The Digital Bedside Manner – What Compassion Looks Like in the Age of AI
Updated: Nov 28, 2025
Dr. Florence Lewis is a licensed Marriage and Family Therapist and the founder of the Upside Health Research Network (UPHRN), where she helps healthcare providers integrate evidence-based tools to measure and support relational health outcomes.
Healthcare is entering a new era where compassion must travel through screens as often as it does through exam rooms. As AI, telehealth, and digital tools transform clinical practice, the meaning of bedside manner is shifting. This article explores how technology and humanity can work hand in hand to preserve empathy, strengthen connection, and redefine care in the age of AI.
A quiet shift in the room
Imagine sitting with a clinician who looked drained yet determined after 12 hours of rounds, the electronic health record still open, the next patient waiting. The clinician said quietly, “I used to feel I had 30 seconds of connection. Now I have 3.”
Moments like these push a truth I had already been exploring, the “bedside manner” of medicine is shifting. It’s no longer simply physical proximity, shared silence, or a reassuring hand. It’s about how humans and machines work together to cultivate connections in a new care ecosystem.
The changes feel subtle at first, a bot replies, a virtual triage tool speaks, and sometimes the message “powered by AI” appears. However, as a relational health researcher and AI consultant, I’ve observed that the meaning of compassion in healthcare is being redefined, and we’re all learning a new protocol.
Why “bedside manner” must go digital
In the era of telehealth, remote monitoring, algorithm-driven triage, and AI-assisted care, the concept of bedside manner remains essential, perhaps more so than ever. According to an editorial in The Lancet, “the human bond between patient and clinician is fundamental yet is affected by limited time, multitasking, and record-keeping demands.”[1]
In other words, when machines and screens mediate care, the relational space is at risk of being collapsed.
A study published in JAMA Internal Medicine compared responses to 195 patient questions by physicians vs. AI chatbots (from a public online forum). The team found that the chatbot responses were preferred in 78.6% of evaluations for both quality and empathy.[2]
Yes, the machine “won” the bedside manner test. But let’s not mistake that for the machine replacing the human, it signals that expectations of connection are shifting.
Then there’s the concept of “digital empathy.” A systematic review in a SAGE-published journal analyzed how telehealth and digital tools attempt to replicate relational cues:
“Future developments will further refine the ability to evaluate digital empathy, ensuring its effective integration into virtual healthcare practices.”[3]
The takeaway? Compassion in healthcare is not vanishing, it’s being redefined.
What compassion looks like now
So what does bedside manner become when part of the system is algorithmic? Here are three relational shifts I’m seeing in my work at Upside Health Research Network:
Transparency about the tool, not secrecy: When patients know that an AI-assistant drafted a note or an algorithm scanned their vitals, the provider’s role shifts from “expert” to guardian of the relationship and meaning. The tech becomes a tool, the human remains a connection-maker.
Listening in new channels: Compassion used to be face-to-face. Now it can be screen-to-screen. Wearables, remote sensors, and virtual visits: these technologies change bodies into data but still require human translation. My consulting work with providers emphasizes that when you see your patient through a portal, you still need to understand what they are experiencing.
Ethics becomes bedside coaching: When an algorithm flags “risk of isolation,” the clinician’s relational skill becomes even more important: How do you respond? How do you open a human space from a digital cue? A recent article on “algorithms with bedside manner” argues that AI must be “technically proficient, socially sensitive, and legally accountable.”[4]
A hypothetical moment (inspired by real patterns)
Imagine a 68-year-old patient with congestive heart failure. Their wearable devices report fluctuating heart rates and declining activity. The health system’s AI flags risk of decompensation and also notes the patient hasn’t logged into the portal for 10 days.
The clinician opens the tele-visit, “I saw your heart rate trending up and your steps trending down. How are things at home? How’s the dog?”
Even before medicine enters the chat, a connection is offered. Then the patient says, “I turned off the portal. It felt like too much.”
The clinician responds, “Thank you for telling me. That’s important. Technology knows numbers; I want to know you tonight.”
In that exchange, the tech performed the pattern detection, but the human performed the relational repair. That’s the digital bedside manner.
Why relational health still matters
Relational health, how people feel, connect, trust, and collaborate, is still the missing metric in most health systems. The trend toward data, efficiency, and remote monitoring may optimize processes but not always restore humanity.
As someone who trains providers and teams globally, Heart is not replaced by data. Heart is what makes data matter.
And in the age of AI, the human clinician becomes even more valuable, not less. Because while a machine may answer a question with empathy (as the JAMA IM study suggests), only a human can remember a patient’s dog’s name, understand the exhaustion behind the cough, hold space for a fear that isn’t in the vitals.
Three relational moves for leaders
If you lead a care team or research initiative, here are pragmatic moves to keep the human at the centre of high-tech care:
Build relational check-ins into tech workflows. When a portal alert flags an issue, schedule a 5-minute human connection moment, not a form-fill.
Train curiosity as a core competency. Teach clinicians to ask: What does this number mean for them today? Data without a story is sterile.
Audit for relational equity. Ask: Which patients are being missed because they don’t log in? Which are slipping through because they lack digital literacy or trust? Compassion means designing for inclusivity.
Closing thought: The touch behind the screen
Here’s how I frame it with teams I consult: Algorithms can remind us of missed tests. Humans can ask, “Is your heart breaking today?”
The digital bedside manner is not just about efficiency, speed, or data, it is about presence. Being seen, known, heard, even when it happens through a screen, a chart, a sensor.
Ultimately, technology will transform our tools, but human connection will remain our ultimate purpose.
Because care is not only what we do, it’s how we relate. And that will never be code.
Read more from Dr. Florence Lewis, PhD, LMFT
Dr. Florence Lewis, PhD, LMFT, Relationships & Health Researcher, Therapist
Dr. Florence Lewis, PhD, LMFT, is a Medical Family Therapist and founder of the Upside Health Research Network (UPHRN), a nonprofit focused on measuring the impact of relationships on health outcomes. With clinical roots in integrated care, she has worked alongside medical teams to support patients' mental, social, and relational well-being. Dr. Lewis is a published author and dynamic speaker on diversity and holistic health. She hosts "The Relational Health Report" podcast. Her current work helps healthcare providers use evidence-based tools and AI to improve relational health metrics in practice. She also runs a private therapy practice supporting individuals and couples in navigating and building healthy relationships amid past emotional trauma.
References:
[1] “Machines and empathy in medicine.” The Lancet. 2023. The Lancet.
[2] Ayers JW, Poliak A, Dredze M, et al. Comparing physician and artificial intelligence chatbot responses to patient questions posted to a public social media forum. JAMA Intern Med. 2023;183(6):589-596. doi:10.1001/jamainternmed.2023.1838. JAMA Network.
[3] “Compassion through technology: Digital empathy concept analysis and development.” Digital Health. 2025. SAGE Journals.
[4] Khaja AM, et al. Algorithms with a bedside manner: Regulating AI’s social and legal impacts in healthcare. IRJEMS. 2025;4(9):55-67. irjems.org.
[5] Ragsdale G. “AI Can Make Healthcare More Empathic.” Psychology Today. June 21, 2024. Psychology Today.
