Time to Modernize? Rethinking the Hospital Round in Today’s Medicine

The Ritual We All Accept—But Rarely Question

Every morning in hospitals around the world, a familiar dance takes place. Attendings lead, residents follow, interns fumble with notes, students stand awkwardly at the back. A human caravan moves from bed to bed, reviewing labs, adjusting meds, offering teaching pearls, and occasionally speaking directly to the patient.

This is the ward round. It’s the heartbeat of inpatient care. But is it still working?

In a world that has reimagined surgery with robotics, restructured diagnostics with AI, and redefined communication with telehealth—why have rounds barely changed in decades?

The Origins of the Ward Round

Traditional ward rounds were designed for two main purposes: patient care and bedside teaching. Early medical education revolved around the concept of “see one, do one, teach one”—and rounds were the perfect platform.

But what once was intimate, reflective, and deeply clinical has, in many institutions, become a mechanical task. A checklist. A speed run.

And as medicine has evolved, many are asking: is the format still serving its purpose?

The Problems with Traditional Rounds

Today’s hospital environment is radically different from that of 50 years ago. Patients are sicker, lengths of stay are shorter, documentation has exploded, and care is more fragmented. Traditional rounds often fail to address these realities.

Common complaints include:

• Time pressure turning patient discussions into rapid-fire monologues
  
  
• Poor engagement from junior staff due to hierarchical dynamics
  
  
• Minimal direct patient interaction, with most communication happening outside the room
  
  
• Rounds dominated by chart reviews rather than clinical examination
  
  
• Teaching moments squeezed into post-round “if we have time” sidebars
  
  
• Poor interdisciplinary coordination, with nurses and allied staff rarely present
  

The result? Rounds often feel more performative than productive.

What Doctors Really Think But Don’t Say

Ask most physicians privately, and they’ll admit it: rounds are inefficient. Some dread them. Some feel they waste valuable time that could be spent at the bedside, with families, or reviewing imaging and labs in depth.

Residents often feel like data presenters rather than learners. Students are passive observers. Attending physicians are under pressure to manage patients, teach, supervise documentation, and stay on schedule.

There’s a shared sense that something is off—but inertia keeps the wheels turning.

Rounds in the Age of Interdisciplinary Care

Modern medicine is a team sport. Patients are managed by physicians, nurses, pharmacists, social workers, dietitians, physical therapists, and case managers. Yet rounds still often occur in silos.

Reinvented rounds must prioritize collaboration. This means:

• Setting structured interdisciplinary rounding times
  
  
• Including nursing voices as equal contributors
  
  
• Allowing case managers to clarify discharge issues early
  
  
• Empowering pharmacists to guide medication optimization
  
  
• Giving space for therapists to explain functional needs
  

This approach doesn’t slow things down—it prevents errors, reduces delays, and improves patient-centered care.

What Patients Experience During Rounds

To many patients, ward rounds feel like a whirlwind. A group of strangers enters the room, talks about them in the third person, throws around acronyms, nods silently, then exits before questions can be formed.

This is not good medicine. Patients want:

• To be seen, not just examined
  
  
• To understand what’s happening to their body
  
  
• To participate in decision-making
  
  
• To feel like they matter
  

Modern rounds must focus not just on teaching and task management, but on communication. That means plain language, eye contact, and invitations to speak. It also means ensuring that the patient isn’t just a passive bystander in their own care.

Should We Abandon Bedside Rounds Altogether?

Some propose skipping bedside rounds entirely in favor of team huddles or digital case reviews. While these may be efficient, they lose something vital: the patient.

The physical act of seeing the patient—assessing their breathing, posture, pallor, comfort—offers insights no chart can. Listening to a patient’s voice reveals far more than reading progress notes. And being present at the bedside is often the most human moment of the entire hospital experience.

So no—bedside rounds should not be abandoned. But they must be reimagined.

Technology Can Enhance, Not Replace, the Round

AI, mobile devices, and digital records are not the enemy of clinical medicine. They are tools. But they must be integrated thoughtfully.

Modern rounds can leverage:

• Real-time access to labs and imaging on tablets
  
  
• AI-generated summaries to focus discussion
  
  
• Tele-rounding for off-site specialists or remote supervision
  
  
• EHRs with patient-facing dashboards for shared decision-making
  

Technology should free the physician from paper—not replace the presence of a thoughtful clinician.

Reinventing Rounds: New Models Worth Exploring

Forward-thinking hospitals are experimenting with new forms of rounding:

• Bullet rounds: Short, focused meetings early in the morning for updates and planning
  
  
• Co-production rounds: Patients actively participate and help guide the plan of care
  
  
• Nurse-led rounding: Nursing staff coordinate the patient’s story and drive daily updates
  
  
• Zone rounding: Teams are geographically assigned to patients on a specific ward, improving continuity and efficiency
  
  
• Hybrid huddles: Virtual discussions followed by select bedside visits
  

These models recognize that no single structure fits every department or specialty. Flexibility is key.

Teaching in the Age of Distracted Medicine

For medical educators, rounds have always been the prime time for bedside teaching. But with time pressures, EMR distractions, and documentation burdens, this purpose is often lost.

Reinvented rounds must:

• Prioritize micro-teaching moments
  
  
• Encourage safe questioning environments
  
  
• Teach clinical reasoning, not just trivia
  
  
• Model patient communication in real time
  
  
• Reinforce the value of physical exam and history-taking
  

Good teaching doesn’t require extra time—it requires intention.

Culture Change: The Hardest Rounding Challenge

Changing how we do rounds is not just a logistical issue. It’s cultural. It means rethinking power dynamics, letting go of hierarchy, and valuing every team member’s input.

That shift is uncomfortable—but necessary. The best rounds aren’t those where the attending impresses with obscure facts. They’re the ones where everyone feels heard, the patient understands their plan, and care moves forward seamlessly.

Rounds Don’t Need to Die—They Need to Evolve

Rounds aren’t the problem. The way we do them is.

The world has changed. Patient expectations have changed. Medical teams have changed. It’s time the daily ritual that anchors hospital medicine catches up.

By reinventing rounds, we’re not abandoning tradition. We’re honoring its purpose—and upgrading its delivery.