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Omar Matuk-Villazon, M.D., MBA '18 joins host David Droogleever to discuss the direct primary care model, innovation in healthcare and what it looks like to build a medical school from scratch.
Owl Have You Know is Rice Business’ podcast created to share the experiences of alumni, faculty, students and other members of our business community – real stories of belonging, failing, rebounding and, ultimately, succeeding. During meaningful conversations, we dive deep into how each guest has built success through troubles and triumphs before, during and after they set foot in McNair Hall.
The Owl Have You Know Podcast is a production of the business school at Rice University (Rice Business) and is produced by University FM.
David Droogleever:
Today on Owl Have You Know.
Omar Matuk-Villazon:
The whole idea is, let's try to deliver the right care at the right time. So as we're seeing telemedicine, we're also seeing in-home healthcare and we're seeing different modalities that at the end is really trying to keep people healthy with all these value-based payment models.
David Droogleever:
Welcome to another episode of Owl Have You Know. I'm your co-host David Droogleever, and I'm on the line here with Omar. Omar is a physician executive, he's an associate professor of pediatrics and healthcare consultant. He's also Rice Business class of 2018, the professional program. So Omar, thank you for coming on. And please say your last name for me.
Omar Matuk-Villazon:
No, David, a pleasure being here. My last name is Matuk-Villazon.
David Droogleever:
So, okay. I'm going to start this a little different. I usually ask for a harbor cruise, but when I looked at your LinkedIn, Omar, and from what I understand about you, you got a lot going on. You're investing, you're advising, you're leading large organizations, you're in academia, medicine, science. So when you wake up in the morning, I already know you're off to do a million things, so how do you go about prioritizing your day?
Omar Matuk-Villazon:
Excellent question. Actually, my wife asks me that every day. So number one thing, I can tell you, there are certain things that I keep on a routine that keep me centered. Number one, I can tell you is time with the kids, time with the wife, mindful time also with family that I have in Mexico. So that's always a must, and that helps me prioritize. And after that, like everyone else probably, the things that have urgency during the day, you try to wrap them up in the morning, especially. And the easy part of my job is being a doctor because I think they really trained us very well, and you do it automatically. But the other part, trying to teach other doctors, trying to do research, which I think I'm terrible, or the leadership part, I think that depends on what is going on at the moment.
David Droogleever:
Exactly. And maybe I should have asked how do you triage your priorities?
Omar Matuk-Villazon:
Yeah, yeah. For example, when the COVID thing will is going on. So what's the most urgent thing right now? Let's say, let's keep our doors open for the clinic. And then with the team, it's not only me, it's really a team behind all of us that help us succeed.
David Droogleever:
Okay. And let's talk about the clinic because I want to say that, of course you're running a clinic and you have a practice, but there's some interesting things you're doing around different types of clinics and getting help to people, yes?
Omar Matuk-Villazon:
Yes, yes. So the main difference... Have you ever gone to the doctor?
David Droogleever:
Don't even get me started about my relationships with the healthcare system, but yes.
Omar Matuk-Villazon:
So when you go to the doctor, it's very transactional. You go to see them and your insurance, or either yourself, we pay for that time. So I think that has been coming for almost 10 years or more. It's a payment system, which you can put in different names, right? But bottom line, you are paying for a bundle. So you may pay a month, you may pay by year. And we basically opened recently a clinic at the College of Medicine. And the term is called direct primary care in which patients pay $60 a month and they get full access to a doctor. So they can see him 24-7, they can see him every time. And that will change the entire relationship because now, there's no financial transaction every time you see them. And that really has helped us to serve patients in Houston, especially the uninsured, which we have 1.5 million, it's a big market. They have access to healthcare now.
David Droogleever:
That's amazing. I think the subscription model is pretty interesting because, well, in regular business, if you're not getting a service you're happy with and you stop the subscription, but I think more broadly, I think the incentive structure is something that's interesting to explore. And I was planning on asking this at the end, but you're making me think of it now. And I wanted to ask, come on, let's call out the elephant in the room. If you go to the doctor more and the more sickly you are, the more transactions happen. So are there incentive systems out there where doctors are incentivized to keep patients healthy and out of a clinic or hospital?
