other cultures and seeing the human side of his work, he realized he“ really did want to be there for people when they needed it,” he says.
Walden chose to become a general internist because he wanted to develop longstanding patient relationships.“ I like to see the big picture for people,” he says, adding that he enjoys working with diverse patient populations.
He will begin practice this fall at Medical Associates of Rhode Island in Bristol and East Providence. Being at a small independent practice means that he is working with people across a range of disciplines, and has flexibility in his schedule. He’ ll be able to learn the financial aspects of being a doctor too.“ I really want to know the business side of medicine,” he says.“ I want to be able to develop my practice and my group.”
Walden was part of Brown’ s medical resident unionization effort and the bargaining team working for their first contract.“ It’ s in everyone’ s best interest to attract good doctors and good students to come to Brown residencies,” he says. They sought pay increases to keep up with the cost of living and benefits like 401K matching.
He also sees why other residents leave Rhode Island after they graduate. Money isn’ t everything, but it is a big something. Most people from his residency program now practice in Boston, he says.
“ There’ s just no reason for people to stay in the state unless they have another tie, like family like I do or they grew up here,” Walden says.“ There needs to be some real action from our political leaders to incentivize primary care so we can all improve access to primary care going forward.”
HELPING TO CLOSE THE GAP Rhode Island has an estimated 700 primary care physicians for the state population of 1.1 million people, according to a study by researchers at Brown. That’ s about one provider for every 1,700 people. The study also found that if every physician saw 1,200 people a year, about 343,000 people would still be without a provider, and that Rhode Island needs 300 additional physicians to close the gap.
Fixing the pay disparity between Rhode Island primary care physicians and those in Massachusetts and Connecticut would be a major step in keeping residents practicing in the state, says McGarry, adding that hospital leaders are campaigning to increase Medicaid reimbursement rates to help level the playing field.
In 2025, the state Office of the Health Insurance
Commissioner released a rule requiring commercial insurance companies to increase funding for primary care services to 10 percent by 2028. It would increase primary care funding by $ 40 million over four years, but OHIC has found that it hasn’ t happened yet.
Also last year, Rhode Island Gov. Dan McKee and the Executive Office of Health and Human Services awarded $ 6.7 million in grants to primary care physicians in the state. The Rhode Island General Assembly passed legislation to ease some administrative burdens primary care physicians face, and also directed EOHHS to increase reimbursement rates to 100 percent of the Medicare fee schedule for fiscal year 2026. OHIC was required to conduct a rate review for primary care services by Sept. 1 as well.
According to OHIC’ s 2026 report, these changes are“ designed to rebalance the health care system by redirecting necessary resources to an area in critical need of support.”
McGarry sees another path forward by recruiting from a talent base that’ s already local: Rhode Island students who are interested in science and medicine. Rather than convincing residents who are from somewhere else that they should stay, this would encourage future doctors to stick with their roots when they’ re ready to practice.
Those efforts include Brown’ s Pathways to Medicine program, where high school students are paired with medical students, residents, and attending physicians who serve as mentors. Through the program, high school students can review medical case studies, participate in health care simulations and interactive workshops, and see things like the anatomy lab. The program introduces them to what medical school is like by putting them in that environment, with guidance on what their next academic steps should be if they want to go into health care fields.
The Medical School operates nine such“ pathways” programs for middle school students all the way through undergraduates. Recognizing that the path to medical school is often not obvious and also requires rigorous preparation, the programs offer mentoring, skill building, and assistance in preparing a medical school application.
McGarry says she’ s met with high school students in the program, and seen how just exposing them to this world can open their eyes to possibilities.
“ If they start to see early on that this is a cool career and interesting job, and they actually see what a generalist or internist gets to do, they might consider it as a future career,” she says. HD @ B
FALL 2026 l HEALTH DISCOVERIES @ BROWN 19