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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
Topic Search
August 14, 2023 | 3 min read

Accentuate The Positive

By Megan Gerber, MD, MPH, Albany Medical College

Sometimes interactions with patients may feel challenging. Expressing gratitude to patients for positive encounters may help reduce stress and bring joy.

May 19, 2025 | 3 min read

The moral injury of divergent healthcare goals 

Moral injury can arise when there’s a tension between business goals and clinicians' mandate to serve patients. Encouraging transparency and commitment to reconverging these goals may improve understanding and lessen distress among hospital administrators, healthcare professionals, and patients.  

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.

June 19, 2019 | <1 min read

Dr. William Ravekes, A CLOSLER Look

By Gretchen Miller, Managing Editor

Taking the time to build trusting relationships with kids and their families is essential.

November 12, 2025 | 2 min read

Paternal insight 

My patient’s father reminded me that exceptional care goes beyond knowledge—it’s also the humility to admit uncertainty and the skill to forge collaborative partnerships with patients and families. 

January 19, 2023 | 2 min read

With Only a Nod

By Becky Sansbury, MDiv, Raleigh, North Carolina

Sometimes the best care we can give is to be quiet, observant, and appreciative of our patient’s sharing a life-changing moment.

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.

July 16, 2024 | 3 min read

A box full of hope 

While working as a doctor in Cameroon, I learned that the most valuable resources aren’t always technological. Instead, generosity, kindness, and human connections may be most important for making healthcare more widely accessible. 

December 23, 2020 | 5 min read

Holiday Rounds

By Samuel Durso, MD, Johns Hopkins Medicine

If you're called on to work through Christmas and New Year’s, there's a bright side. This is typically a quieter period and may allow more time to learn from clinically excellent role models.

The author's pediatrician was an early role model in her development as a neurologist.

October 15, 2018 | 1 min read

Respect, Empathy, and Communciation

By Andrea Corse, MD, Johns Hopkins University School of Medicine

My approach to care is to provide the kind of care you would want for yourself and your family.

October 21, 2021 | 2 min read

Be a Team Player: Get Vaccinated

By Alexis Coslick, DO, MS, Johns Hopkins Medicine

Be a teammate to everyone in your community. Get vaccinated and encourage others to do so.

June 26, 2019 | <1 min read

Dr. Panagis Galiatsatos, A CLOSLER Look

By Gretchen Miller, Managing Editor

We need to think of ourselves as community members who happen to be clinicians.

February 13, 2024 | 3 min read

Unsent letters from a palliative care doctor to a patient and her dog 

By Lingsheng Li, MD, MHS, University of California, San Franscisco

Sometimes we never get the chance to tell a patient what we admire about them. After my patient died, I realized I’d been inspired by the inner strength she showed by caring for her dog despite health and life challenges. 

November 11, 2025 | 1 min read

Purpose shapes practice

I found more meaning in my work when I stopped treating “cases” and started seeing people. Compassionate attention became my most effective clinical tool.

January 17, 2023 | 2 min read

Finding Meaning

By Jaime Jump, DO, Texas Childrens Hospital

When my seven-month-old-patient suffered severe neurological damage, despite having little to offer medically, I remembered I could still support her mother through this tragedy. Taking solace in this helps me to be present for my other patients. 

June 15, 2020 | 1 min read

Getting CLOSLER: A Note to Our Readers

By Margaret Chisolm, MD, Johns Hopkins Medicine, Scott Wright, MD, Johns Hopkins Medicine

For two years, CLOSLER has been stimulating healthcare professionals and trainees to reflect on giving exceptional care to every patient.

July 8, 2024 | 2 min read

Suturing stories 

By Andrea Merrill, MD, Boston Medical Center

By using writing to process patient care experiences, I'm able to learn from challenging events at work and find more meaning in medicine. 

April 25, 2018 | 1 min read

How To Maintain Joy In Practice

By Steve Kravet, MD, MBA, Johns Hopkins Community Physicians

Maintaining joy in practice requires deliberate attention. The emotional and physical investments demanded by healthcare professions are additive and contribute to high levels of stress and burnout. Mitigating this trend requires effort and attention on the part of all stakeholders.  

