The effect of recent changes in federal preventive guidance on patients and primary care practice.

Abstract

Recent federal policy discussions and guidance have altered perceptions of preventive care. This study assesses the effect of recent changes in federal preventive guidance on primary care practice and patients. A national crowd-sourced survey of primary care clinicians, conducted December 4 to 11, 2025. Among 568 respondents from 47 states, over sampled for family medicine and with demographic characteristics similar to national primary care characteristics in terms of rurality, size, ownership, and percent in direct primary care, clinicians report that patients are increasingly hesitant about vaccines and preventive services. For example: 64% report patients are confused as to what vaccination guidelines they should follow; 46% report parents are expressing new hesitancy about childhood vaccinations; 36% report patients are declining preventive services they previously accepted. Most responding clinicians (58%) report spending more visit time explaining the evidence behind clinical recommendations, and 61% report patients more frequently are seeking information from non-medical sources. Findings differ by location, with 58% of rural clinicians, vs. 42% of non-rural clinicians reporting new hesitancy about childhood vaccinations. Recent changes in Federal guidance are making it more difficult to provide evidence-based preventive services on the frontlines of primary care, with worrisome potential for increases in preventable diseases, particularly in rural areas.