JMIR Publications

ABSTRACT

Background:

Primary care is becoming increasingly complex, with primary care physicians (PCPs) facing rising workloads driven by workforce shortages, growing administrative demands, and expanding clinical responsibilities. These pressures have been associated with increased stress and risk of burnout among PCPs, potentially threatening the sustainability and quality of primary care delivery. Recent advances in large language models (LLMs) offer new opportunities to support PCPs across clinical, administrative, and communication-related tasks within their workflows. Understanding how these technologies are perceived and used in primary care practice is therefore critical to inform their safe, effective, and human-centered implementation.

Objective:

The objective of this study is to explore primary care physicians’ perceptions and experiences regarding the use of LLMs in clinical practice, with particular attention to clinical usability, communication and teamwork, and implications for everyday workflows.

Methods:

We conducted a qualitative study using semi-structured interviews with 15 primary care physicians from the United States and the Netherlands. Data were collected between February and June 2025 and analyzed using inductive thematic analysis. Thematic analysis was performed iteratively, with themes developed through affinity diagramming, team-based coding, regular reflexive discussions with an experienced advisor, and a practicing primary care physician.

Results:

From our thematic analysis, we identified three overarching categories: (1) Clinical work support, (2) Teamwork and communication, and (3) Risks and concerns. In total, these categories encompass ten emerging themes related to the use of LLMs in primary care clinical practice. Each theme consists of a set of subthemes.

Conclusions:

LLMs are being integrated into primary care as both clinical and communication support tools, assisting with diagnostic reasoning, administrative tasks, workload management, and interprofessional and patient communication. While PCPs reported perceived benefits, they also expressed concerns about safety, efficiency, authenticity, and the preservation of the therapeutic relationship, highlighting the need for careful, context-sensitive use. Understanding how clinicians navigate these trade-offs in everyday practice is essential to ensure that LLMs support high-quality, patient-centered primary care and inform organizational policy and LLM design.