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C L O S L E R
Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative
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Creative Arts in Medicine
Connecting with Patients
Passion in the Medical Profession
Lifelong Learning in Clinical Excellence
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April 6, 2020 | 1 min read

Addiction Recovery During the Pandemic

By Mike Fingerhood, MD, Johns Hopkins Medicine

We are all stressed by the great uncertainty related to COVID-19, but for our patients with addiction, it is much greater. Check in with your patients and support them in finding healthy ways to cope.

October 27, 2021 | 4 min read

Digital Media Addiction: It’s Complicated

By Natalie Gukasyan, MD, Johns Hopkins Medicine

It’s tempting to resort to simple explanations for complex behaviors like digital media use. Deep relationships with patients can help you understand what’s behind the behavior. 

July 27, 2023 | 2 min read

Book Review of “The Pastoral Clinic” 

By Juliana Fan, medical student, Johns Hopkins Medicine

Garcia’s ethnography highlights the need for healthcare professionals to foster hope, particularly when working with patients with opioid use disorder. Remember to be kind, patient, and positive with those who are suffering. 

January 29, 2025 | 2 min read

Addiction in older adults 

By Bethea (Annie) Kleykamp, PhD, MA, University of Maryland

Deaths in the U.S. due to tobacco and opioid-related overdose are more common among older adults from historically marginalized groups. Treatments tailored to their unique needs can help reverse this trend.

January 9, 2023 | 2 min read

Questions Raised by “There, There” 

By Mike Fingerhood, MD, Johns Hopkins Medicine

Reflecting on our own “there” (the place where we grew up) can trigger conversation that helps us to understand our patients’ “there.” This can strengthen the patient-clinician relationship.

December 14, 2021 | 1 min read

Supporting Loved Ones of People With Addictions

By Angela Orozco, MD, Johns Hopkins Medicine

The impact of addiction extends beyond the individual. We can offer and introduce resources like Al-Anon to both patients and their loved ones. 

June 22, 2022 | 1 min read

Explaining The Risks of Vaping

By Panagis Galiatsatos, MD, Johns Hopkins Medicine

Prioritize discussions about the long-term consequences of smoking. Be aware that just because someone has quit doesn’t mean that they won’t relapse.

October 28, 2024 | 2 min read

Spark the change

By Sadiqua Sadaf, MBBS, Deccan College of Medical Sciences, Hyderabad, India

To motivate patients toward change, healthcare professionals can focus on building trust and setting achievable goals.

July 18, 2022 | 2 min read

How to have effective discussions about alcohol 

By Beth McGinty, PhD, Johns Hopkins Medicine, Mike Fingerhood, MD, Johns Hopkins Medicine

Talking with patients about the risks of heavy alcohol consumption and the benefits of change can have a positive impact on their health. 

May 17, 2022 | 1 min read

Word Choice Related to Substance Use Disorders

By Beth McGinty, PhD, Johns Hopkins Medicine

Words matter; calling patients with a substance use disorder an “addict” defines them by their addiction. We need to ensure that our patients feel comfortable and supported so that they will engage in treatment.  

"Macy uses personal stories to follow the threads of the opioid crisis that has blanketed Appalachia."

April 29, 2021 | 2 min read

Book Review of “Dopesick”

By Suchita Sata, MD, Duke University

Treatment for opioid use disorder is often inaccessible and unaffordable. Nevertheless, clinicians must connect patients to available services while advocating for improved systems of care.

September 21, 2023 | 1 min read

Healthcare Professionals And Fatal Overdose

By Hannah Fetting, MSN, CRNP, Johns Hopkins Medicine

Colleagues with a substance use disorder deserve the utmost compassion. We can offer nonjudgmental support, just like we do for all other conditions. 

September 28, 2021 | 1 min read

Considerations When Talking With Patients About Cannabis

By Mike Fingerhood, MD, Johns Hopkins Medicine

The medical literature on cannabis use is not clear, making it difficult to know what to tell patients. Share both positives and negatives about using marijuana, and help your patient make the best care plan for them.

September 27, 2023 | 1 min read

Guardrails And Ambulances 

By Mike Fingerhood, MD, Johns Hopkins Medicine

Over 100,000 Americans die every year from overdoses, and most are preventable. Discuss with patients and loved ones the dangers of having old prescription or counterfeit pills, as well as the importance of keeping naloxone on hand.

June 16, 2021 | 1 min read

Why we Must Talk About E-cigarettes with Teen Patients

By Mike Fingerhood, MD, Johns Hopkins Medicine

Proactively counseling adolescents about the risks of e-cigarette use is essential. The message should acknowledge both the health implications and the pressures that they may feel from their peers.

December 11, 2019 | <1 min read

Medication for Opioid Use Disorder

By Mike Fingerhood, MD, Johns Hopkins Medicine

Building a therapeutic relationship with people with substance use disorders is critical when supporting them on their journey to health.

