Doctor pitches $9/month opt-out telemedicine plan to Mesquite council

Dr. Dirk Parrott, a practicing emergency physician and founder of MD Health Pathways, told the Mesquite City Council on Aug. 18 that his company can give residents immediate access to a doctor by texting or calling — for a proposed $9 monthly opt-out fee billed on the water utility. Parrott said the fee would cover up to 10 household members and could be sustained citywide using an opt‑out model similar to a long‑standing air‑ambulance program.

The proposal was presented as a pilot-style service already operating in nearly 20 municipalities across South Carolina and Texas and in partnership with local organizations. "You literally text in and within 60 seconds" a clinician will respond, Parrott said, adding that 95% of interactions begin and end by text and about 5% escalate to an audio or video call. He said the service would not bill a resident's insurance and would include a 90-day refund for residents who say they did not know the fee was on their bill.

Council members asked detailed implementation questions. Councilmember Elizabeth Rodriguez Ross asked whether insured residents would be impacted; Parrott said the service is provided outside insurance and will not affect eligibility. Mayor Pro Tem raised concerns about perception — "for your average resident it is gonna feel like a $9 tax increase" — and whether the city could be seen as increasing utility bills. Councilmember BW Smith pressed whether the utility-billing staff could handle opt-out calls; Parrott said MD Health Pathways funds two utility‑department workers initially and trains city staff to manage the process.

Council members also asked about capacity and equity. Councilmember Kenny Green asked whether the company could scale to Mesquite's population; Parrott said providers are local and that their operation is scalable. For renters who cannot individually control master-metered apartment bills, Parrott said MD Health Pathways would cover those households for the first year to demonstrate value, then work with property owners on billing.

Parrott cited utilization figures from other customers — roughly 30% of families use the service in year one, with utilization rising to about 85% by year three, and an average opt‑out rate of about 11%. He also said the service can reduce school absenteeism, claiming a 2.5-day earlier return to school in communities using the product and estimating potential district savings. The council asked for references and additional data; Parrott encouraged council to contact current client cities and offered example outreach materials.

No formal council action was taken on the proposal during the Aug. 18 meeting; council members asked staff to perform due diligence, including legal review of billing mechanics and to watch the Garland rollout before advancing a contract.