MedicalPressureBench: Evaluating Care Pathway Integrity of Medical Agents Under Workplace Pressure

Medical agents are being developed for workflows that require information gathering, tool use, and completion of care beyond a single answer. In healthcare, workplace pressure can affect decisions and leave required care unfinished. Yet medical agent evaluations have not systematically tested whether agents preserve safe and complete care under such pressure when patient evidence and the appropriate endpoint remain unchanged. We introduce MedicalPressureBench, a controlled benchmark for measuring medical process integrity under workplace pressure. Its matched design varies six forms of workplace pressure while holding medical evidence, authorization, tools, and completion requirements fixed for each task. The benchmark contains 200 tasks across five workflow functions, reviewed by physicians, and 17 conditions per task, yielding 3,400 task condition configurations evaluated across five model families. Completion quality declines in all 30 comparisons between the five models and six individual pressures. Recorded risk also declines in 27 comparisons, each accompanied by lower completion quality. Paired trajectory analysis shows that communication, handoff, and subsequent care can remain unfinished even without unsafe execution. These findings show why medical agent safety evaluation must track completed care obligations alongside unsafe actions.