California academic health system and group-model health maintenance organization were conducted to assess physician perspectives regarding the benefits and challenges of telemedicine. Results: Physicians indicated that telemedicine improved patient access to care by providing greater convenience, although some expressed concern that certain groups of vulnerable patients were unable to navigate or did not possess the technology required to participate in telemedicine visits. Physicians noted that telemedicine visits offered more time for patient counseling, opportunities for better medication reconciliations, and the ability to see and evaluate patient home environments and connect with patient families. Challenges existed when visits required a physical examination. Physicians were very concerned about the loss of personal connections and touch, which they believed diminished expected rituals that typically strengthen physician-patient relationships. Physicians also observed that careful consideration to physician workflows may be needed to avoid physician burnout. Conclusions: Physicians reported that telemedicine visits offer new opportunities to improve the quality of patient care but noted changes to their interactions with patients. Many of these changes are positive, but it remains to be seen whether others such as lack of physical examination and loss of physical presence and touch adversely influence provider-patient communication, patient willingness to disclose concerns that may affect their care, and, ultimately, patient health outcomes. ( J Am Board Fam Med 2021;34:S61–S70.) Keywords: Ambulatory Care, COVID-19, Health Communication, Pandemics, Primary Care Physicians, Primary Health Care, Qualitative Research Telemedicine Introduction Opportunities for using telemedicine have existed for some time but have remained limited among primary care providers.1 The coronavirus 2019 (COVID-19) pandemic sparked regulatory changes that reduced barriers to telemedicine and resulted in large-scale expansion of telemedicine use throughout health care systems and primary care practices.2,3 Despite this tremendous growth, insufficient knowledge exists about primary care physician perceptions of telemedicine visits. Existing studies have focused primarily on patient perspectives about telemedicine visits4–6 or on those of physician specialists and mental health professionals.7,8 Emerging evidence has documented physician views about the challenges of rapidly implementing telemedicine visits in response to the pandemic9,10 and has revealed barriers to patient access such as poor technological competency.11 The few studies that have examined views about physician-patient interactions during This article was externally peer reviewed. Submitted 1 October 2020; revised 12 November 2020; accepted 12 November 2020. From the Department of Family Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, CA. Funding: None. Conflicts of interest: Drs Gomez, Anaya, and Shih report no conflicts of interest. Dr Tarn has been funded by the BMS/Pfizer Alliance ARISTA-USA to conduct unrelated research studies. Corresponding author: Teresita Gomez, MD, David Geffen School of Medicine at UCLA, Department of Family Medicine, 1920 Colorado Avenue, Santa Monica, CA 90404 (E-mail: tgomez@mednet.ucla.edu). doi: 10.3122/jabfm.2021.S1.200517 Physicians’ Experiences With Telemedicine During COVID-19 S61 on 6 July 2022 by guest. Protected by copyright. http://www.jabfm.org/ J Am Board Fam Med: first published as 10.3122/jabfm.2021.S1.200517 on 23 February 2021. Downloaded from telemedicine visits have been primarily from the patient perspective. These studies investigated patient views of interactions with specialists, urgent care, and primary care physicians in Veterans Affairs and academic settings.4,12–14 In-depth exploration of physician perspectives regarding their interactions with patients also is lacking.14 The objective of this study was to identify the range of primary care physician perceptions of the benefits and challenges of telemedicine use, particularly around physician-patient interactions. Methods Setting, Participants, and Study Design We invited primary care physicians working in practices affiliated with University of California, Los Angeles (UCLA) Health (an academic medical center), and with a Southern California group-model health maintenance organization, to participate in semistructured interviews. Purposive sampling was used to balance physician characteristics based on gender, age, and training (practicing physician vs physician-in-training). Three participants were identified via snowball sampling, in which participants invited or recommended other potential participants. All physicians had conducted telemedicine visits, although some had newly adopted them within 1–2 months before their interview. The UCLA institutional review board deemed this study exempt from review. Data Collection Physicians participated in 30-minute interviews by video conference between April 19 and June 28, 2020. To provide context, Los Angeles was abiding by a strict stay-at-home order because of the COVID-19 pandemic from March 19 to May 31, 2020. Interviewers used a semistructured interview guide to ask physicians