Doctors are spending less time at the bedside with patients, a trend that has led to diagnostic errors, poorer outcomes, and increased costs in health care. A new report from Northwestern University and the University of Alabama at Birmingham outlines six strategies to help restore bedside medicine skills among clinicians and trainees.
The report, which will be published November 12 in the New England Journal of Medicine as part of a series on medical education, highlights how advances in technology and artificial intelligence have contributed to declining bedside skills and weakened doctor-patient relationships. The authors point out that lack of empathy and rising physician burnout are also linked to these changes.
Dr. Brian Garibaldi, corresponding author of the report and director of Northwestern University's Center for Bedside Medicine, emphasized the importance of direct patient interaction: "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." He added, "There’s only so much tech can do without the correct inputs from humans — both physicians and patients."
Garibaldi also noted that dedicating an educational series to these issues demonstrates their significance: "If we don’t intentionally cultivate them, they’re at risk of being lost."
The six recommended strategies include:
1. Going to the bedside and observing patients directly—whether in person or via telemedicine—to gather important clues about diagnosis and prognosis.
2. Practicing a hypothesis-driven approach to physical exams rather than relying solely on standard procedures or technology.
3. Creating opportunities for intentional practice by conducting rounds with learners at the bedside early in medical training.
4. Using technology like AI tools or portable ultrasound devices to support—but not replace—human observation and decision-making.
5. Seeking and providing feedback on clinical skills during patient encounters while maintaining trust between trainees and patients.
6. Recognizing that bedside encounters offer benefits beyond diagnosis, such as addressing uncertainty together with patients and helping reduce health disparities.
The report notes that these approaches can improve diagnostic reasoning, strengthen relationships between doctors and patients, address inequities in care delivery, increase professional satisfaction among clinicians, and reduce burnout.
Dr. Stephen Russell from the University of Alabama at Birmingham commented on this educational focus: "From an educational standpoint, the best way to learn about patients is to be with them," he said. "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."
The publication is part of ongoing efforts by academic institutions like Northwestern University to shape future medical education by emphasizing core clinical skills alongside technological advancements.