Defining the elusive 'medical practice'.

Rhode Island’s small size creates unique opportunities for public health. We can easily imagine how the Rhode Island Department of Health (HEALTH) might partner with primary care and specialty physicians to bring effective prevention and treatment to the entire population. We can also imagine how we might use primary care medical assets in non-traditional ways during emergencies when mobility is restricted to care for our population in place. At present, however, we do not have the means formally to address Rhode Island’s physicians above the individual provider level because the medical practices with which they are associated have been heretofore ill-defined. To be sure, we know a medical practice when we see one, but because “medical practices” are not defined by Rhode Island state law, and therefore have no formal relationship with state government, we do not know how many medical practices exist, where they are located, or who works in them. Also, because medical practices come in many shapes and sizes and have many kinds of legal structures, we do not really know how best to use the natural organization of the medical assets they contain. Finally – and vitally important to protecting the public’s health – we do not know what people (patients) these heterogeneous medical practices serve. By partnering with practices, Rhode Island can make use of these collaborations to reduce the incidence and prevalence of disease, but first we need a good definition of a “medical practice.”