A friend recently returned from a doctor’s office visit upset the doctor didn’t explain much of anything. He hardly entered the examination room, asked a few superficial questions while he typed on his laptop, gave her an order for lab tests and told her to schedule a follow-up visit. The rushed encounter left her anxious, wondering if she’d been to a doctor’s office at all.
While the majority of U.S. physicians practice caring, patient-centered medicine, my friend’s experience has become more common in American health care. As a retired physician who practiced for over 40 years, I’ve seen medical encounters transform from thoughtful, personalized interactions into business transactions. It’s a dangerous trend that’s harming both patients and the practice of medicine itself.
While in medical school in the 1960s, we learned that being a clinician meant far more than diagnosing diseases. We were taught not just the mechanics of examination, but the art of clinical practice. Evaluate the whole person — their personal life, psychological makeup, fears and concerns. The lesson was simple: you don’t treat diseases; you treat human beings who are ill.
There is a methodical approach for every patient encounter to ensure nothing important is missed. We learned to take a comprehensive history, conduct a thorough physical examination, order appropriate lab tests based on our findings and explain our reasoning to patients in plain language they could understand. Eye contact was essential. Empathy was expected. Being attentive and curious were valued attributes.
Today’s medical visits tell a different story. Encounters have become briefer, more impersonal and increasingly commercialized. Health care has evolved from a profession into big business. The federal government alone spent $1.9 trillion on health care in fiscal year 2024, amounting to 27% of all federal spending.
Financial pressure from health insurers has transformed how health care providers view their patients. As Dr. Dhruv Khullar observes, we’ve entered the “gilded age of medicine,” where “providers, hospitals, and insurers view patients as consumers who generate profits rather than human beings needing medical care.”
The consequences are troubling. When productivity metrics and profit margins drive medical practice, thoughtful patient encounters become luxuries few can afford. Doctors feel pressured to see more patients in less time, leading to the kind of superficial interactions my friend experienced.
A high-quality medical visit includes key elements often lacking today. The physician should be genuinely curious about the patient’s condition. Clinicians should explain the reasons behind their recommendations, tests, treatments and referrals in understandable terms. Above all, they should give you their full attention without giving the impression they’re rushing to see the next patient. They should provide confidence while being honest about uncertainties. Doctors can’t know everything, but they can say they will do their best to help. This isn’t just good bedside manner — it’s fundamental to high-quality medical care.
As patients, we must take steps ourselves to receive better care. Come with a specific list of concerns, including a concise history of your symptoms, when they began, and what makes them better or worse. Know your medical history, including dates of surgeries, major illnesses and current medications. Arrive early to handle paperwork and consider bringing a spouse or family member to help listen, take notes and ask questions.
Avoid presenting a “shopping list” of issues — focus on your primary concern and schedule a future appointment for less urgent matters. Listen carefully and ask for clarification if necessary. Follow the doctor’s recommendations. Be assertive, not demanding, and always respectful. You are your own best advocate.
The erosion of the traditional doctor-patient relationship isn’t just a foregone conclusion — it’s a threat to the quality of medical care. When physicians don’t have time to truly listen to patients, diagnoses get missed, treatments become less effective and patient satisfaction plummets.
Health care policymakers must recognize that efficient care and high-quality care aren’t mutually exclusive. Insurance reimbursement should reward thoroughness, not just volume. Medical training must emphasize the human side of medicine alongside technical skills. Physicians should remember the words of Sir William Osler, renowned physician and medical educator, “Listen to your patient, he is telling you the diagnosis.”
The next time you visit your doctor, expect more than a hurried encounter. The future of American health care depends on maintaining a healthy and mutually beneficial doctor-patient relationship.
Robert D. Greenberg is a retired physician who lives in Maryland.