Priced Out of a $150 DPC Membership, Pregnant Patients Get Free Care

Esther Khatibi’s pregnant patients kept hitting the same wall. Her Corpus Christi practice, New Life Direct Primary Care, offered a maternity membership for $150 a month, and many of the women who needed it couldn’t pay, Medical Economics reported on Oct. 23. Many also had no insurance or financial assistance to fall back on.

“I couldn’t desert these patients,” Khatibi told the magazine.

So the family physician, who has extra training in obstetrics, built a second organization to carry them. My DOC, short for My Direct Obstetrics Care, is a nonprofit that now offers free obstetric, delivery and postpartum care to patients who are uninsured, underinsured or facing higher-risk pregnancies.

It’s one clinic in South Texas. It’s also a clean test of something DPC doctors argue about all the time: can a membership practice reach the patients who can’t afford the membership?

How the free clinic got built

According to My DOC’s own account, a small group met in January 2021 to plan a program that gave pregnant women direct access to a physician, “based on the direct primary care model.” The nonprofit cites Texas’s uninsured rate as its reason for existing. The Census Bureau’s latest state comparison backs the premise: in 2024, Texas had the highest uninsured rate of any state, at 16.7%.

Medical Economics says Khatibi established My DOC in 2022 and opened its doors in September 2023. The work list she describes is unglamorous. A lawyer. A board. Bylaws, referral arrangements, fundraising and grant applications.

Her first fundraiser brought in about $3,500. Local grants later paid for an ultrasound machine.

The podcast episode published with the article adds detail. Its published timestamps say her practice covered the nonprofit’s costs for about a year, until she realized that would sink her business. They also say My DOC charged $25 a month before it became a charitable clinic, and that going free changed how people responded to it.

Grants have been hard. One fell through because My DOC shares space with her for-profit practice, per the timestamps, and both organizations list the same suite on Saratoga Boulevard. “You almost have to have somebody who’s in a paid position,” Khatibi said of grant writing. “And for the one doc trying to run two businesses, it can be very difficult.”

Obstetrics is the hard part

Family physicians who deliver babies were already scarce. A 2017 study in the Journal of the American Board of Family Medicine found that 21% of new family medicine graduates in 2016 intended to include obstetric delivery in their practice, while only 7% of family physicians did so.

Khatibi’s account shows what makes it harder for a solo DPC doctor. When one patient’s membranes ruptured at about 24 weeks, she had to round on her every day until delivery. “It’s just me and a clinic, and I have my own kids,” she said.

She also ran into the concierge assumption. Some colleagues, she said, think “your patients are paying you tons of money to get that cellphone number and to have access to you.” Most of her patients were struggling financially, and that wasn’t obvious to the physicians covering for her. She now frames them to colleagues as “our patients,” and that pitch has brought in volunteers and funding.

Her advice to DPC doctors who want to add obstetrics is to get buy-in first: backup and strong relationships with hospital colleagues. Today she has stepped back from doing deliveries herself. Volunteer physicians handle them while she runs the nonprofit, recruits and raises money.

Where the practice stands

New Life’s website now says the practice is not accepting patients and enrollment is closed. A practice update page on the same site says the practice “continues to transition,” explains how to request medical records, and thanks patients for “the opportunity to have been part of your care.” The Medical Economics piece doesn’t address the practice’s status, and neither page says what the transition involves.

Khatibi’s plan for My DOC points outward. She envisions branches that physicians could join while running their own DPC practices, drawing on the legal and fundraising work the nonprofit has already done. Her long-term goal includes paid positions for family physicians who want to keep practicing obstetrics.

Who pays for the long visit

Khatibi’s case for direct obstetric care is time. She says it often takes at least 10 minutes before a patient opens up, and that’s when she may learn about domestic abuse, sexual assault or other circumstances that shape the pregnancy. “The longer you’re in the room, the more likely you will get to the complicated part of medicine,” she said.

That time is what a DPC membership sells. In her own telling, the patients who most needed it couldn’t buy it at $150 a month, and the practice that tried to absorb the cost for a year couldn’t keep doing it. The nonprofit fixes the price for the patient. It moves the cost to donors, grant committees and volunteer hours, including roughly 30 unpaid hours a week from Khatibi, by the episode timestamps’ count.

A branch network could spread that load across more doctors, and each branch would still need donors. If you’re a DPC doctor weighing obstetrics, you might read My DOC as proof that the care can be given away, and also as an itemized bill for what giving it away costs.