RI is in need of primary care providers. Commission begins task to see if URI is the answer

PROVIDENCE – On paper, Rhode Island’s primary care landscape looks healthy. The Ocean State ranks in the top five states for health care overall and fourth for primary care supply.

These numbers, however, can be misleading, argues Michael Fine.

A former director of Rhode Island’s Department of Health and a doctor – plus a fiction and nonfiction author in his spare time – Fine presented data on the state of primary care in Rhode Island at the first meeting of a commission studying the possibility of a medical school at the University of Rhode Island.

A closer look at the numbers paints a different picture. About 348 primary care physicians in Rhode Island are over 60 years old, Fine estimated. If 10% to 20% retire, the state will lose between 55 to 110 providers every year. Yet only about 11 Rhode Islanders a year become primary care physicians.

Rhode Island is running on a deficit of providers that is leaving tens of thousands of residents without access to primary care.

“We got the best deck chair on the Titanic,” Fine told the commission members.

In search of a solution, the Rhode Island Senate created in June a commission to conduct a feasibility study on opening a medical school at the University of Rhode Island. Currently, aspiring doctors only have one option in Rhode Island for pursuing medical school, at Brown University’s Warren Alpert School of Medicine, which has an acceptance rate of less than 3%, according to U.S. News & World Report , and costs over $71,000 a year in tuition fees.

Sen. Pamela J. Lauria, a Democrat representing Barrington, Bristol and East Providence, co-chairs the commission with URI President Marc B. Parlange. Commission members include several state senators and representatives, officials from the Department of Health and URI and former health insurance commissioners, among others.

Why the need for primary care

Fine’s presentation at the commission’s inaugural meeting, held at the State House on Aug. 28, underscored the necessity of adding to Rhode Island’s primary care workforce but also the complexity of the task at hand.

Primary care providers – who are usually family doctors, pediatricians or hospitalists – help curb health care costs by reducing emergency room visits and readmissions, coordinating care and providing evidence-based preventative care.

“Primary care works because of the relationships primary care physicians and other clinicians have with the people who are their patients,” Fine said.

But primary care faces strong headwinds. Besides the attrition due to an aging population, the specialty seems to attract fewer doctors because it pays less than other specialties. Up to 60% of earnings go to cover overhead expenses, especially billing services, according to Fine’s presentation, and because insurance prices are fixed, their potential earnings are limited, too.

Physician’s panel size – the number of individual patients they care for – is also shrinking. This is due to administrative burdens that take physicians away from patients’ rooms.

A need for more diversity

And there is a lack of ethnic representation in the field. Only 4% of family practitioners are Hispanic, compared to about 16% of Rhode Island’s population.

“We are just not training people from the Latino population in any meaningful way or at least not retaining them in those positions,” Fine said.

The commission hopes a medical school at URI could be a pipeline not only for training primary care physicians but also for providing opportunities for students from historically disadvantaged backgrounds.

“When I talk to kids from Central Falls who are thinking about medical school, they are scared to death of what it’s going to cost, because their first-generation families can’t imagine graduating from anything with half a million dollars worth of debt,” said Fine, who serves as chief health strategist for the city. “That is our opportunity to change that. So those kids from our communities can see a pathway for themselves both to medical school and to primary care practice in the communities from which they come with which they so desperately love.”

Over the next year, the commission will conduct a feasibility study that will look at the viability of a medical school and its economic impact, among other factors. It has a deadline of Dec. 20, 2025, to submit recommendations to the Senate.

This article originally appeared on The Providence Journal: RI is in need of primary care providers. Commission begins task to see if URI is the answer