Geospatial Analysis of Telemedicine Physicians in the United States

Background: Telemedicine can increase care access and may be particularly helpful for rural patients. We sought to conduct a geospatial analysis of telemedicine physicians in the United States with attention to urban-rural and specialty-level differences. Methods: We used the Doctors and Clinicians national downloadable file. We assessed urban-rural differences in telemedicine physician density, categorized by Rural-Urban Continuum Codes. We analyzed telemedicine physician distribution using spatial clustering and choropleth graphs. Results: Our cohort comprised 660,537 physicians, of whom 136,462 (20.7%) offered telemedicine services. Physicians offering telemedicine services were less likely to practice in rural environments (p-value < 0.001) than nontelemedicine physicians. There were clusters of low telemedicine physician density in the South. Discussion: Telemedicine physicians were less likely to practice in rural areas, which may exacerbate health care disparities. Targeted interventions to increase telemedicine accessibility in rural and underserved areas should be pursued.