BACKGROUND The Covid-19 Pandemic prompted the widespread implementation of telemedicine across healthcare. OBJECTIVE To analyze telemedicine adoption by Mohs Micrographic surgeons (MMS) during the COVID-19 pandemic; to analyze the attitudes and perceived barriers to its long-term continuation by MMS practices. METHODS AND MATERIALS An online multiple-choice survey was distributed to members of the American College of Mohs Surgeons. RESULTS 86.1% of surveyed Mohs surgeons initiated telemedicine during the pandemic surge. The most common uses for telemedicine amongst respondents were post-surgery management (77.4%), "spot checks" (60.9%), and surgical consultations (59.1%). 73.1% report patients were receptive to telemedicine. 68.6% believe that telemedicine has a place in dermatologic surgery; 49.5% plan to incorporate telemedicine into their surgical practices long-term. Physical exam limitations, fitting telemedicine into practice workflow, and patient reception/patient training were viewed as the most significant barriers to long-term implementation. CONCLUSIONS While valuable use cases for telemedicine were identified with most Mohs surgeon respondents feeling that telemedicine has a place in their practices, there is uncertainty in how to implement telemedicine into the dermatologic surgery practice workflow.T elemedicine has been a promising technology with the potential to expand and improve health care delivery. However, widespread adoption in both primary care and specialty medicine has been slow. A 2016 study found that only 42% of hospitals and 15% of family physicians had adopted telemedicine in any form. 1 Major historical barriers to telemedicine adoption were lack of payer reimbursement and requirements for special licensure to treat patients across state lines. 2,3 As is often the case with implementation of new health care technology, the necessary legislative and regulatory updates required to bring telemedicine to the forefront were slow to be adopted. 4 In March 2020, one of the first of many stay-at-home orders across the United States was enacted to slow the spread of the surging COVID-19 viral pandemic. As such many medical practices had to shut down, and the adoption of telemedicine became not just a promising option, but a necessity for many patients. This led to a major effort by all health care stakeholders-regulators, payors, patients, and providers-to implement telemedicine. 5 The goal of this study was to analyze telemedicine adoption and usage patterns by Mohs micrographic surgeons (MMS) before and during the initial surges of COVID-19, as well as the attitudes and perceived barriers to its long-term postpandemic continuation by MMS practices. MethodsAfter institutional review board approval, a 23-question multiple choice survey was approved and distributed by the American College of Mohs Surgery (ACMS) in September 2020 through a monthly bulletin-board email. During the month of October 2020, we sent an additional email to 500 ACMS members based on their geographic distribution with...

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