about their views regarding the benefits and challenges of telemedicine visits (interview guide in Appendix). Physicians provided verbal informed consent for the interviews, which were audio recorded and transcribed verbatim for analysis. Physicians were not compensated for their participation. Qualitative Analysis A physician-in-training (TG) moderated all semistructured interviews and was accompanied by DMT (a physician-investigator with qualitative research expertise) for all but 3 interviews. The 2 investigators met after each interview to discuss and assess the interview content for theoretical saturation (when no new themes can be identified from the data),15 which was reached based on consensus. They performed a thematic analysis16–18 in which they reviewed each transcript line-by-line and applied codes to describe obstacles to and facilitators of telemedicine visits. Discrepancies were reconciled via consensus. DMT and KJS (a sociologist) subsequently independently grouped codes into thematic categories. All investigators reviewed the thematic categories, and adjustments were made based on group discussions. EXCEL 2016 was used for data management. Results Fifteen primary care physicians participated in the study, 11 practicing physicians and 4 physicians-intraining. Eight (53%) were women and 6 (40%) were aged 50 years or older. Ten physicians (67%) had no telemedicine experience before the COVID-19 pandemic (Table 1). Below are major themes raised during the interviews that describe a range of physician perspectives regarding the benefits and challenges of telemedicine visits. Table 1. Participant Characteristics Characteristics N (%) Sex Female 8 (53) Male 7 (47) Age, years 50 6 (40) Race/ethnicity Asian 6 (40) Hispanic or Spanish origin 3 (20) More than 1 race/ethnicity 1 (7) White 5 (33) Physician type Practicing primary care physician 11 (73) Resident 4 (27) Use of telemedicine before onset of COVID-19 pandemic Yes 5 (33) No 10 (67) COVID-19, coronavirus 2019. S62 JABFM February 2021 Vol. 34 Supplement http://www.jabfm.org 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 Improves Patient Access to Care but Leaves Out Some Groups Physicians highlighted several ways in which telemedicine increases patient access to medical care, including the convenience of not having to “skip work or find a ride to come to the clinic for things you could do over telemedicine” (P6). They stated that telemedicine visits increased patient access by leading to “people seeking care sooner if they needed to; it is more accessible” (P4). Physicians also observed that they felt more comfortable asking patients to follow up more frequently if warranted because with telemedicine visits, patients experience fewer travel-related inconveniences such as traffic and parking. Several physicians noted that patients missed fewer appointments with telemedicine visits because when they call patients who do not show up for a telemedicine visit, “patients will pick up their phone ... and it is a way to have adherence to their clinical appointment” (P2). Because patients who are reached by phone can immediately enter a telemedicine visit, physicians perceived that patients were less likely to miss visits, as exemplified by 1 physician’s comment: “I’d say the no-show rate is even less for telehealth [compared with in-person visits] because you can get hold of [patients] easier” (P5). However, many physicians commented that certain groups of patients have difficulty accessing telemedicine visits. These include patients who do not own or have problems using a smartphone, and as 1 physician explained, “Patients who are less likely to use telehealth are older people who can barely handle their cell phone” (P3). Physicians also observed that older patients often required substantial assistance to participate in a telemedicine visit. As 1 physician observed, “We have to acknowledge that [telemedicine] is not an easy process, especially for people as they get older and they are not computer savvy. Designated staff members in the office might need to spend time ahead of the visit, showing them, this is how you do it” (P10). Another physician noted that “most of my elderly patients, they do not know how to use their phone or the app or they do not really like to deal with technology. Initially, they could give some resistance [to telemedicine], but we encourage families to help them and set up for their video visit and that has worked” (P14). Another physician observed other obstacles to accessing telemedicine, for example, “if there’s any additional barriers like language or cognition barriers from the patient, it can be really hard to get a good history” (P7) via telemedicine. Physicians Believe Many Visits Are Well Suited for Telemedicine Physicians believed that many types of visits could be conducted successfully via telemedicine, particularly those focused on counseling and discussion that do not require a physical examination. One physician observed, “I suddenly have 6 or 7 or 8 or 9 minutes that I would have spent on physical examination to devote toward discussion” (P3). Visits that physicians deemed well suited for telemedicine included review and discussion of laboratory or other