Esther Khatibi — MD, owner, operator and the sole physician at New Life Direct Primary Care — has dared to imagine a world in which access to your physician is as easy as sending a text message. In the current climate of transactional medical care that often limits patients’ access to their physician to a few minutes at a time, Khatibi took a leap of faith, left money on the table and opened the first direct primary care clinic of its kind in the Coastal Bend.
“It’s kind of like the old days when you had a family doctor who just came to your house,” she said of her current clinic’s operations. Times are different, sure, and in her tenure as a physician, patient care has gotten convoluted with insurance and billing confusion. Not to mention that getting to actually see a physician was a challenge. “For some reason, after the 20-minute mark, patients start to really open up,” she said.
By opening the lines of communication beyond short office visits, she learned critical information and even saved her patients some expensive trips to the emergency room based on intake from an evening phone call. When she heard about the Direct Primary Care model, she leaned in without hesitation because it was what she was basically already doing.
Telehealth is changing the landscape of medical care, but the concept of direct primary care is revolutionary in its own right, especially in the Coastal Bend. New Life doesn’t bill insurance, but charges a flat monthly fee. Patients get Khatibi’s phone number and all correspondence gets digitized directly into their chart, so she doesn’t miss a thing. She works closely with the clinic’s medical assistant and a patient who calls is guaranteed to speak with them, no matter the time of day. Patients are guaranteed honest, direct, proactive and cumulative care without a long wait in an office or a time limit on visits.
Currently, Khatibi is working to bridge the gap for those who might not qualify for Medicaid, but can’t quite afford steep insurance prices; or those who have coverage for catastrophic events with astronomic deductibles and co-pays. New Life has negotiated pricing for imaging and prescriptions, and even for patients with insurance, its prices are often cheaper. Her credentialing allows for a wide scope of expertise, but her passion — and the area in which she has seen a deficit in quality care — is obstetrics. What started as looping OB care under the umbrella of New Life has morphed into starting a non-profit called My DOC, which stands for Direct Obstetric Care, for prenatal, birth and post-natal care.
“We’re hoping to help lower morbidity and mortality rates for high-risk women in the community,” Khatibi said. “Studies have shown even though people have insurance, they don’t feel comfortable telling their doctor when something is going on. It’ll be a week or two before they’ll admit their blood pressure is a little high, and when you’re pregnant, that could be very concerning. So hopefully, with this model, they have access to their physician.”
By going the non-profit route, she can receive funding for supplies and equipment like an ultrasound machine, which will allow the cost of obstetric care to be even lower. When it comes to delivering babies, there is no question she will be the one there — something Khatibi feels is of utmost importance. “I’m your doctor. I’ll arrange my vacation time around your delivery,” she insisted.
A guarantee like that is rare, but in going the extra mile, she doesn’t bill for the delivery, for rounding or for postnatal care in the hospital. Patients pay the fixed monthly price, which depending on circumstances, is between $50 – $150 per month, and that’s it. Insurance or not, her OB care is focused on lowering the Maternal Vulnerability Index score, which is unnecessarily high for women in our country, specifically women of color. This is something she strongly believes can be reversed through consistent, accessible, non-discriminatory care.
For Khatibi, success has never been just about money. “I really think being a community leader and having a good reputation where you’re respected for the care you give has always been way more important to me,” she said. Her generous spirit and willingness to step away from a secure position in order to work toward creating a better system for all solidifies her as a hero in the Coastal Bend medical community. She hopes to see more physicians open their minds to consider this model of care, question the limitations of the norm and work to see progress in medical care for all.