Abstract
BACKGROUND: Artificial intelligence (AI) shows strong potential to transform primary care by streamlining workflows, improving diagnostics, and enhancing patient outcomes. However, integration faces barriers, including PCPs' concerns about workflow disruptions, reliability, and loss of human connection. This study explored PCPs' perspectives and challenges around AI integration in primary care to inform the development of practical, human-centered tools. METHOD: This qualitative study included four focus groups (n = 40), comprising PCPs, residents, and AI developers, in December 2024. Sessions were recorded, transcribed, and analyzed using thematic analysis. Three main themes emerged: (1) From Frustration to Innovation: PCPs' experiences with current technological gaps and their vision for improved support; (2) The Integration Paradox: tensions in embedding AI while safeguarding care quality; and (3) Beyond Basic Automation: future solutions that preserve clinical judgment. RESULT: Key findings emphasized the need for incremental AI adoption, starting with administrative tasks and progressing to clinical decision support, with systems acting as "silent partners" to enhance rather than replace human judgment. PCPs see AI as a promising way to reduce administrative burden and improve care quality but stress the need for human-centered design that protects the doctor-patient relationship. CONCLUSION: Successful integration requires addressing workflow compatibility, ethical concerns, and preserving clinical autonomy through collaborative development.