Omar Matuk-Villazon:
Oh my, yes. You hit the question. Very good question and right on the spot. So they are different, let's say, mechanism in which you can do that. Let's speak about direct primary care because where they touch that point. So direct primary care is modeling, which initially it started more as a concierge medicine now. So you have the doctor that was tired of the insurance. And the doctor says, you know, I am only going to accept cash and no insurance. So what happened? You will see a lot of clinics popping around the country and in Texas. But few of these providers target their services specifically to our patients who have no access to healthcare insurance. So that's where we try to find our niche and the innovation.
Omar Matuk-Villazon:
And if you think about it, you're aligning the financial incentive with the clinical incentive, because as you write full cell phone, if the consumer is not satisfied with your services, they will just go to somewhere else. So you really have a model with the strong incentives to innovate in how you deliver care. In this case, primary care. And then you can aim to improve quality or be more effective because your patients are going to reach out if they're sick. So you actually want to keep them healthy. So their utilization is not that high and you can have more members. So like a subscription model, right?
David Droogleever:
Of course. Yeah. I'm very familiar with that being in technology sales and subscription or software as a service. So that's just it. You want the subscription to keep going and the utilization to be relatively low. And in the case of healthcare, that's good. Everyone's winning, you don't as a patient, you don't want to be "utilizing."
Omar Matuk-Villazon:
And I mean, there's always downsides to this, right? Because you always need insurance for bad things. You cannot prevent an appendicitis or a fracture or a catastrophic diagnosis. So you will always have to have that piece of protection and really that's what you need insurance. And the typical example is you don't use any insurance. Speaking about the car industry. You never use the insurance to change the oil. Use the insurance if you have a major crash. And there's a lot of comparison that people do that in healthcare.
Omar Matuk-Villazon:
Now in another segment of the population, 65 and above, there's a governmental program that is called Medicare, everyone gets insurance. And there's a part of that that is called Medicare advantage. And I'm going to there because you asked about the incentives. So from a business perspective, there's so much private equity, capital venture funds going into that arena because what the government is doing, they're giving a fixed amount per month to these different programs. And then you have to take care of the patient, you assume, full risk. So you just think for a moment, do you have an elderly or in your life, they tend to be healthy. Or if they're sick, trying to get the right healthcare for them is challenging. So you have all these clinics developing all around the country trying to tackle that, doing excellent service and whatever they save, they may keep a portion of it. And that's where the, from a business perspective, that's where the money is.
David Droogleever:
Thanks for the primer there. And just an understanding of where things could possibly be heading. And it's just wild to me because I recently had to, well, let's shift to say remote care or telehealth. And to me, when I had a telehealth appointment quite recently, because it was so hard to go see my primary, I just went on and essentially did direct primary care. It was a doctor. There were a different company that I've never used before and it was less than $50. And I saw a doctor in 20 minutes and was able to get the help that I needed. And I'm sitting here thinking, my goodness, why does it feel like that telehealth is not as pervasive as one would hope it to be? Or maybe I'm missing something. It seems like that should be much more accessible. What does that look like from your perspective?
Omar Matuk-Villazon:
And again, this will be my perspective. I think it's a modality of care. It doesn't mean that everything that you do needs to be telehealth now. So what we discover is basically for individuals and especially the payers, insurance side, prior that they were not willing to compensate anyone's time to do telehealth. COVID happened. It forced society to, as a patient to agree, to see a doctor on the video, because also the patient didn't want and agree the payers to pay for that.
Omar Matuk-Villazon:
So it was just an acceleration for folks that have been doing this. I don't know, 20 years that they say this is coming, this is coming. They just accelerate the transition 10 years. What we're seeing right now, and there are folks that study these, publish an article, it's a modality of care. So we need to understand certain things. You can do a telehealth visit and telemedicine doesn't necessarily need to mean having a video. And if you know how many people are zoom out nowadays, you can have a phone call. You can have a text message, all this as synchronous communication. And the whole idea is let's try to deliver the right care at the right time. So as we're seeing telemedicine, we're also seeing in home healthcare and we're seeing different modalities that at the end is really trying to keep people healthy with all these value-based payment models.