September 13, 2022 | 2 min read

Psychedelics and Health

By Mary Yaden, MD, Johns Hopkins Medicine

Psychedelic therapies have long been feared and avoided. We must acknowledge that there are clinical indications where these treatments are profoundly beneficial.   

April 17, 2024 | 2 min read

Kratom—the opioid-like herbal drug your patients may be using  

By Megan Buresh, MD, Johns Hopkins Medicine

Kratom use is on the rise. It is important to ask patients about use in a nonjudgmental manner. 

November 14, 2022 | 2 min read

The Benefits of Overdose Prevention Centers (OPCs)

By Bennett Allen, PhD, New York University, Noa Krawczyk, PhD, New York University

Supervised injection facilities prevent death and do not encourage drug use. Sharing this information can keep our patients safer. 

August 26, 2021 | 1 min read

Destigmatizing Addiction: The Power of Words

By Namrata Walia, MD, Baylor College of Medicine

Please use the term 'person with substance use disorder’ instead of ‘addict’!

September 26, 2023 | 2 min read

Talk Less, Listen More

By Aurora Grutman, medical student, Johns Hopkins Medicine

A conversation with a fentanyl overdose survivor taught me to listen with humble curiosity, and talk to patients thoughtfully with respect and sensitivity.

"Facilitate finding new ways to stay busy and have fun. Recovery is not punishment. Helping your patient find new ways to have fun is crucial."

October 3, 2018 | <1 min read

Dr. Mike Fingerhood: A CLOSLER Look

By Gretchen Miller, Managing Editor

Every time I see a patient I ask them about their home environment, and what the main stressors in their life are right now.

February 22, 2018 | 3 min read

Family History and Addiction Risk

By Margaret Chisolm, MD, Johns Hopkins Medicine

For some patients the risk of becoming addicted to prescription opioids is extraordinarily high and may outweigh any pain control benefit.

April 6, 2018 | 1 min read

The Human Tragedy of the Opioid Crisis

By Margaret Chisolm, MD, Johns Hopkins Medicine

Addiction impacts more than just my patient, but their entire family. And our job as doctors is—in some way—to care for all of them, to bring them in close, and to try to relieve their suffering in some way.

December 10, 2024 | 1 min read

A breath of fresh air

By Mike Fingerhood, MD, Johns Hopkins Medicine

Healthcare professionals can prioritize ongoing conversations about the risks of smoking and vaping with young patients, tailoring their approach to address specific concerns and misconceptions.

The author having fun ice skating with colleagues at Patterson Park, Baltimore, Maryland.

February 25, 2019 | 5 min read

General Internal Medicine: An Opportunity to Engage Holistically

By Paul O'Rourke, MD, MPH, Johns Hopkins University School of Medicine

General internal medicine focuses on the importance of knowing and treating the whole patient. The entire patient, in their biopsychosocial context, must always be considered to provide high-quality, patient-centered care.

Miami, FL, USA - March 23, 2024: Passing out Narcan nasal spray at the Ultra Music Festival Miami.

April 23, 2024 | 1 min read

Outside the clinic walls: making Narcan accessible to everyone

By Panagis Galiatsatos, MD, Johns Hopkins Medicine

Addiction is a chronic disease that requires a combined approach of medical treatment and community engagement. Clinicians must work to educate their community about addiction and provide them with resources like Narcan.

December 8, 2023 | 1 min read

Supporting those with AUD through the holidays

By Megan Gerber, MD, MPH, Albany Medical College

Find a way to celebrate this holiday season that includes and validates those who may be in recovery. 

November 22, 2024 | 2 min read

The challenges of alcohol use disorder during the holidays

By Megan Gerber, MD, MPH, Albany Medical College

Find a way to celebrate this holiday season that includes and validates those who may be in recovery.

May 29, 2018 | 2 min read

Love At First Sight

By Margaret Chisolm, MD, Johns Hopkins Medicine

A clinically excellent physician always takes the time to ask his/her patient about the history of substance use in their parents and siblings, as well as aunts, uncles, grandparents, and cousins; and always asks about adoption.

March 13, 2018 | 2 min read

Reading Your Patient and Changing Your Plan

By Mike Fingerhood, MD, Johns Hopkins Medicine

We usually already have an agenda set when we see patients. However, we have to be ready to improvise by reading the patient, and be open to changing our plan.

December 19, 2023 | 3 min read

Spinoza and 21st-century medicine

By Jonathan McFarland, Medical Humanist, Autonomous University of Madrid & University of Pompeu Fabra

I learned about the mind-body connection from the philosopher Spinoza. A holistic clinical approach emphasizes the relationship between mental well-being and physical health. 

February 13, 2020 | 2 min read

Takeaways from “Long Walk out of the Woods”

By Shannon Scott-Vernaglia, MD, Mass General

Sometimes sharing our own struggles with patients can highlight our shared humanity and provide them with hope.