October 8, 2018 | <1 min read

Alleviating Patients’ Emotional Burden

By Paul Manson, MD, Johns Hopkins University School of Medicine

My approach to clinical care involves making a dual diagnosis for each patient: identifying the problem, and understanding how that problem affects the patient psychologically and emotionally.

August 3, 2023 | 3 min read

A Glass of Milk

By Kyle Glienke, MD, Buena Vista Regional Medical Center, Iowa

When I was working with my grandpa as a dairy farmer, he said what made it all worth it was knowing how many children needed the milk. As a doctor, I find meaning by reminding myself how many people need care. 

May 24, 2018 | 2 min read

My Professional Totem

By Margaret Chisolm, MD, Johns Hopkins Medicine

A psychiatrist shares her story of how a painting by Raphael has reminded her of of why she wanted to become a doctor and what the profession of medicine is all about.

June 12, 2019 | <1 min read

Dr. Jamie Wright, A CLOSLER Look

Making the time to ensure that patients understand what you are teaching them about their bodies will help them make better decisions about their care.

January 11, 2023 | 3 min read

Joy in Primary Care 

By Jane Abernethy, MD, MBE, Johns Hopkins Medicine

Meaningful longitudinal primary care relationships with patients are fulfilling and rewarding. Modeling for trainees that this career path can be gratifying and fun is vital. 

July 30, 2020 | 2 min read

Taking a Moment to Pause

By Jareatha Abdul-Raheem, Med Student, Johns Hopkins Medicine

When hearing disappointing news or encountering stress, making time to step back and reassess may help with coping and gaining perspective.

August 13, 2018 | 1 min read

How I Uphold My Hippocratic Oath

By Marcia Canto, MD, Johns Hopkins University School of Medicine

I try to take care of each patient as if he or she is my close relative or friend. I believe this is the only way that we can uphold our Hippocratic oath in the modern era of medicine, which tends to depersonalize physician-patient interactions. 

November 2, 2020 | 4 min read

Prescription for a healthy future—vote!

By Deanna Behrens, MD, Advocate Children\'s Hospital, Elizabeth Mack, MD, Jenna Miller, MD, Katherine Hoops, MD, Johns Hopkins Medicine

Clinicians have a responsibility to advocate for policies that can improve the health of all. We must take our civic responsibility seriously and make a plan to vote. 

"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.

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. 

April 22, 2025 | 5 min read

Let the language live 

Daily clinical interactions, marked by honest communication and empathy, hold unique power for healing and justice. 

Photograph by Sheldon H. Gottlieb, MD, (c) 2018, all rights reserved.

June 5, 2018 | 2 min read

Clinical Excellence: It Takes A Village

By William Greenough, MD, Johns Hopkins University School of Medicine

The key to clinical excellence in long term care rests not solely on the physician, but also with hands-on bedside caregivers—the unsung heroes of healthcare—nurses, and in this patient story, a recreational therapist.

June 5, 2019 | <1 min read

Dr. David Hellmann, A CLOSLER Look

By Gretchen Miller, Managing Editor

The greatest joy is to know your patients as people.

February 6, 2024 | 2 min read

Co-bearers of suffering

By Mike McCarthy, MD, Johns Hopkins Medicine

Sometimes a patient’s pain can’t be eliminated. However, we can still walk with them as a co-bearer of suffering. 

October 23, 2025 | 2 min read

Move over FOMO 

ROMO—the Relief of Missing Out—is the burnout antidote you can start tonight. Consider skipping the next conference and protecting your weekends to have energy to give exceptional care to every patient. 

June 1, 2020 | 3 min read

Tribute to the Med School Class of 2020

By Donald Berwick, MD

The pandemic is an ongoing reminder of the privilege of caring for our fellow humans. It also gives healthcare professionals the opportunity to reconnect with our deepest values—healing, justice, equity, respect, and love for our work.