David Droogleever:
I love that. The right care at the right time. And it seems so obvious, but so hard to get to.
Omar Matuk-Villazon:
Yes, the execution is key.
David Droogleever:
Oh, that's great. Well, you're doing the work of the Lord. So, and I didn't want to-
Omar Matuk-Villazon:
No, it's a team. It's not me. I'm telling you, the healthcare, it's a team sport.
David Droogleever:
I wanted to also look at something I read on your profile as well, that you're focused on the intersection of primary care and then digital health, and we're alluding to it. So what does that exactly mean and why is that important?
Omar Matuk-Villazon:
Oh yeah, absolutely. You know, as I was doing my MBA, Rice is wonderful at really poking all of our inner bird to do something entrepreneurial. And I'm thinking, okay, I'm a pediatrician, what can I do? With all the technology that has been going on for 15, 20 years, it's clearly that a slack text message, how you manage projects. That's how we probably can manage disease or health. Like every single person, let's say if you're a diabetic, we need to manage the diabetes like if it was a project. You need to have your project manager, call the doctor, you need to have a nurse, a nutritionist, you need to have a pharmacist, even social worker, you need a whole team to take care of you. And for that, for each one of those diseases, and there are a lot of solutions that can be applied in primary care.
Omar Matuk-Villazon:
The biggest difficulty with the term primary care is so broad. It's like saying that you are doing business. It's like, what is that? It's the same on primary care? You have the burden of trying to do everything with little reimbursement and little incentive from the system, but you have the opportunity from an entrepreneurial perspective to target one segment of the population, perhaps one, a couple conditions at a time, and really narrowing your product. That is for example, what Hims & Hers have been doing. They did an IPO and they did very good. There are other companies, RO. There are a bunch of companies popping up in the nation really on that intersection because the market is so broad and the consumer wants solutions that as our doctors, we fail to provide on a traditional visit in the office, like it's 10 minutes and people hate.
David Droogleever:
Well, I actually looked up, why is it that I just can't get someone to come to my home? So I have my chiropractor come, I have my vet come to take care of my animals. I have a masseuse come to my place. And a lot of that, of course, I thought, well, we're in a pandemic. Sounds like I shouldn't be going out to large groups of people. And we've all seen the movies of the doctor showing up with his bag to the home, taking care of the patient in their bed and so on. And I said, why did that go away in the, I don't know, 40's or so. And the answer is pretty, and you're already talking about it, but go ahead, please.
Omar Matuk-Villazon:
No, I mean, it's intuitive. Who's paying for it?
David Droogleever:
Exactly.
Omar Matuk-Villazon:
Yeah. At the end, there are companies, actually there's one in New York, I don't know how they're doing. Pager was the name. There's one other in LA. There are a bunch of, especially in big cities that you have this concierge doctor that goes to your house, but you know, the prices is not for the masses at this moment. But again, you don't need every single doctor to go to your house for every single element. We just need to find the right modality of care that you need. So I think there's a lot of opportunities there and it's exciting. I had opportunity actually last year to start teaching a course for the MBA about this at Rice. So if anyone wants this, a small problem, you can go and sign up. It's actually called Intro to Value-based Care.
David Droogleever:
I love it, Omar. So, okay. I'm going to shift a little bit and just to make sure. So you're currently chief medical officer at the University of Houston College of Medicine. Did I get that right?
Omar Matuk-Villazon:
Yes. I'm having really the honor and the opportunity to do that. We are building the school. It's a brand new school, so it's a big title, but we are small. And I'm very lucky that they are giving me this opportunity, and so far has been a great journey.
David Droogleever:
Could you help us and describe your charter with this CMO role?
