Awareness and Perspectives on the Role of Artificial Intelligence in Primary Care: A Cross-Sectional Survey of Rural and Urban Primary Care Physicians in Alberta, Canada
DOI:
https://doi.org/10.5195/ijms.2025.2906Keywords:
Artificial Intelligence, Primary Care, Medicine, Machine Learning, Surveys and QuestionnairesAbstract
Background: Artificial intelligence (AI) is increasingly integrated into healthcare, yet physicians’ awareness and perspectives remain underexplored. While often associated with imaging, AI applications also include online scheduling, digitized records, virtual consultations, and drug dosage algorithms. This study surveyed Canadian primary care physicians (PCPs) to assess their awareness and attitudes toward AI in healthcare.
Methods: A cross-sectional survey was distributed via email and newsletters to family physicians across Alberta, including both urban and rural settings. Responses were collected through Qualtrics.
Results: Of 79 responses, 46 met inclusion criteria. Most respondents practiced in urban areas (63%) and had no prior AI training (65%). Rural physicians reported greater comfort and interest in AI, including its use for monitoring treatment adherence (p=0.043) and analyzing EMR data for health management (p=0.027). Knowledge of AI varied widely: only 30% recognized that deep learning involves artificial neural networks, while 44% reported no knowledge of the concept. Commonly used AI tools included ECG interpreters (65%) and language translators (37%). Physicians showed interest in expanded medical uses of AI.
Conclusion: There is a lack of knowledge and use of AI tools in medicine, with both urban and rural physicians’ responses suggesting a need for more education and training in AI. The “Lack of human connection” was the main fear that was expressed regarding the use of AI in healthcare suggesting concerns about potential impacts on patient-provider relationships. This survey's findings may inform future research into the development and implementation of AI in primary care.
Metrics
References
Johnson KW, Torres SJ, Glicksberg BS, Shameer K, Miotto R, Ali M, et al. Artificial Intelligence in Cardiology. J Am Coll Cardiol. 2018 Jun 12;71(23):2668–79.
Tang A, Tam R, Cadrin-Chênevert A, Guest W, Chong J, Barfett J, et al. Canadian Association of Radiologists White Paper on Artificial Intelligence in Radiology. Can Assoc Radiol J. 2018 May 1;69(2):120–35.
Avati A, Jung K, Harman S, Downing L, Ng A, Shah NH. Improving palliative care with deep learning. BMC Med Inform Decis Mak. 2018 Dec 12;18(Suppl 4):122.
Schwab K, Nguyen D, Ungab G, Feld G, Maisel AS, Than M, et al. Artificial intelligence MacHIne learning for the detection and treatment of atrial fibrillation guidelines in the emergency department setting (AIM HIGHER): Assessing a machine learning clinical decision support tool to detect and treat non-valvular atrial fibrillation in the emergency department. J Am Coll Emerg Physicians Open. 2021 Aug;2(4):e12534.
Kassam A, Kassam N. Artificial intelligence in healthcare: A Canadian context. Healthc Manage Forum. 2020 Jan 1;33(1):5–9.
Waymel Q, Badr S, Demondion X, Cotten A, Jacques T. Impact of the rise of artificial intelligence in radiology: What do radiologists think? Diagn Interv Imaging. 2019 Jun 1;100(6):327–36.
Kueper JK, Terry AL, Zwarenstein M, Lizotte DJ. Artificial Intelligence and Primary Care Research: A Scoping Review. Ann Fam Med. 2020 May;18(3):250–8.
Lin S. A Clinician’s Guide to Artificial Intelligence (AI): Why and How Primary Care Should Lead the Health Care AI Revolution. J Am Board Fam Med. 2022 Jan 1;35(1):175–84.
Amisha null, Malik P, Pathania M, Rathaur VK. Overview of artificial intelligence in medicine. J Fam Med Prim Care. 2019 Jul;8(7):2328–31.
Fenton JJ, Taplin SH, Carney PA, Abraham L, Sickles EA, D’Orsi C, et al. Influence of computer-aided detection on performance of screening mammography. N Engl J Med. 2007 Apr 5;356(14):1399–409.
London S. DXplain: a Web-based diagnostic decision support system for medical students. Med Ref Serv Q. 1998;17(2):17–28.
Kahn MG, Steib SA, Fraser VJ, Dunagan WC. An expert system for culture-based infection control surveillance. Proc Symp Comput Appl Med Care. 1993;171–5.
Stewart M, Ryan B. Ecology of health care in Canada. Can Fam Physician. 2015 May;61(5):449–53.
Liyanage H, Liaw ST, Jonnagaddala J, Schreiber R, Kuziemsky C, Terry AL, et al. Artificial Intelligence in Primary Health Care: Perceptions, Issues, and Challenges. Yearb Med Inform. 2019 Aug;28(1):41–6.
