Decades of inaction have wrought R.I.’s primary care crisis. We must address it right now, then nurse the state back to health. – The Boston Globe

Yet, as a state, we have not properly maintained the health of our primary care environment, nor have we responded to the signs of its disintegration.

Now we must respond to a full-blown crisis.

Just as a person who suffers a heart attack receives emergency care and then is often advised to adopt lifestyle changes to restore their health, our state must deal with this crisis with emergency measures, as well as with medium- and long-term efforts to sustain and strengthen primary care.

While our Department of Health and Executive Office of Health and Human Services work to try to keep Anchor’s providers in Rhode Island, we and our Senate colleagues are working to enact legislation addressing Rhode Island’s shortage of primary care providers in the near and long term.

One root cause is clear: Primary care is reimbursed by health insurance at much lower rates than specialties, making it difficult for debt-burdened young providers to choose primary care when entering practice. Rhode Island is further disadvantaged in recruiting and keeping those who do go into primary care because our immediate neighbors are paying clinicians significantly more.

Senator Sosnowski has advocated for improved and equitable insurance payments to hospitals and providers for years. We must address reimbursement rates as an immediate step to maintain our current providers and recruit more to practice primary care here. That effort must include a Medicaid rate review for primary care providers now, not in 2027 as is proposed in the governor’s budget. It’s going to take continuing, coordinated effort to ensure our rates don’t force doctors to leave for surrounding states with higher rates, or choose other specialties.

Another immediate need is addressing the extra stressors on our primary care providers. Senator DiMario has focused on better supporting the incredibly under-resourced mental health system that would help PCPs and patients alike. We must also demand that insurers reduce the needless administrative burdens they place on primary care providers, and increase patients’ access to specialists to decrease time demands on PCPs. The R.I. Senate has focused on resolving these issues, and we currently have many bills under consideration to accomplish those goals.

Rhode Island must also make a concerted effort to encourage medical students to specialize in primary care, and to choose Rhode Island when they graduate. Senator Lauria has introduced bills that focus on those goals. One would fund four primary care residency positions annually at a community-based health care organization that provides primary care and support services to underserved populations, increasing our workforce and supporting these critical agencies. In addition, reducing student loan debt, scholarships for students entering medical school and studying to become nurse practitioners or physician’s assistants in exchange for a commitment to specialize in primary care and work in Rhode Island are all current proposals under consideration.

As we work to improve our primary care workforce, we must also build in a mechanism for accountability to consistently meet the health care needs of our communities. We need specific targets, action plans, and ongoing monitoring to first ensure every Rhode Islander has access to a primary care provider, and then to take earlier corrective action in the future, so we do not face this crisis again.

We are all members of the Senate’s commission exploring the education and retention of primary care providers in Rhode Island, whose charge, in part, is to consider the possibility of establishing a medical school at University of Rhode Island. While this commission’s work is ongoing, the possibility of a public educational pipeline graduating doctors right here in Rhode Island holds promise for sustainably addressing our shortage of primary care providers.

Our current primary care crisis is the product of decades of inaction. We urge our colleagues across state government to work collaboratively right now, and in the future, to nurse it back to health.

Senators Pamela J. Lauria (D-Dist. 32, Barrington, Bristol, East Providence), V. Susan Sosnowski (D-Dist. 37, South Kingstown) and Alana M. DiMario (D-Dist. 26, Narragansett, North Kingstown, New Shoreham) are members of a Senate commission studying the education and retention of primary care physicians and the feasibility of establishing a medical school at URI.