Omar Matuk-Villazon:
Yeah. Since we're really a starting, right now it's more on building the clinical infrastructure, setting up the clinical policies and procedures, and trying to determine with a team, right, is not only my decision, especially in a big university. Where do we want to be headed as a school? Where do we want to be seen? Where do we want the students to really learn how to be good primary care doctors? Because our mission is to train unrepresented minorities and lure them to stay in primary care, which financially doesn't make a lot of sense because if you're a specialist you make double. So you really need to create these experiences that attract the students to an area in which it can be very enjoyable. You can have a very good lifestyle. And I guess that's for now in the short term, right? We don't have any hospital right now. It's mostly clinics. And then other projects on the site.
David Droogleever:
So pull out your magic wands and use that for the future of this new school you're building. Where do you see it going? And what does success look like for your new school?
Omar Matuk-Villazon:
Yeah. And full disclosure. This is Omar Matuk. The school strategy, this will be my thought. I would love to see, we can really build those direct primary care practices. I think there's a huge opportunity to serve folks that have no insurance on their, I call this like a value-based care arrangement, but it's really not because you have no insurance, but on the membership model.
Omar Matuk-Villazon:
And then have a student see a primary care doctor can practice without the pressure of keeping up 30, 40 visits every day. Here, you can see 15 patients where you really get to know the the people, keep them healthy like if we are really able to create a marketplace for what we are now teaching, because there's always a disconnect because what you see in the classroom where you want to teach someone, and then you finish your degree. And you're like, oh, well, look at the marketplace. It's behind of what you're trying to tell me, like is the right thing to do. So it's 10 years. If we're able to change the local marketplace, of course, or even be a model, honestly, in the nation of, Hey guys, we can do this. And it's actually financially successful. That will be a magic one. I think that will be a great contribution to the city.
David Droogleever:
It's a very cogent answer. I feel you're a little shy there, but that sounds very exciting.
Omar Matuk-Villazon:
Yeah, no, and I may be having, yeah, another opportunity and I may move from UH, because we probably are going to build something for Hispanics in Texas and it's on the same arena, let's put it that way.
David Droogleever:
Very good. So one last topic I think, and we'll slowly land the plane. And again, something else I found on your profile, mental health, is that something that you focus on? And if so, into what capacity?
Omar Matuk-Villazon:
You know, I'm not on that expert professionally on mental health. I have become just savvy as a pediatrician because I have seen a rise on mental health issues on my practice on children that now, of course was exacerbated with isolation, COVID restrictions, dads at home working keeps on a screen. And I feel it's something that now we need to really focus and be mindful, especially on first world countries. I'm still very connected to my home, which is Mexico city. And I go once a month to practice with my dad who is also a doctor, and it's very interesting to see. Here, we have everything in the United States, but our mental health suffers because either we don't recognize it or we don't use the proper techniques. And sometimes I feel like back home there's not a lot, so many mental health issues. There are other problems, right?
Omar Matuk-Villazon:
So I just feel as a doctor right now, we really need to understand the patient as a whole, and really not disregard symptoms that are related in the mental health. And we have a shortage. There's not enough psychiatrist or even child psychiatrists, even if you speak in Texas, I can't cover the demand that is needed. So I think that's why my interest came up and really my desire to train better as a professional, and I don't have a solution. I know there's a company in California trying to solve this problem, doing telehealth visits on therapy. There's other company in Mexico that I'm just advising that is doing, but for the Latin market on this is named Therapify. So I think there's a big need in the market there to really address on the mental health.
David Droogleever:
So on COVID and whether it's mental health, or just more broadly looking at the healthcare system, what things do you feel, and let's try to, I'm sure we can find bad things, good things. So let's talk about a spread, some things that you think have improved as a result of the world managing through COVID and some things that you can call out as, hey, broadly speaking, we could have really done better or at least learned from that and improve going forward.
Omar Matuk-Villazon:
Oh yes. I think number one thing, pandemics are political, are not medical. So there's a lot of things that will not have happened if we really have followed the science. That's like number one thing. And I guess people are realizing now that instead of living on the 21st century where you have evidence of things and you have the tools to really describe what's happening, we are forcing ourselves somehow in the conversation from the dark ages in terms of beliefs and who do you follow, and I think that was an eye opener for me. And there's some people that discussed this, but I think that was key. Fabulous, the development of technology.
