OBJECTIVES: To understand and quantify the consumers' choice and preferences for the heavily discussed and politically promoted introduction of gatekeeper models in primary care as a measure of effective cost containment. Furthermore, to explore which of the patients' segments could be addressed by which value proposition , which design elements to use and what kind of incentive structures to create. METHODS: Applying stochastic methods, a representative sample of 3024 people from the health insured population was taken and segmented according to four basic dimensions (age, gender, income, and insurance status). About 1000 interviews were performed in a telephone survey. Participants were asked 10 questions about their knowledge on primary care and gatekeeper models. Other questions addressed aspects such as design elements of potential gatekeeper models, parameters for the interviewee's choice on a potential family doctor, demands on the quality of a family doctor, and incentive structures. RESULTS: The participants showed differentiated answer profiles. Older and currently ill people were significantly better informed concerning gate keeper models in primary care. In total, 88% already go to their family doctor and 60% use their family doctor as the primary address and would participate at a gatekeeper model without extra incentives. The demands on family doctors are dependent on age and gender. Neighbourhood and personal experience as well as quality and service level are key factors. CONCLUSIONS: It can be concluded that even without being well informed and without explicit incentive structures, the insured already behave according to the principles of primary care and gatekeeper models, limiting the political effect of reorganising patient streams in ambulatory care. Furthermore, insurance companies should investigate consumers' choices in primary care before setting up sophisticated incentive systems.