Physicians’ Perceptions of AI and Extended Reality in Telemedicine: A Multi-Specialty Cross-Sectional Survey in Romania

<b>Background and Objectives:</b> Artificial intelligence (AI) and extended reality (XR) are reshaping telemedicine, yet physician-level adoption depends on perceived value, training needs, and specialty context. We quantified attitudes toward AI/XR, identified barriers/benefits, and tested advanced relationships (moderation and mediation). <b>Methods:</b> Cross-sectional survey of Romanian physicians (<i>n</i> = 43) across anesthesiology and ICU, surgical, medical, and dentistry. Items were translated into English and mapped to 5-point scales. A 10-item Telemedicine Acceptance Index (TAI; α = 0.86) and a 2-item XR Utility Index (XUI) were computed. Moderation by specialty (Training Priority × Specialty) and bootstrap mediation (2000 resamples) of Future Potential → XUI → TAI were performed. <b>Results:</b> Overall acceptance and perceived utility of XR were moderate to high across specialties; participants most frequently identified technical and financial constraints as barriers and time efficiency and improved access as key benefits. Acceptance patterns were similar across specialties and aligned most strongly with beliefs about future system-level potential and the priority assigned to hands-on training. <b>Conclusions:</b> Physicians reported favorable acceptance of AI/XR-enabled telemedicine. Perceived future system-level value and prioritization of hands-on training were the most consistent correlates of acceptance across specialties. Technical and financial constraints remained the primary barriers, while time efficiency and access emerged as leading perceived benefits. Acceptance appears to be driven more by beliefs about system-level potential and practical upskilling than by specialty identity.