When primary care nurse practitioner and state Sen. Pamela Lauria, D-Bristol, sees patients with urgent symptoms, she finds that a potential medical emergency isn’t always the patient’s greatest concern.
In hospitals throughout the state, emergency rooms are often synonymous with long waits, over-burdened staff, patients spilling into hallways, and eventually, medical bills reflecting insurance that covers less and charges more for essential care.
“I have patients in my office with chest pains, and [I struggle] to convince them to go to [an emergency department] when they are aware what that experience is going to be,” Lauria said.
By the time symptoms have become too severe to ignore, patients face worse health outcomes and even higher out-of-pocket expenses. “It has an effect economically on our state, but also on the health of our citizens because they are avoiding that critical need,” Lauria said.
Lauria spoke on one of the panels at Providence Business News’ spring 2026 Health Care Summit, which took place April 2 at the Providence Marriott Downtown.
On the panel with Lauria were Dr. Ana Tuya Fulton, chief population health officer at Care New England Health System, and Dr. Raj Hazarika, vice president and chief medical officer of commercial products at Harvard Pilgrim Health Care of New England Inc.
Strained emergency rooms exist in the same web of challenges plaguing the state’s health care system: primary care provider shortages, low reimbursement rates, and increased labor, drug and supply expenses, to name a few.
In this dire health care landscape, panelists see some reason for optimism, or at least relief: Georgia-based nonprofit The Centurion Foundation’s recent purchase of Roger Williams Medical Center and Our Lady of Fatima Hospital, for instance, has spared two safety net facilities from immediate closure – previously a real threat after the previous owner, Prospect Medical Holdings, declared bankruptcy in January.
Some observers also hope that a proposed medical school at the University of Rhode Island can help to ease the state’s primary care shortage.
People who go to college or university in their home state are much more likely to stay after graduation, Lauria said, evidenced in a phenomenon known as the “sticky effect.” Currently, the only in-state option for aspiring physicians is Brown University’s Warren Alpert Medical School.
Fulton agreed that a second medical school would help mitigate shortages but added that this resource – if it comes to fruition – remains years down the road. Patients and providers can’t wait that long, she said, noting that hospitals throughout the U.S. are currently spending more than 50% of their financial resources on recruiting and retaining trained staff.
“We have a lot of good medium to long-term solutions that are being discussed in the state, and I’m so thankful for that,” Fulton said. “Like the medical school, the scholarships. All those things are going to help us. But those are medium to long term. We need some short-term solutions.”
Amid an already limited supply of primary care practitioners, burnout is also driving more providers to concierge practices, Lauria said. These practices, which require patients to pay a membership fee, come with lighter patient loads that help overburdened providers, but are less accessible to lower-income patients.
“Burnout is real, and I think it’s a big part of why you’re seeing clinicians turn to concierge,” Lauria said. But “what does that do to our equity?”
Medicaid reimbursement poses another major challenge, Fulton said, with behavioral health and older adult patients most acutely feeling gaps in care and access. Meanwhile, chronic behavioral issues commonly lead to other chronic medical conditions, Fulton noted.
Officials and health care leaders need to find solutions that can benefit both patients and providers, panelists said.
In the short term, the state can start leveraging technology to relieve primary care physicians of nonclinical burdens such as paperwork, Fulton said. Team-based approaches involving multiple health care professionals, from doctors and nurses to pharmacists, can also help providers with heavy patient loads, she said.
But panelists’ views on how significantly artificial intelligence can replace direct interactions between providers and patients were somewhat divided.
Hazarika said that some relationship-based interactions between patients and providers will always be essential. But for routine communication or confirming a normal test result, Hazarika says the health system can benefit from more automation.
“We need to learn to do more with less human interaction whenever possible,” Hazarika said.
Health care leaders will have more opportunities to take this route as AI becomes more advanced, he added.
“We use AI as one word, but it’s actually a bunch of different solutions,” with implications on burnout, revenue and clinical care, Hazarika said. “It’s going to have a very meaningful impact on the industry as a whole.”
But Lauria said that the system needs more, rather than fewer, conversations between providers and patients.
“There’s nothing like being able to walk a patient over to the next person, have a conversation about what this patient needs, and then the reverse happening as well,” Lauria said. “We’re relying too much on electronic health records.”
