Background: Telemedicine is now a sustained modality of ambulatory surgical oncology care, yet its association with workforce utilization, patient volume, and visit type at high-volume academic centers remains understudied. Characterizing these patterns is essential for guiding clinical operations and long-term integration of telemedicine into surgical oncology practice. Methods: We conducted a retrospective cohort study across nine oncology subspecialties at Stanford Medicine's ambulatory surgical oncology clinics from January 2019 to December 2023 to compare yearly visit volumes and telemedicine use. The study included a total of 231,746 visits, including 50,667 new and 181,079 return visits. We measured overall visit volumes, telemedicine utilization, and their association with increase in unique patients served, including both new and return visits. Results: In 2023, visit volumes increased by 44% (46,726 to 67,259), and the clinician workforce grew by 16.8% (107 to 125) compared with 2019. The number of unique patients served rose by 39% (20,620 to 28,711), while visits per patient remained stable (2.3 +/- 2.1 to 2.3 +/- 2.2). Telemedicine use increased from 0.5% (244/46,726) to 37% (24,906/67,259), correlating with serving more patients per year (r = 0.776, p = 0.030) and return visits (r = 0.796, p = 0.010), but not new visits (r = 0.432, p = 0.245).Conclusions: At this academic medical center, telemedicine use is associated with an expansion of the clinician workforce, an increase in patient volume, and more return visits rather than new visits, without contributing to overall higher healthcare utilization. This suggests that telemedicine can deliver a significant proportion of ambulatory surgical oncological visits while preserving access to care and operational efficiency.
