMD
Dr. Rakotz: “So I would like to talk to ZDoggMD now if we can.”
Without hesitation Dr. Damania flipped on his shades and effectively transformed into ZDoggMD—and Dr. Rakotz joined him.
Dr. Rakotz: “What comes first—do you pick a song to parody, or do you have an idea in mind and go looking for a song to remix?”
ZDoggMD: “It’s a mix of things. For example, we did a song called ‘Re-admission,’ which was a parody of the [R. Kelly] song ‘Ignition.’ I forgot how dope that song is … I listened through it and I thought, I just want to go to the hospital and lip-sync this song in various medical spots, and then I started working on the lyrics. I realized they fit so perfectly.”
Dr. Rakotz: “Who are you trying to reach … physicians, residents, students?”
ZDoggMD: “We struggled in the beginning [to identify the audience], and then I realized we just have to make the videos and then figure out who the audience is. The truth is, I found I couldn’t censor myself as a doc. I had to speak in this language that is the tribal language of physicians. And then what ended up happening was nurses, docs, PAs, dentists, vets started becoming the fans.”
“At first I wanted to be broader than that. I wanted to reach laypeople. But then I said … there is so much suffering in our own tribe, let’s focus on them and give them something that they can say, ‘this is my anthem.’”
Dr. Rakotz: "What’s next for ZDoggMD?”
ZDoggMD: “I want to try to help give a voice to people in health care that don’t really have much of a voice. When I think about that, I think about the lab. Those guys, they’re down in the basement … doing their thing … people always kind of dump on them … so we did a parody of 50 Cent’s ‘In Da Club,’ called ‘In Da Lab.’”
“It goes: ‘Go go go, go redraw, there’s no birthdate, you didn’t label it, there’s no birthdate, it’s in the wrong tube, and yo there’s no birthdate, and you know we don’t draw no blood without no birthdate … You can find me in the lab, bottle full of cr@p, but, homie, I got the plates if you’re in to growin’ that ….”