June 27, 2024 | 2 min read

Lessons from earlier in life: from public school teaching to doctoring  

By Tyler Mains, MD, University of California, San Francisco

I apply the principles I learned as a public school teacher to patient care: asking insightful questions, seeing the whole person, and fostering motivation for positive change. 

October 27, 2020 | 3 min read

Beyond The CV

By Kayla Eboreime, Medical Student, University of Texas Medical Branch

There will always be both accolades and critiques that come your way. Neither define who you are. Nourishing your whole self can maintain balance so that you can flourish professionally and personally.

September 24, 2018 | 1 min read

Healing, Counseling, and Consoling

By Satish Shanbhag, MBBS, MPH, Johns Hopkins University School of Medicine

An essential part of clinically excellent care is empathy with our patients—a trait that can be cultivated by visualizing ourselves as an extension of our patient’s family helping them get through a rough patch in life.

July 19, 2023 | 2 min read

Sacred Spaces

By Eric Last, DO, Northwell Health, Wantagh, New York

Patients often experience the most vulnerable moments of their lives with clinicians. These shared intimacies refuel my passion for caregiving and are a fulfilling part of medical practice.  

August 24, 2021 | 2 min read

5 Lessons From my Nonlinear Career in Medicine

By Thelben Mullett, MD, Seattle, Washington

Instead of asking medical students what specialty they intend to pursue, we should help them reflect on their natural strengths and values in planning their career.

November 10, 2023 | 2 min read

Final journeys

By Elizabeth Gundersen, MD, University of Colorado

Today, we remember patients who have served our country. We are grateful for the honor and privilege of caring for these veterans through their final journeys.

October 20, 2025 | 2 min read

White coat/blue gown 

When I became a patient, loss of control helped me realize how much trust I needed to place in my doctor. As a clinician, I will remember my experience and the need to build trust with candor and clear communication. 

July 8, 2020 | 2 min read

Appreciating ALL Healthcare Workers

By Gaye Cunnane, MD, PhD, Trinity College Dublin

All healthcare workers contribute meaningfully to the care of patients. Taking the time to offer a kind word to those who may be underappreciated can make an enormous difference.

June 26, 2024 | 2 min read

White Coat Ceremony 

By Richard Schaefer, MD, MPH, Johns Hopkins Medicine

Medical school traditions and ceremonies are to be cherished and appreciated. They also provide educators with an opportunity to reflect on the importance of teaching and mentoring. 

September 22, 2020 | 1 min read

Voting as part of clinical excellence

By Margot Kelly-Hedrick, MD, University of Washington

Voting is a way you can advocate for your patients and improve health outcomes.

March 5, 2018 | 2 min read

Introducing Monday Mission and Values Statements

By Gretchen Miller, Managing Editor

Begin with the end in mind. ~Stephen Covey

July 12, 2023 | 3 min read

Act now: save the planet

By Evans Brown, MD, Johns Hopkins Medicine

Climate change is a public health emergency. As healthcare professionals, we have a responsibility to advocate for reducing carbon emissions to ensure everyone’s health. 

May 25, 2018 | <1 min read

“The Secret of Quality is Love”

By Scott Wright, MD, Johns Hopkins Medicine

Connecting with patients, caring deeply, and remembering your sense of calling will bring joy and fulfillment to the practice of medicine.

June 4, 2019 | 3 min read

Haiku on Phone

By Crystal Jing Jing Yeo, MD, PhD, MassGeneral, Brigham and Women Hospital, Harvard Medical School

To be a true healer is to heal not just in life, but also through dying and death.

January 29, 2024 | 2 min read

Life after grief 

By Jaime Jump, DO, Texas Childrens Hospital

I was invited to a baby shower for the sibling of a baby who had died in my care. Talking with the parents taught me that beyond sadness, there can be hope and joy.  

October 15, 2025 | 3 min read

Mea culpa 

When speaking with a patient who was upset about the long wait time, I reminded myself to apologize without excuses and center the patient’s reality over my schedule. 

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