Exploring the Role of Large Language Models in Primary Care: Qualitative Study of Physicians in the United States and the Netherlands.

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. 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: This study aimed to explore Dutch and US PCPs' 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 semistructured interviews with 15 PCPs from the United States and the Netherlands. Data were collected between February and June 2025 and analyzed using reflexive inductive thematic analysis. RESULTS: Ten themes emerged related to the use of LLMs in primary care clinical practice, each theme consisting of a set of subthemes. We found that 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 related to safety, efficiency, authenticity, and the preservation of the therapeutic relationship, highlighting the need for careful and context-sensitive use. CONCLUSIONS: Our findings suggest that LLMs are already being integrated into primary care in diverse ways, with their value shaped by both contextual factors and clinician judgment. Understanding how clinicians navigate LLM use in everyday practice is essential to ensuring that LLMs support high-quality, patient-centered primary care and inform organizational policy and LLM design.