The Effect of Recent Changes in Federal Preventive Guidance on Patients and Primary Care Practice

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 practices and patients.

A national crowd-sourced survey of primary care clinicians was conducted from December 4 to 11, 2025.

Among 568 respondents from 47 states, who were oversampled for family medicine and had demographic characteristics similar to national primary care characteristics in terms of rurality, size, ownership, and percentage in direct primary care, clinicians reported that patients were increasingly hesitant about vaccines and preventive services. For example, 64% reported that patients were confused as to what vaccination guidelines they should follow, 46% reported that parents were expressing new hesitancy about childhood vaccinations, and 36% reported that patients were declining preventive services that they had previously accepted. Most responding clinicians (58%) reported spending more visit time explaining the evidence behind clinical recommendations, and 61% reported that patients were more frequently seeking information from nonmedical sources. Findings differed by location, with 58% of rural clinicians versus 42% of nonrural 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.