Are We Building a Car Factory Because We Need a New Car?
Imagine a town where residents are struggling to afford the cars they already own.
Maintenance costs are rising. Fuel is expensive. Mechanics are leaving town.
Then the town announces it will build a brand new car factory.
That might be a great long-term investment, but it doesn’t solve the problem facing drivers today.
Rhode Island’s healthcare workforce challenge raises a similar question.
A Big Idea for the Future
Rhode Island has a real and growing shortage of primary care doctors.
A recent Senate study commission, co-chaired by URI President Marc Parlange and State Senator Pamela Lauria, recommended creating a medical school at the University of Rhode Island, with the first class of students targeted for 2029.
The commission’s work deserves credit for highlighting an important challenge facing our state.
The proposal is ambitious. The study suggests the school could eventually generate:
$200 million in annual economic activity
1,300 jobs
$4.5 million in state and local tax revenue
Those are meaningful numbers and part of a broader conversation about Rhode Island’s long-term future.
But the proposal also raises an important question.
How do we balance long-term investments with the immediate healthcare access challenges Rhode Islanders are facing today?
The Timeline Reality
Even if everything goes perfectly, a medical school starting in 2029 does not produce practicing doctors overnight.
Medical training typically works like this:
4 years of medical school
3–7 years of residency training
That means students entering the first URI class in 2029 may not be practicing independently until 2036–2040.
That doesn’t mean the idea is wrong.
Building a medical school could be a valuable long-term investment in Rhode Island’s healthcare workforce, but it does mean something important.
A medical school is primarily a long-term solution to a workforce challenge that is already affecting patients today.
I Say This as a URI Alum
Before going further, I want to be clear about something.
I went to the University of Rhode Island, and I’m proud of that.
URI is a tremendous institution and one of the reasons so many people choose to stay in Rhode Island.
I would love to see URI continue to grow in national reputation and recognition.
In fact, I would welcome the day when URI is known not just as one of the best public universities in New England, but as one of the best public universities in the country.
So this is not an argument against URI.
It’s simply a conversation about timing and priorities.
It’s about acknowledging that long-term investments in education and workforce development are important, but many Rhode Islanders are currently struggling with access to primary care and rising healthcare costs right now.
Those challenges deserve attention as well.
The Short-Term Bottleneck
The study commission itself noted that physician reimbursement plays a role in workforce decisions.
Reimbursement levels influence:
where doctors choose to practice
whether primary care practices remain financially viable
whether new physicians stay in Rhode Island after training
Even Senator Lauria noted that the Office of the Health Insurance Commissioner will review Medicaid reimbursement rates this year.
That review is an important part of the conversation.
Improving the economic environment for primary care practices can help address access challenges much sooner than the timeline required to train new physicians.
A Pattern Worth Thinking About
Rhode Island has no shortage of good ideas and thoughtful proposals.
Over the years we’ve seen a range of approaches designed to address workforce shortages including loan forgiveness programs intended to encourage certain professionals to stay in the state.
Those programs can help some individuals and may play a role in broader workforce strategies.
At the same time, they often address specific pieces of a larger challenge, rather than the underlying cost structure that affects everyone who lives and works in Rhode Island.
The proposed medical school raises a different version of that same question.
Instead of a short-term program, it represents a long-term investment.
Both approaches can be part of the solution, but in my opinion, it’s fair to ask whether we are also focusing enough attention on the economic fundamentals that shape workforce decisions today.
Thinking in the Right Order
A medical school at URI may ultimately become an important part of Rhode Island’s long-term healthcare strategy, but the order matters.
Strengthening the healthcare system physicians will enter, while also planning for future workforce needs, may be the most effective path forward.
Government has the ability to think big, and in many ways that is a good thing.
Long-term investments in education, research, and infrastructure often require exactly that kind of vision, but there is also a practical reality.
In government, timelines can stretch out over many years. Funding discussions can unfold over long legislative cycles.
In the private sector, things work a little differently.
As a small business owner, I can think big too, but I also have to move quickly, because if I don’t solve problems in real time, tomorrow may not come.
That mindset tends to focus your attention on what needs to be fixed right now, not just what might work ten or fifteen years from now.
Getting the Balance Right
Rhode Island doesn’t lack thoughtful leaders or creative ideas.
What we need is a continued focus on the root causes of our challenges, while making sure the people who have chosen Rhode Island as their home see real improvements in their daily lives.
If we get that balance right, we won’t just build new institutions, we’ll build a Rhode Island people don’t want to leave.
