CHICAGO --- Today’s doctor visits look and feel a lot different than they did even just a couple decades ago.
Rushed physicians and medical trainees are spending less time with patients , leading to diagnostic errors, poor patient outcomes and increased costs in health care . The influx of AI and other new technology has led to a decline in modern medical trainees’ fundamental bedside skills and a weakening of the doctor-patient relationship . There is a lack of empathy and an increase in physician stress and burnout. The list goes on.
To help reverse these trends, a new report from Northwestern University and the University of Alabama at Birmingham provides six practical strategies to reinvigorate a waning culture of bedside medicine in this new health care environment. The suggestions give clinicians and medical educators guidance on how to better teach and practice important bedside clinical skills, such as the physical exam.
“An appropriate physical exam can help avoid the need for additional diagnostic testing, yet research has shown the most commonly reported error in the physical exam is simply that the exam was never performed,” said corresponding author Dr. Brian Garibaldi , a nationally recognized expert in bedside teaching and the inaugural director of Northwestern University’s new Center for Bedside Medicine .
“Every day, there’s more information coming out about technology and AI, and the more that people use these tools, the more they realize the primary information we get from patients during the history and physical exam is increasingly critical to the decisions we make. There’s only so much tech can do without the correct inputs from humans — both physicians and patients.”
The report will be published Nov. 12 in the New England Journal of Medicine . It is the final issue in the journal’s six-part series on medical education.
“Dedicating part of an education series to these issues underscores the recognition of the value of these skills,” said Garibaldi, the Charles Horace Mayo Professor of medicine in the division of pulmonary and critical care at Northwestern University Feinberg School of Medicine. “If we don’t intentionally cultivate them, they’re at risk of being lost.”
Six ways to reinvigorate the bedside encounter:
By employing these six strategies, clinical educators can help trainees appreciate the value of the bedside encounter in diagnostic reasoning, strengthen the patient-physician relationship, combat health care inequities, and improve professional fulfillment and burnout, the report said. The words of master clinician educator Sir William Osler ring true over a century later, the report reads: “Medicine is learned by the bedside and not in the classroom. Let not your conceptions of the manifestations of disease come from words heard in the lecture room or read from the book. See, and then reason and compare and control. But see first.”
"From an educational standpoint, the best way to learn about patients is to be with them,” said Dr. Stephen Russell , a physician and professor in the University of Alabama at Birmingham’s division of general internal medicine and population science. “Each of these six steps was crafted under the mindset of finding ways to get doctors out of the conference room and hallways and back to the bedside where their patients are located.”
New England Journal of Medicine
Strategies to Reinvigorate the Bedside Clinical Encounter
12-Nov-2025