Mache Stefanie, Bernburg Monika, Würtenberger Annika, Groneberg David A
Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany.
Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, 60590 Frankfurt, Germany.
Clin Pract. 2025 Jul 25;15(8):138. doi: 10.3390/clinpract15080138.
: Artificial intelligence (AI) is being increasingly promoted as a means to enhance diagnostic accuracy, to streamline workflows, and to improve overall care quality in primary care. However, empirical evidence on how primary care physicians (PCPs) perceive, engage with, and emotionally respond to AI technologies in everyday clinical settings remains limited. Concerns persist regarding AI's usability, transparency, and potential impact on professional identity, workload, and the physician-patient relationship. : This qualitative study investigated the lived experiences and perceptions of 28 PCPs practicing in diverse outpatient settings across Germany. Participants were purposively sampled to ensure variation in age, practice characteristics, and digital proficiency. Data were collected through in-depth, semi-structured interviews, which were audio-recorded, transcribed verbatim, and subjected to rigorous thematic analysis employing Mayring's qualitative content analysis framework. : Participants demonstrated a fundamentally ambivalent stance toward AI integration in primary care. Perceived advantages included enhanced diagnostic support, relief from administrative burdens, and facilitation of preventive care. Conversely, physicians reported concerns about workflow disruption due to excessive system prompts, lack of algorithmic transparency, increased cognitive and emotional strain, and perceived threats to clinical autonomy and accountability. The implications for the physician-patient relationship were seen as double-edged: while some believed AI could foster trust through transparent use, others feared depersonalization of care. Crucial prerequisites for successful implementation included transparent and explainable systems, structured training opportunities, clinician involvement in design processes, and seamless integration into clinical routines. : Primary care physicians' engagement with AI is marked by cautious optimism, shaped by both perceived utility and significant concerns. Effective and ethically sound implementation requires co-design approaches that embed clinical expertise, ensure algorithmic transparency, and align AI applications with the realities of primary care workflows. Moreover, foundational AI literacy should be incorporated into undergraduate health professional curricula to equip future clinicians with the competencies necessary for responsible and confident use. These strategies are essential to safeguard professional integrity, support clinician well-being, and maintain the humanistic core of primary care.
人工智能（AI）作为提高诊断准确性、简化工作流程以及改善初级保健整体护理质量的一种手段，正得到越来越多的推广。然而，关于初级保健医生（PCP）在日常临床环境中如何看待、使用以及对人工智能技术产生情感反应的实证证据仍然有限。人们对人工智能的可用性、透明度以及对职业身份、工作量和医患关系的潜在影响仍然存在担忧。
本定性研究调查了德国不同门诊环境中28名初级保健医生的实际经历和看法。参与者是经过有目的抽样选取的，以确保年龄、执业特点和数字技能方面的差异。数据通过深入的半结构化访谈收集，访谈进行了录音，逐字转录，并采用梅林的定性内容分析框架进行了严格的主题分析。
参与者对初级保健中整合人工智能表现出基本矛盾的态度。感知到的优势包括增强诊断支持、减轻行政负担以及促进预防保健。相反，医生们报告了对因系统提示过多导致工作流程中断、算法缺乏透明度、认知和情感压力增加以及对临床自主权和问责制的感知威胁的担忧。对医患关系的影响被视为双刃剑：一些人认为人工智能可以通过透明使用促进信任，而另一些人则担心护理的非个性化。成功实施的关键前提包括透明且可解释的系统、结构化的培训机会、临床医生参与设计过程以及无缝融入临床常规。
初级保健医生对人工智能的参与以谨慎的乐观为特征，这受到感知到的效用和重大担忧的影响。有效且符合道德规范的实施需要共同设计方法，将临床专业知识融入其中，确保算法透明度，并使人工智能应用与初级保健工作流程的实际情况保持一致。此外，基础人工智能素养应纳入本科健康专业课程，以使未来的临床医生具备负责任且自信使用所需的能力。这些策略对于维护职业操守、支持临床医生的福祉以及保持初级保健的人文核心至关重要。
