Physician perspectives on Point-of-care ultrasound (POCUS) in primary care: a cross-sectional study in Israel

Point-of-care ultrasound (POCUS) offers significant potential to enhance diagnostic certainty and therapeutic decision-making in primary care settings. Despite widespread conceptual endorsement and the introduction of training programs, real-world adoption remains limited. This study aimed to evaluate attitudes, clinical practice patterns, and barriers to integration among Primary Care Physicians (PCPs) who received formal POCUS training within a large Israeli healthcare organization. A cross-sectional study was conducted among PCPs in one Healthcare Maintenance Organization in Israel who had previously completed POCUS training. Data were collected via an electronic questionnaire assessing specific modules used, device types, satisfaction levels, and perceived barriers. Respondents were categorized as active, former, or never users, and statistical analyses were performed to identify correlations among device type, usage, and satisfaction. Of 341 eligible PCPs, 126 completed the survey (37% response rate). The majority (88%) were active users. The most frequently utilized applications were lung (93%), abdominal (79%), and musculoskeletal (55%) assessments, with a specific focus on lung parenchyma and urinary pathologies. Active users reported high levels of diagnostic confidence (84%) and believed POCUS improved treatment (77%). The primary barriers cited were a lack of time (60%), a lack of experience (50%), a lack of confidence (39%), and insufficient compensation (32%). Trained PCPs perceive POCUS as a valuable tool that enhances diagnosis and treatment. However, barriers regarding time constraints, confidence, and experience persist despite formal training. Successful integration of POCUS in primary care requires addressing these workflow-specific challenges and selecting devices that align with the unique needs of ambulatory practice.