The Clinician's Perspective: Giving Medicine Back What Always Belonged to It: the doctor-patient relationship

This article is part of our series, The Clinician’s Perspective, where we explore the intersection of AI and healthcare through the eyes of our team – former clinicians who understand the realities and complexities of patient care first hand.

A Memory From My First Days in Medicine

Twelve years ago, a younger version of myself began studying Medicine at the Autonomous University of Madrid. It had taken years of effort and sacrifice to reach that moment. But at last, I had earned the chance to study a discipline that, to me, felt like a way to help people live better lives.

The First Signs That Something Was Wrong

Despite all the years that have passed, I still remember what struck me most during my clinical rotations: patients leaving their appointments disappointed. Many said their doctor hadn’t looked them in the eye for even five seconds while they spoke about something that deeply worried them — their own health. Some moved from disappointment to indignation, frustrated that they couldn’t build the relationship of trust they expected.

And the few who did experience that connection felt as if they had won the lottery. They listened, stunned, to other patients’ stories, feeling lucky to have met a doctor who truly saw them — or grateful for whatever computer glitch had forced that doctor to look away from the screen.

A Lesson I Never Forgot

I also remember how, in my early years of medical school, our Pathophysiology lectures always began with a painting — its author I can no longer recall — showing Gregorio Marañón, a hugely respected Spanish physician and scientist, visiting a patient in their home. Our professors would point to the painting and ask: What instrument do you think is the most important in patient care?

The Most Important Tool in Medicine

We students would debate among ourselves: “the stethoscope,” some would say; “the ultrasound,” others would call out from the back. The professor would listen quietly and then respond: “In the words of Gregorio Marañón, nothing is more important than the chair — to sit down and listen to the patient, who knows their own body better than anyone and can often tell us their own diagnosis.”

What Modern Medicine Asks of Us

Years have passed since the time of Dr. Marañón, though far fewer since I sat in those lectures. Over my twelve years working in the hospital, that reflection about the chair kept coming back to me — and it felt more relevant each time. Today’s physicians are expected to do everything. We are expected to know, and to stay up to date. We are expected to diagnose and to treat. We are expected to be perfect, and never make mistakes. But there is one thing we are never forgiven for: not listening.

When the Computer Replaced the Patient

In the twenty-first century, I have witnessed —and at times taken part in— how we stopped truly listening to patients. We were too busy typing as fast as we could, trying to capture every detail of their story in an electronic record. In medical school, we were even told to learn touch-typing and to take transcription courses. Rivers of digital ink, endless lines of text — and yet in Spain, if you’re in Madrid, you still can’t know what happened to a patient from Galicia because you can’t access their records.

Meanwhile, patients have slowly accepted this screen-focused attitude as normal. I even had one tell me, “Don’t worry, doctor, I’ll dictate it for you so you can write it more easily.”

Now, in November 2025, a quarter century into the digital era, I find myself asking: are we really unable to do better? Or is it simply easier to let this evolution —or rather, this involution— carry us along, hiding behind the computer and losing sight of the patient entirely?

Can We Really Not Do Better?

And in the midst of these reflections, almost without noticing it, medical scribes powered by Artificial Intelligence began to appear. The idea felt both fitting and simple: let the same technology that once distanced us from patients help restore what we should never have lost. Let AI structure the clinical record so we can focus on the relationship in front of us. Sometimes the best solutions are the simplest ones — medical notes that write themselves.

But if we choose this path, we must do it right. The clinical data we record belongs to the patient, and it must be protected. Over these past weeks, I realized that many tools claim to protect data, but very few gave me real peace of mind. The thought of handing over clinical information —the most sensitive data a person has— to something that could sell it, leak it, or be hacked is terrifying.

Letting Technology Repair What It Broke

Yet not everything is dark in this uncertain landscape of health technology. About a month ago, I was introduced to Tandem — an AI assistant created by doctors and for doctors. To me, that felt like the bare minimum. How could a clinical record, shaped by a physician listening to a patient, be generated by someone who has never written a clinical note? And yet, somehow, this is often considered acceptable.

At a recent healthcare innovation event, I heard the Director of Healthcare Management from one of the largest hospital groups in my region admit that they had built a similar tool without involving physicians because, “they’ll have to adapt to whatever we give them since they’re always against everything.”

Hearing that made my stomach turn. I felt sorry for their clinicians — and even more for their patients. In an era of widespread burnout, imposing top-down rules on how consultations should run is a recipe for failure.

Where I Finally Saw a Different Approach

And so, I had the chance to try Tandem during real consultations, with real patients and real cases. I needed to trust that my patients’ data wouldn’t end up where it shouldn’t — and this copilot gave me that confidence.

What happened next stunned me. My patients looked at me with a kind of gratitude I hadn’t seen in years — gratitude for being fully heard. And every clinical detail was still captured and neatly structured in their record. All of it without me having to focus on the computer, and in record time. I had never finished a consultation so quickly, nor spent so much of it simply listening to the patient.

Recovering What Was Always Ours

I end up asking myself: is it time to reclaim what has always been ours by vocation? I don’t know if technology can fix everything. But I do know that, with this tool, I felt like I was recovering something we should never have lost. And that is why I want other colleagues to experience it too.

‍

About Álvaro Mingote Lladó

Dr Álvaro Mingote is a medical doctor, specialized in anesthesiology, intensive care medicine and pain management for more than six years in the Spanish public health system. He has completed a PhD in medical research in the critical-care area and is focused on bringing AI solutions to medicine. He is now an associate professor of medicine at CEU San Pablo University and vice-president of the Spanish Society of Anesthesiology, Intensive Care and Pain Management (SEDAR). If you want to learn more about how AI solutions can improve your clinical practice, you can reach Álvaro in Linkedin