Telemedicine Adoption and Attitudes Among Procedural Physicians in Ohio: A Cross-Sectional Mixed-Methods Survey.

INTRODUCTION: Telemedicine expanded during the COVID-19 pandemic, but its role in procedural and surgical specialties is less well described. We evaluated telemedicine adoption, physician attitudes, and perceived barriers among procedural physicians in Ohio. METHODS: We conducted a statewide cross-sectional electronic survey of procedural physicians practicing in Ohio, with optional semistructured follow-up interviews. Survey domains included telemedicine utilization, adoption drivers, usability, and barriers. Quantitative analyses included descriptive statistics, multivariable logistic regression to evaluate predictors of telemedicine use, and ordinal logistic regression to evaluate predictors of telehealth acceptability and willingness to use telehealth again. Interviews were analyzed descriptively to contextualize survey findings. RESULTS: Of 191 respondents, 156 (81.7%) reported prior telemedicine use; among these users, 129 (82.7%) first used telemedicine after the emergence of COVID-19. Telemedicine was used most often for follow-up visits (73.7%); however, few respondents perceived telemedicine encounters as equivalent to in-person visits. In multivariable analyses, more years in procedural practice were associated with lower odds of telemedicine use (odds ratio [OR] 0.53, 95% confidence interval [CI] 0.33-0.86). Logistic regression analysis demonstrated higher odds of telemedicine use among physicians practicing in mixed (OR = 3.10, 95% CI 1.06-9.07) and rural (OR = 3.02, 95% CI 1.03-8.80) settings compared with urban settings, whereas ordinal regression models showed no significant association between community type and telehealth acceptability or willingness to use telehealth again. Interviews emphasized physical examination limitations, workflow inefficiencies, and reimbursement barriers. CONCLUSION: Telemedicine adoption among procedural physicians is widespread but selective, functioning primarily as an adjunct for counseling and follow-up rather than a replacement for in-person surgical evaluation.