Connection is vital in medicine, and is often ruptured by institutional demand for rushing and the culture of separation. That’s two strikes against doctors who want to connect, understand the importance, and need to feel connected themselves, and all doctors need to feel connected, whether or not they recognize it.
Rushing forces the disconnection. It puts them in fight-or-flight mode, and people can’t connect when they’re on Red Alert and running from the administrator’s whip that drives them to feel unsafe in their workplace–so many things, especially within corporate walls.
My experience with a dermatologist exemplifies this. He burst into the exam room without knocking, setting off my startle reflex. He was sweating and out of breath, like he’d been running from a lion. In his stressed condition, he was unable to connect.
I brought up that I had Medical PTSD, explained in a handout I had asked his assistant to give him in advance. “I know!” he exclaimed, and then advised, “Just think about how great it’ll be to have this behind you,” as if my thoughts were the problem instead of the repeated medical neglect and abuse I had experienced. A complete disconnect was the best the surgeon could offer. He couldn’t see me as a person with unique needs; he only saw someone he needed to get through the system faster. I could not trust such a disconnected practitioner or the facility that employed him.
Trust is built through attunement, regulation, and safety, none of which the dermatologist provided. Bursting into the room without knocking disregarded the human nervous system’s need for predictability and respect. His dysregulated state–sweating, breathing hard–signaled danger to my body. When he ignored my disclosure of Medical PTSD and dismissed the importance of my handout, he demonstrated a lack of curiosity, empathy, and presence, which are key ingredients for co-regulation. Without felt safety and attuned connection, my nervous system correctly registered him as someone I could not trust.
The experience of connection in medicine is foundational to health for patients and clinicians. Yet, the structure of many medical environments directly undermines it.
From an Interpersonal Neurobiology (IPNB) perspective, connection is a biological imperative. Our nervous systems are shaped in relationship, and healing is facilitated through safe, attuned relational presence. When this is absent, particularly in vulnerable moments like receiving care, the nervous system considers it a threat.
Rushing destroys the possibility of attunement. It signals danger. It fractures the sense of being seen, felt, and valued. For doctors, the pressure to move quickly–whether due to administrative demands, productivity metrics, or the sheer volume of patients–keeps them in a chronic state of threat. This shifts their physiology into a defensive stance, narrowing their capacity for empathy and deep listening. Even the desire to connect can be overridden by the body’s drive to survive the day.
In this state, the doctor is unable to co-regulate with their patient. And the patient, sensing the absence of real presence, becomes more dysregulated. This can be subtle or overt, but it accumulates over time, breeding mistrust, miscommunication, and a profound sense of isolation in a place that is supposed to offer care.
Rushing gives the illusion of efficiency, but it erodes both care quality and the long-term sustainability of the system.
When clinicians are stuck in a stress-driven mode, their cognitive flexibility, emotional regulation, and capacity for insight all shrink. This leads to more mistakes, less thoughtful communication, and more fractured relationships with patients. That leads to more follow-up visits, unnecessary tests, missed diagnoses, complaints, lawsuits, burnout, turnover, and harm.
From an IPNB lens, real efficiency would come from investing in relational time, because that’s what builds trust, reduces conflict, supports healing, and keeps patients and doctors more regulated. A connected system is a healthier system. Rushing disconnects us from that possibility.
Tragically, most clinicians entered medicine intending to help, connect, and be present for suffering, yet the industry induces a physiological state incompatible with connection. It undermines the deepest instincts of human caregiving. Restoring connection in medicine is not just a nice idea, but a neurobiological necessity. Without it, everyone suffers.
