Tuesday, September 29 · An Evening with Lou Riley · Alpine Country Club, Cranston

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Plank Four of four. In a district where the nearest hospital is a drive and a primary care appointment can be a months-long wait, physician supply is a practical problem for families here, not a policy abstraction for a committee room.

What’s actually driving doctors out

Ask a physician in Rhode Island why colleagues leave and you generally hear three things, in some order: what they get reimbursed, what it costs to practice here, and how long it takes to get licensed and credentialed. All three are things the General Assembly can touch.

  • Reimbursement. Rates paid to Rhode Island physicians have lagged those in neighboring states. A doctor practicing twenty minutes over a state line can be paid meaningfully more for the same work. That is a solvable policy problem, and it is the single most-cited reason for attrition.
  • Cost of practice. Malpractice premiums, administrative burden, staffing costs, and the sheer weight of paperwork make an independent practice hard to sustain. Practices consolidate or close, and access narrows.
  • Licensing and credentialing. The time it takes a qualified physician to get licensed and credentialed in Rhode Island is time that physician is not seeing patients. Streamlining that process, and taking seriously proposals for interstate licensure compacts, is low-hanging fruit.
Why there are no statistics on this page. There are widely circulated figures on Rhode Island physician attrition and primary care wait times. Lou won’t print one on a palm card or a website until it’s confirmed against the issuing source — the Department of Health, the Board of Medical Licensure and Discipline, or the medical society — rather than a press account of it. A number that gets fact-checked and comes back wrong costs more than it earns.

Why this lands hard in District 41

Scituate and western Cranston are not walking distance from a hospital. When a primary care practice in the area closes or stops taking new patients, the fallback isn’t another office down the street — it’s a longer drive, a longer wait, or an emergency room visit that shouldn’t have been necessary. That falls hardest on older residents and on families with young children, which describes a great deal of this district.

What Lou will actually do

  • Support reimbursement reform that closes the gap with Massachusetts and Connecticut, so practicing here isn’t a financial penalty.
  • Back licensing and credentialing reform, including interstate compact participation, to shorten the runway for physicians who want to practice in Rhode Island.
  • Look hard at the cost side — malpractice environment, administrative mandates, and reporting burdens that consume clinical time.
  • Treat primary care access in rural and semi-rural parts of the state as its own problem, not a rounding error in a statewide average.

Lost a doctor? Waiting months for an appointment? Lou wants the details.

Constituent stories are what make this argument land at the State House.