Patient Enrollment
Patients of enrolled physicians were eligible if they were aged 18 years or older, English-speaking, had email access, and had not opted out of research invitations. For each physician, we recruited at least 10 patients with scheduled in-person annual visits (study visits). We recruited patients for each matched physician pair sequentially and on a rolling basis to account for temporal trends. Patients were recruited via personalized portal-based letters that included links to the prestudy survey, with telephone follow-up for initial nonresponders. Among intervention group patients who completed the study, we used maximum variation sampling (according to age, gender, race and ethnicity, knowledge, preferences, and conversation content to capture a diversity of perspectives) to invite at least 1 patient per physician for exit interviews.