doctors who struggle with burdensome government regulations and daily ad- ministrative hassles. (See “The Rhythm and the Rhyme: The Rapper, the Physi- cian,” page 53.) Dr. Damania says physicians practic- ing in traditional settings don’t have to take on a hip-hop alter ego to incorpo- rate elements of the Turntable model into their practices. One suggestion he has for physicians involves accepting some direct-pay patients, a move he says frees doctors from the constraints of the traditional insurance model, allowing them to deliver better care. If doctors feel they have delivered the best care they can give to a patient, some of the joy returns to practicing medicine, Dr. Damania says. He says even though Turntable Health is a com- pany, it empowers doctors to practice autonomously, “the way they’ve always wanted to practice. We’re reconnecting with why we went into medicine.”


Fight the power Dr. Damania’s music videos caught the eye of Tony Hsieh, chief executive of- ficer of Zappos, Inc. He encouraged Dr. Damania to move from his home in the California Bay Area to Las Vegas to cre- ate a better health care archetype. Dr. Damania opened the doors to


Turntable Health in December. Its mis- sion is “to fix health care for everyone,” he says.


In less than two months, the facility had 250 members. Dr. Damania says he wants his practice to serve as a model for a new wave of health care. Turntable members pay an $80 monthly flat fee for primary care. The practice offers same- day or next-day appointments, 24-7 ac- cess to physicians by phone, nutrition classes, yoga, and group therapy. “You have the ability to impact mul- tiple aspects of people’s lives,” he said. The organization’s operating partner, Iora Health, based in Cambridge, Mass.,


has been experimenting with a similar model for several years, Dr. Damania says. Iora has a handful of flat-fee prac- tices, but they cater to individual spon- sors, such as unions and colleges. “We’ve seen the early pilots,” Dr. Da- mania said. “Now we want to optimize and bring the model to everyone.” Unlike a clinic funded by a union or an employer, Turntable is open to the public. “We’re not the first, but we think we’re the more sustainable solution to get it established,” he said. Patient feedback has been positive, he says. Postvisit surveys show a 97-per- cent satisfaction rating from the first 50 patients.


Many patient members struggled with poor health care in the past and are grateful the facility opened its doors, he says. Turntable Health attracts patients from a broad socioeconomic spectrum but doesn’t accept Medicare or Medicaid patients.


Several small businesses and young


entrepreneurs in the city provide Turn- table Health membership to their em- ployees, including Project 100, a transit service that offers shared electric cars and bicycles, shuttles, and chauffeured vehicles for a flat monthly fee. “The demographic is younger, but


they’re not necessarily healthier,” Dr. Da- mania said, adding that these patients often struggle with substance abuse problems and mental health concerns. He says Turntable Heath focuses on


the relationship between the patient and the physician, a critical aspect of health care that he plans to examine in his Tex- Med presentation.


“If we do the right thing for the pa- tients, they’re going to respect that,” he said. Turntable Health is now free for many members of the Nevada Health Co-Op, a state health insurance cooperative cre- ated under the Affordable Care Act. Dr. Damania plans to build more Turntable locations — first in the Las Vegas sub- urbs, then in other states. “If we could make it work in Las Ve-


gas, we think we could make it work anywhere,” he said.


54 TEXAS MEDICINE April 2014

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