Hogg HDJ, Al-Zubaidy M, Technology Enhanced Macular Services Study Reference Group, Talks J, Denniston AK, Kelly CJ, et al. Stakeholder Perspectives of Clinical Artificial Intelligence Implementation: Systematic Review of Qualitative Evidence. J Med Internet Res. 2023 Jan 10;25:e39742.
Santomartino SM, Yi PH. Systematic Review of Radiologist and Medical Student Attitudes on the Role and Impact of AI in Radiology. Acad Radiol. 2022 Jan 29;S1076-6332(21)00624-3.
Artificial intelligence (AI) and emerging digital technologies :: The Royal College of Physicians and Surgeons of Canada [Internet]. [cited 2023 Mar 11]. Available from: https://www.royalcollege.ca/rcsite/health-policy/initiatives/ai-task-force-e
Teng M, Singla R, Yau O, Lamoureux D, Gupta A, Hu Z, et al. Health Care Students’ Perspectives on Artificial Intelligence: Countrywide Survey in Canada. JMIR Med Educ. 2022 Jan 31;8(1):e33390.
Number of Physicians by Specialty Within Alberta Health Services Geographic Zones - Open Government [Internet]. [cited 2023 Jul 10]. Available from: https://open.alberta.ca/opendata/number-of-physicians-by-specialty-within-alberta-health-services-geographic-zones
Kirby JB, Yabroff KR. Rural–Urban Differences in Access to Primary Care: Beyond the Usual Source of Care Provider. Am J Prev Med. 2020 Jan 1;58(1):89–96.
Butzner M, Cuffee Y. Telehealth Interventions and Outcomes Across Rural Communities in the United States: Narrative Review. J Med Internet Res. 2021 Aug 26;23(8):e29575.
Buyting R, Melville S, Chatur H, White CW, Légaré JF, Lutchmedial S, et al. Virtual Care With Digital Technologies for Rural Canadians Living With Cardiovascular Disease. CJC Open. 2022 Feb 1;4(2):133–47.
Wong TY, Sabanayagam C. Strategies to Tackle the Global Burden of Diabetic Retinopathy: From Epidemiology to Artificial Intelligence. Ophthalmologica. 2019 Aug 13;243(1):9–20.
He J, Baxter SL, Xu J, Xu J, Zhou X, Zhang K. The practical implementation of artificial intelligence technologies in medicine. Nat Med. 2019 Jan;25(1):30–6.

Published
How to Cite
License
Copyright (c) 2025 Jose Uriel Perez

This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- The Author retains copyright in the Work, where the term “Work” shall include all digital objects that may result in subsequent electronic publication or distribution.
- Upon acceptance of the Work, the author shall grant to the Publisher the right of first publication of the Work.
- The Author shall grant to the Publisher and its agents the nonexclusive perpetual right and license to publish, archive, and make accessible the Work in whole or in part in all forms of media now or hereafter known under a Creative Commons Attribution 4.0 International License or its equivalent, which, for the avoidance of doubt, allows others to copy, distribute, and transmit the Work under the following conditions:
- Attribution—other users must attribute the Work in the manner specified by the author as indicated on the journal Web site; with the understanding that the above condition can be waived with permission from the Author and that where the Work or any of its elements is in the public domain under applicable law, that status is in no way affected by the license.
- The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post online a prepublication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. Any such posting made before acceptance and publication of the Work shall be updated upon publication to include a reference to the Publisher-assigned DOI (Digital Object Identifier) and a link to the online abstract for the final published Work in the Journal.
- Upon Publisher’s request, the Author agrees to furnish promptly to Publisher, at the Author’s own expense, written evidence of the permissions, licenses, and consents for use of third-party material included within the Work, except as determined by Publisher to be covered by the principles of Fair Use.
- The Author represents and warrants that:
- the Work is the Author’s original work;
- the Author has not transferred, and will not transfer, exclusive rights in the Work to any third party;
- the Work is not pending review or under consideration by another publisher;
- the Work has not previously been published;
- the Work contains no misrepresentation or infringement of the Work or property of other authors or third parties; and
- the Work contains no libel, invasion of privacy, or other unlawful matter.
- The Author agrees to indemnify and hold Publisher harmless from the Author’s breach of the representations and warranties contained in Paragraph 6 above, as well as any claim or proceeding relating to Publisher’s use and publication of any content contained in the Work, including third-party content.
Enforcement of copyright
The IJMS takes the protection of copyright very seriously.
If the IJMS discovers that you have used its copyright materials in contravention of the license above, the IJMS may bring legal proceedings against you seeking reparation and an injunction to stop you using those materials. You could also be ordered to pay legal costs.
If you become aware of any use of the IJMS' copyright materials that contravenes or may contravene the license above, please report this by email to contact@ijms.org
Infringing material
If you become aware of any material on the website that you believe infringes your or any other person's copyright, please report this by email to contact@ijms.org