Decoding the drivers and deterrents of physician-led innovation: a systematic qualitative review

Objective To encourage clinical innovation in healthcare, policy makers and healthcare leaders need evidence-based insights into the factors that drive and deter physicians’ use of novel technologies and introduction of new practices. While qualitative studies have explored these factors, there has been no comprehensive review to guide policymaking in this area. The authors aimed to synthesise this research and identify gaps to inform policy development. Design A qualitative synthesis using a modified version of the method by Thomas and Harden was conducted in February 2025. Data sources Medline, Scopus, Embase and Web of Science. Eligibility criteria for selecting studies Qualitative studies published between 1960 and 2025 exploring physicians’ views towards factors influencing their decision to innovate. Results 1025 title and abstracts were screened, with 34 articles included in the final review. Studies described the barriers to, and facilitators of clinical innovation across seven domains: individual characteristics, peer influence, institutional support, organisational and health system culture, industry collaboration, legal hurdles and the usability of innovative interventions. Study participants also articulated the skills required for ‘responsible’ innovation—including proactive management of conflicts of interest and prioritisation of patient interests despite patient demand and commercial pressures. Conclusions This review identifies the common drivers and deterrents of clinical innovation that are experienced by physicians across diverse specialties—providing theory-independent insights to inform the development of pragmatic strategies. Based on these insights, we outline directions for further research and offer practical recommendations to help healthcare leaders and policy makers encourage responsible physician-led innovation.