Omar Matuk-Villazon:
There's a doctor that I follow on Twitter and is name is Eric Topal. He's amazing. The guy is physician, scientist, cardiologist, and he has a thing tweeted on his profile. And you can see he put the timeline of the development of the COVID vaccine. So that was fantastic. Never has happened in life. And going back to my first comment, we have the tools and the capacity as society to develop solutions for things that 50 years ago, or 20 might kill a bunch of us, but we are not using them because we are being so politicized. And I think, I don't know how you fix that, but that's an issue.
Omar Matuk-Villazon:
Misinformation. There's a huge now trend on how, as a medical professionals or even maybe professional, you're going to combat misinformation and really trying to, it's not about, hey, hear my voice. It's about, guys, the sun is in the sky. It's not like someone painted or the sky is blue, like realities that you need to face. That even seeing with my own kids, because I see how between kids, they discuss things that they hear from their dads and they come to my house and they tell me certain rational in thought that I think is dangerous because we have to think, what are we trying to raise or to train for the next generation.
Omar Matuk-Villazon:
So I think that's, I saw that with COVID. A lot of disparities. I think if you are well of people in the pandemic, you suffer, but they're really pointed out as a society that there's a segment of the population that, you take away certain things and they cannot just do the same as you do. And even you do that as a countries like the pandemic has not ended in other parts of the world. So that's what show me. It's more like reality.
Omar Matuk-Villazon:
And the last thing, if you follow all the environmental stuff, all the pollution that we did with the COVID was going to happen with that. I feel like it's a tsunami that is coming right. All the masks that we use. I was reading in Atlantic last time, I think 3 million masks per minute, it was like a ridiculous amount of waste that we're creating now, only of COVID.
Omar Matuk-Villazon:
So, we could keep talking about this, but I think there's a lot of things that were just eye openers, that hopefully, Rice folks, if they want, there's a launch of business opportunity there, right? But you can also do good now. So I think that combination of social enterprise, which actually took that class, I forgot the guy by, God, he's going to kill me, but there's like a very good book of Muhammad Yunus. The guy won the Nobel prize and he actually writes his book about social enterprises. And I'm very into that. I think you can do very good money with a mission. And I think we should probably aim to that.
David Droogleever:
Absolutely. And it just feels good that we have alumni that are focusing on these things. And we've had prior podcasts about that, as well as conscious capitalism as well, similar energy as well. So lots to talk about there and it'd be great to maybe have a round two after things have fleshed out in your various projects.
Omar Matuk-Villazon:
Yeah. I'd love to.
David Droogleever:
Omar. Thank you for coming on. I'll have you know, and for folks listening, remember we have our reunion coming up in April, so be sure to register for that. And so Omar, just final thoughts from you in terms of either call to action, general messages for the Rice Business community. The mic is yours.
Omar Matuk-Villazon:
No, thank you. You guys can connect me on LinkedIn or Twitter, O.M.A.T.U.K, Omar Matuk. I'm teaching a course at the MBA Rice. I would love to see some of you there on value based care. And really, let's try to keep a community. As a Mexican that came to the United States, Rice has been a good tree. Something that you can hold and you can connect. And I'm very grateful to Rice. I'm happy to help or work with someone else from the Rice community.
David Droogleever:
Absolutely. And for you and everyone else listening in, invite folks on to the podcast that have their leading and they have messages and they're wanting to change things and make things better and we can help to amplify that message into give you a bullhorn. We are here at the ready. Omar, thank you for coming on.
Omar Matuk-Villazon:
No, thank you so much.
Christine Dobbyn:
This has been Owl Have You Know. Thanks for listening. You can find links and more information about our guests, hosts and announcements on our website, business.rice.edu. Please subscribe to this podcast wherever you find your favorite podcasts and leave us a comment while you're at it. Let us know what you think. Owl Have You Know is a production of Rice Business and is sponsored by the Rice Business Alumni board. The hosts of Owl Have You Know are myself, Christine Dobbyn and David Droogleever.