Six Strategies to Revive the Doctor-Patient Bedside Encounter Amid Rising Tech Use
Modern doctor-patient visits have become increasingly rushed, with physicians and trainees spending less time with patients due to growing workloads and the integration of AI and digital tools. This shift has led to a decline in foundational bedside skills, weakened patient relationships, reduced empathy, and higher rates of diagnostic errors, poor outcomes, and physician burnout. To address this growing concern, a new report from Northwestern University and the University of Alabama at Birmingham outlines six evidence-based strategies to reinvigorate the culture of bedside medicine in today’s healthcare environment. The report, published in the New England Journal of Medicine, is the final installment of a six-part series on medical education and highlights the enduring importance of direct patient interaction. Dr. Brian Garibaldi, a leading expert in bedside teaching and the inaugural director of Northwestern’s Center for Bedside Medicine, emphasizes that the physical exam remains a vital diagnostic tool. He notes that a key error in clinical practice is simply not performing the exam at all, despite its ability to reduce unnecessary testing and improve care. The first strategy is to go to the bedside and observe. Simply being present at a patient’s side—whether in a hospital room, outpatient clinic, or through telehealth—allows clinicians to pick up on subtle but critical signs, such as a patient’s posture, breathing, or emotional state. The report points to historical examples like James Parkinson’s description of the "Shaking Palsy," which relied entirely on direct observation. Even in modern practice, observation skills can be strengthened early by training students to study art or other non-medical visual cues. Second, the report advocates for an evidence-based, hypothesis-driven approach to the physical exam. Instead of following a rigid head-to-toe routine, clinicians should use patient history and clinical knowledge to guide targeted exam steps. This approach reduces reliance on expensive tests and strengthens diagnostic reasoning. Third, educators should create intentional opportunities for bedside learning early in medical training. Regular bedside sessions during rounds help students develop habits that shape their lifelong practice. Exposure to both real and standardized patients during pre-clinical years improves clinical skills by the time students enter clerkships. Fourth, technology—particularly AI and point-of-care ultrasound—should be used to enhance, not replace, bedside interaction. For example, portable ultrasound can reveal conditions missed by traditional exams, but its effectiveness depends on the clinician being present, communicating with the patient, and making informed decisions about what to examine. Fifth, feedback on clinical skills must be delivered thoughtfully and in context. Providing constructive feedback during bedside encounters, especially when correcting mistakes, can reassure patients that their care is being carefully reviewed by the entire team—when done respectfully and transparently. Sixth, the report underscores that the bedside encounter holds value beyond diagnosis. It fosters curiosity, helps manage uncertainty, strengthens trust, and can reduce health disparities. For example, minority adolescents are less likely to receive routine physical exams, highlighting the need for equitable bedside engagement. The report concludes with a timeless quote from Sir William Osler: “Medicine is learned by the bedside and not in the classroom.” Dr. Stephen Russell of UAB reinforces this idea, noting that the best way to learn about patients is to be with them. These six strategies aim to bring doctors back to the bedside, where the human connection and clinical insight that define medicine truly begin.
