According to a recent Organization for Economic Co-operation and Development report, patients who believe that their primary care clinician has spent sufficient time with them are nearly 90% more likely to trust their healthcare system . This finding highlights a fundamental crisis in modern practice: Time is the basis of trust.

However, the data also revealed that less than half (47%) of the patients with multiple chronic conditions are seen in primary care practices scheduling over 15 minutes for regular consultations and follow-up appointment figures ranging from more than 80% in Norway and Portugal to less than 10% in Spain.

The struggle to secure even a 10-minute consultation is a defining challenge for primary care, exacerbated by unrelenting demand and structural physician shortages.

“While already severe in primary care, specialist services are also strained, with long waiting lists shrinking appointment times across the system.”

This pervasive time pressure — a global phenomenon eroding the clinician-patient relationship — is the focus of a new, actionable framework. Published in The New England Journal of Medicine (NEJM), a report from experts at Northwestern University in Chicago and the University of Alabama at Birmingham offers six practical strategies to reclaim the essential human connection at the heart of medicine, even within the constraints of the system.

The Unsustainable Strain on Time and Trust

An obvious solution is to extend the time spent with each patient. However, with rising waiting lists, especially in primary care, no straightforward method exists to make this feasible.

A simulation study published in Applied Clinical Informatics evaluated an increase in the average consultation time from 5 to 10 minutes. The model showed that longer consultations not only worsened waiting times but also lengthened the total time a primary care physician needed to see all patients in a day. When the patient arrival rate was kept constant, the increase in the consultation duration from 5 to 10 minutes added 167.54 minutes to the clinician’s working day.

This concept must be combined with a clear view of the current reality of medical consultations.

A recent meta-analysis of 67 studies with 16,076 participants found an overall burnout prevalence of 24% among physicians.

This burden directly affects the doctor-patient relationship.

Burnout Burden

The NEJM report emphasized that excessive workload among doctors and residents not only continues to reduce the time available for patients but also contributes to diagnostic errors, poor outcomes, and rising healthcare costs. Therefore, revitalizing the doctor-patient relationship is urgent.

“An appropriate physical exam can help avoid the need for additional diagnostic testing, yet research has shown that the most commonly reported error in the physical exam is simply that the exam was never performed,” said Brian Thomas Garibaldi, MD, a nationally recognized expert in bedside teaching and the inaugural director of Northwestern University’s Center for Bedside Medicine, talking with a patient at a Northwestern Medicine hospital in a press release.

The arrival of artificial intelligence (AI) and other new technologies is expected to reduce bureaucracy and support doctor-patient relationships. However, this has coincided with a decline in residents’ basic clinical skills and a weakening of connections with patients. Combined with widespread burnout and rising stress, these factors reduce clinicians’ empathy toward patients.

“From an educational standpoint, the best way to learn about patients is to be with them,” said Stephen Russell, a physician and professor at the University of Alabama at Birmingham’s Division of General Internal Medicine and Population Science in a press release.

The six steps aim to ensure that modern technology and digitization truly serve patient care by helping clinicians spend less time in conference rooms and on screens and more time with patients.

6 Steps to Revitalize the Doctor-Patient Relationship

Approaching the patient’s bedside and observation. Observing the patient reveals essential clues regarding their diagnosis, prognosis, and personal circumstances. According to the report, today’s clinical care extends across telemedicine, home visits, hospitals, and healthcare centers. During the preclinical years, practicing observation in nonmedical contexts, such as studying art, can strengthen clinical observational skills.

Practice and teach an evidence-based approach to physical examination. Medical students often learn a head-to-toe exam, which may encourage reliance on tests over direct examinations. A hypothesis-guided physical examination offers a more effective approach by selecting each maneuver based on the clinician’s diagnostic suspicions, medical history, and knowledge of disease patterns.

Promote opportunities for intentional practice. Patient-centered education delivered at the bedside or in the clinic can improve efficiency and physician satisfaction. Bedside sessions should begin early in medical training because early habits shape lifelong practice. Students who participate in supervised bedside encounters with real and standardized patients demonstrate stronger clinical skills by the end of their third-year rotations.

Use of technology to teach and reinforce examination skills. Bedside AI-supported medicine is still evolving, but AI output should complement — not replace — clinical observation, reasoning, and communication. For instance, point-of-care ultrasound can identify diagnoses missed on traditional examination, but its value depends on clinicians being physically present, engaging with the patient, and correctly identifying the anatomy examined.

Request and provide feedback on clinical skills. Providing feedback in front of patients is challenging, especially when correcting techniques or modifying diagnoses or treatments. Poorly delivered feedback may undermine the student-patient relationship. However, thoughtfully framed feedback can reassure patients that the team is committed to providing high-quality care.

Recognizing the power of patient interaction beyond diagnosis. Uncertainty is inherent in clinical care, but curiosity can help clinicians and patients navigate it together, strengthening the doctor-patient relationship. Bedside interactions can also help reduce healthcare inequalities.

According to the study, applying these six strategies enables clinical tutors to reinforce the importance of direct patient interaction in diagnostic reasoning, strengthen the doctor-patient relationship, reduce inequities in care, improve professional satisfaction, and reduce burnout among clinicians.

This story was translated from El Medico Interactivo, part of the Medscape Professional Network.