Rewiring the Research Enterprise: Why Primary Care Is the Next Frontier.

Primary care research remains underused for generating pragmatic, generalizable evidence to enhance patient care. Despite the prominent national focus on addressing chronic disease and the high volume of patients seen in primary care, primary care research remains critically underfunded. In April 2025, the Duke Clinical Research Institute convened a national "Think Tank" of cross-disciplinary experts to explore how to better integrate clinical research into primary care. Primary care holds promise to improve clinical research by offering rapid recruitment of diverse patients and engagement of potential participants by trusted "front-line" providers, by allowing enhanced pragmatic data collection methods, and by addressing critical disease-specific and population health questions. However, primary care research is challenged by workforce shortages, fragmented research infrastructure, funding uncertainty, and misaligned incentives. Three key approaches were identified to bolster the future of primary care research: (1) expanding practice-based research networks, (2) leveraging digital health technologies, and (3) investing in the future of primary care research through increased funding and training opportunities. Together, these approaches can advance patient-oriented, pragmatic research in primary care to create a healthier future for all.