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Strategies to Reinvigorate the Bedside Clinical Encounter

Garibaldi BT, Russell SW. Strategies to Reinvigorate the Bedside Clinical Encounter. N Engl J Med. 2025 Nov 27;393(21):2142-2150. doi: 10.1056/NEJMra2500226. Epub 2025 Nov 12. PMID: 41223363.

Medical trainees today spend as little as 13% of their time in direct contact with patients.1 As physicians spend less time with patients, fundamental bedside skills decline.2 This decline contributes to diagnostic error, poor clinical outcomes, and increased health care costs.3 More than half of outpatient diagnostic errors have been attributed to poor history taking and mistakes in the physical examination.4 An overreliance on technology, due in part to declining clinical skills, leads to overinvestigation and rising costs.5 The drift away from direct contact with patients contributes to a decrease in empathy on the part of medical students and residents and an increase in stress and burnout among practicing physicians. It also leads to a weakening of the doctor–patient relationship. 6,7 Lack of time at the bedside disproportionally affects marginalized groups and propagates health care disparities.8 As bedside skills have declined, so too has the number of faculty members who are comfortable teaching those skills, which further contributes to their decay.9 To help reverse these trends, we provide practical suggestions for clinical educators to reinvigorate the teaching and practice of bedside clinical skills in the modern health care environment.
 
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