October 10, 2024 | 1 min read

Trust and truth

Nonjudgmental communication can help us understand the true nature of a patient’s condition and motivations. Connecting more deeply with a patient over time allowed us to learn more of the story. 

February 12, 2024 | 2 min read

Recognizing and treating substance use disorders in healthcare professionals 

By Gregory Hobelmann, MD, MPH, President of Ashley Addiction Treatment

Healthcare professionals are at least just as vulnerable to substance use disorders as the general public. It never occurred to me that I may be among those numbers, but I am. 

November 19, 2020 | <1 min read

Quitting Smoking During The Pandemic

By Panagis Galiatsatos, MD, Johns Hopkins Medicine

Remind patients that quitting smoking is hard and takes time. This will help them take a first step toward better health.

October 31, 2023 | 2 min read

It is 4 a.m.

By David Kopacz, MD, University of Washington

Burnout and emotional detachment are common in medical training. Being aware of this and truly listening to patients can help us renew our compassion.

September 24, 2019 | 1 min read

Counseling Patients on the Dangers of E-cigarettes

By Panagis Galiatsatos, MD, Johns Hopkins Medicine

E-cigarettes pose unique health risks. Screening and informing our patients of these concerns is imperative.

August 1, 2018 | <1 min read

Introducing “A CLOSLER Look”

By Gretchen Miller, Managing Editor

Check out the first video our new weekly series, “A CLOSLER Look,” featuring short and sweet interviews with clinically excellent physicians. On tap today - psychiatrist Dr. Margaret Chisolm.

June 4, 2018 | 2 min read

Half Baked

By Wilma Ferthler, MD, Rural Country Doctor, Northeast Kingdom, Vermont

Your monthly dose of comic relief from William Osler's long lost cousin Wilma Ferthler.

August 21, 2018 | 1 min read

Talking With Young Adult Patients About Alcohol

By Mike Fingerhood, MD, Johns Hopkins Medicine

Clinicians need to be vigilant to discuss alcohol use with patients and remember that the legal drug, alcohol, causes more morbidity and mortality than opioids.

"Heart Meditation," original painting by the author. Copyright by the author.

March 19, 2020 | 3 min read

Returning to Medicine of the Heart During a Pandemic

By David Kopacz, MD, University of Washington

How can we practice the kind of medicine that we so desperately need right now? Perhaps it is time to return to a medicine of the heart and of the soul.

April 14, 2022 | 3 min read

Afraid to Tell The Truth

By Kirsten Elin Smith, PhD, National Institute on Drug Abuse

When I shared with my clinician that I had previously been a heroin user, she made me feel ashamed. This taught me the importance of listening to patients with nonjudgmental curiosity. 

May 6, 2024 | 2 min read

A lesson in humility

By Jonathan McFarland, Medical Humanist, Autonomous University of Madrid & University of Pompeu Fabra

All patients deserve to be treated with respect, listened to attentively, and seen as individuals.

One way to fight ableism it to ensure that all conferences and events are wheelchair accessible.

October 14, 2020 | 2 min read

How Language Can Fight Ableism

By Harry Paul (he/him), MD/PhD student, Johns Hopkins Medicine

The first step to being an ally for the disabled community is to educate yourself about the meaning of your word choice.

Employers must cultivate a nurturing culture that supports the emotional and physical needs of their employees.

February 9, 2021 | 3 min read

How to Support Patients With Chronic Pain and Substance Use Disorder

By Juliette Perzhinsky, MD, MSc, Central Michigan University

All patients must be treated with empathy. Those suffering with chronic pain and addiction may be especially deserving of compassion.

May 28, 2019 | 3 min read

Supporting my Patients who Smoke

By Panagis Galiatsatos, MD, Johns Hopkins Medicine

It's important to make sure that the responsibility for addressing tobacco dependence is placed on the shoulders of clinicians, and off of the shoulders of the afflicted.

April 23, 2020 | 1 min read

Bibliotherapy

By Scott Wright, MD, Johns Hopkins Medicine

Happy World Book Day! Read more fiction to broaden your perspectives. If you've never listened to an audiobook, try it! It might just change your life!

April 14, 2022 | 1 min read

Supporting Young Adults Who Use E-Cigarettes

By Panagis Galiatsatos, MD, Johns Hopkins Medicine

When talking with young patients about tobacco dependence, first create a judgment-free zone and ask open-ended questions to understand why they use the product. 

"Facilitate finding new ways of having fun and staying busy. Recovery is not punishment."

April 3, 2018 | 1 min read

10 tips to support patients with a substance use disorder

By Mike Fingerhood, MD, Johns Hopkins Medicine

I’ve devoted my entire career to supporting patients with substance use disorders (SUD). Here are the top 10 tips that I’ve learned over the past few decades.

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