A recently widowed mathematics professor walked into a gastroenterologist’s office expecting another routine visit. Instead, he offered an observation that would stay with his doctor long after the appointment ended.
“So I see you’re not a fan of Pythagoras,” the professor said as the doctor stood to examine him. “This is my first visit in years not from a right angle. Usually the doctor is facing the computer with his gaze fixed ninety degrees to mine.”
It was a witty complaint, but it landed hard. Dr. Michael Gerdis, chief of gastroenterology at Mount Sinai Doctors of Westchester, found himself thinking about that comment all evening. The patient wasn’t just making a geometry joke. He was describing a profession that has fundamentally changed, and not for the better.
When Attention Becomes Diagnostic
Gerdis has spent 29 years in medicine, working as a specialist, primary care practitioner, and emergency room physician. He knows what others in his field might not admit: small observations matter enormously. A patient rubbing their forehead, a quick wipe at the corner of their eyes, a momentary avoidance of eye contact. These are the details that can reveal what a symptom checklist never will.
One patient who periodically rubbed his forehead with his palm eventually opened up about serious life stressors. That conversation led to a discussion connecting the brain and gut, and ultimately to a much more effective treatment for irritable bowel syndrome. None of that would have happened if the doctor was facing a different direction.
The math professor’s experience has become the norm, Gerdis argues. Online check-ins days before the appointment. Tablets in the waiting room. A physician typing into a computer during the visit. An online survey hitting your phone before you’ve even reached your car.
It’s functional. It’s efficient. It’s not medicine as it should be.
The Technology That Solved One Problem, Created Another
Electronic health records were supposed to help. They provide crucial access to a patient’s medical history and ensure nothing falls through the cracks. What they’ve actually done is create an environment where completing computer templates matters more than the actual human sitting across from you.
A 2017 study from the American Medical Association and the Dartmouth-Hitchcock health care system found something startling: physicians spend nearly double their time on electronic health record demands compared to direct face-to-face clinical time with patients. Many doctors, when speaking candidly, admit their biggest daily stress isn’t about diagnostic puzzles or treatment challenges. It’s about completing EHR obligations.
“The EHR is not the patient,” Gerdis writes. It’s a simple statement, but it cuts to something fundamental about what’s been lost.
A Profession Becoming Unrecognizable
The larger structural problems in American healthcare are real and well-documented. Dysfunctional insurance models. Inequitable access to care. Pharmaceutical costs that destroy families. The fact that most medical practices are now owned by third parties with their own financial incentives. Those are macro failures that require systemic solutions.
But something else has shifted at the micro level, in the actual moment when a doctor and patient meet in a private room. The connection that once reliably stemmed from empathy, focus, and genuine collaboration has frayed. And while electronic health records bear some responsibility, they’re not the whole story.
Gerdis senses that patients have begun to accept this as normal. Expected, even. A doctor arrives, mostly focused elsewhere, and that’s just how it works now. The ideal of medicine, where a caregiver brings their full attention and skill to understanding a human being’s suffering, has quietly receded.
What Needs to Change
Some of the burden could be lifted by artificial intelligence innovations that handle routine documentation. Future tools might free physicians from some EHR tedium, returning more time to actual patient interaction.
But technology won’t solve this alone. When a doctor opens that exam room door, the responsibility falls squarely on them. Making sure that connection happens. Looking directly at the patient. Noticing the small, telling details that only appear when you’re truly paying attention.
Physicians can do better. The harder question is whether the systems they work within will ever allow them to.
