Why You're Losing Your Doctor
A growing number of Rhode Island doctors are changing how they practice medicine.
They are not leaving. They are changing how they serve.
Across the state, primary care physicians are transitioning to concierge medicine or direct primary care.
Both models charge patients a membership fee for better access, longer visits, and more personalized care.
For some patients, it’s a better experience. For others, it’s the moment they lose their doctor.
This Isn’t Just a Local Story
A recent study from Harvard Medical School found that concierge and direct primary care practices grew 83% nationwide between 2018 and 2023, with the number of clinicians in those models rising nearly as fast.
This is not a fringe trend.
It’s a structural shift in how primary care is being delivered in the United States.
What It Looks Like in Rhode Island
Here in Rhode Island, the impact is more immediate.
One local patient described receiving a letter after 20 years with her doctor. He was switching to a concierge model with a $2,600 annual fee.
Direct primary care options exist at lower price points. They are typically $80 to $135 per month, but they still require patients to pay out of pocket.
For many families, that simply isn’t realistic.
Fewer Patients, More Time and a Growing Gap
These models dramatically reduce how many patients a doctor sees.
Traditional primary care: 1,500–2,500 patients per doctor
Concierge/direct care: 300–500 patients per doctor
That means when one doctor makes the switch, over a thousand patients may need to find care elsewhere.
Now scale that across a state already facing a shortage.
Rhode Island is currently short roughly 300 primary care physicians, and nearly half of its current doctors are approaching retirement.
Why Doctors Are Making the Switch
This isn’t happening because doctors want to leave patients behind.
It’s happening because the system is pushing them there.
Doctors in traditional practices face:
High patient volumes just to stay financially viable
Heavy administrative burdens from insurance and prior authorizations
Shorter visit times and increasing burnout
Concierge and direct care offer:
Smaller patient panels
More time with each patient
Less administrative overhead
A more sustainable work-life balance
In other words, they offer a way to keep practicing medicine without burning out.
The Rhode Island Problem
This is where Rhode Island stands out.
Reimbursement rates here are lower than in neighboring states.
In fact, commercial insurance reimbursement rates are about 29% higher in nearby Massachusetts communities.
Medicare rates also trail the Boston area and Connecticut, and Medicaid reimbursements are higher just across state lines.
When you combine:
Lower reimbursement
A shrinking workforce
An aging physician population
You create the conditions where more doctors feel they have no choice but to leave the traditional system.
A System Under Pressure
Even experts agree this is bigger than individual decisions.
As one physician put it, this is the result of decades of policy decisions, not a single issue like reimbursement alone, and that’s the real concern.
When doctors reduce their patient panels from 2,000 people to 400…
The patients who can’t afford the membership fee are the ones left searching.
Where Do We Go From Here?
Concierge medicine isn’t going away, and for some patients, it provides real value.
Unfortunately, it cannot scale to serve an entire population.
That means the real question isn’t whether these models should exist.
It’s whether Rhode Island is doing enough to make traditional primary care sustainable.
Look at it this way.
If we don’t fix this, we won’t just lose doctors.
We’ll lose access.
Wrapping It Up
This isn’t about blaming doctors.
They’re adapting to the system they’re in.
The responsibility is on us to build a system that works for them and for every Rhode Islander who still needs care.
