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study provides insight into how physicians view the direct access PGx test delivery model, further research will be needed to assess the patients’ perspectives of this model, including perceived benefits and challenges. Study limitations This was an exploratory study to assess physicians’ experiences with pharmacogenomics testing. However, the small sample size may not fully represent the opinions of physicians within the primary practice sites selected, nor held by primary care physicians as a whole, thereby limiting generalizability. Further quantitative studies will be helpful in evaluating whether these opinions are more universal among other primary care physicians and specialists. During semi-structured interviewing, the manner in which interviewers ask questions of participants has the potential to introduce bias to responses. However, the semi-structured questions were designed to elicit open-ended responses and allow the participant to respond to the questions in a manner that has relevance to them. This allows for more varied responses and for new or additional information to emerge. Given that the test kits were complimentary for the participants, it's possible that individuals who would have to pay for the test would hold different opinions on the utility and benefit of the test. Conclusion Physicians in this study expressed views on the value and utility of PGx testing to help guide decision-making and improve patient outcomes. While providers viewed benefits of PGx testing as avoiding side effects, titrating doses more quickly, and improving shared decision-making; they also discussed areas of concern and future need, such as addressing cost, insurance coverage and complexity of PGx test results. Within this health system, perceived concerns and needs have started to be addressed, including the reduction of test cost, clarification of result reports and increased educational opportunities on PGx. Future studies will need to assess a larger sample of physicians’ and patients’ perspectives on the value and utility of direct access pharmacogenomics testing. Providers also requested: clarification of the PGx results report; patient and provider educational materials; and assistance addressing cost and insurance coverage with patients. Acknowledgements The authors acknowledge the contributions of KL Kaul; DL Helseth Jr; K Gulukota; and the NorthShore University HealthSystem Molecular Genetics Laboratory for their essential contributions in the delivery of clinical pharmacogenomics. They especially thank the physicians who participated in this study. Open access This work is licensed under the Attribution-NonCommercial-NoDerivatives 4.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/ Financial & competing interests disclosure P Hulick receives financial compensation as an Up-To-Date topic author on the subject of “Principles and clinical applications of next-generation DNA sequencing”. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript. Ethical conduct of research The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. This investigation received a waiver of in-person consent per the institutional review board; implied consent was received via participant email invitation acceptance.