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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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August 24, 2022 | 2 min read

Conversations With Those Who Are Vaccine-Hesitant

By Joan Park, MD, Johns Hopkins Medicine

Talking about vaccines with patients can sometimes feel challenging. Extending empathy, sharing your own story, and being honest about potential side effects can be helpful. 

May 9, 2019 | 2 min read

Ending Conversion Therapy

By Carl G. Streed Jr., MD, MPH, Boston Medical Center

Speaking up to end conversion therapy is fulfilling one of our fundamental oaths: primum non nocere—first do no harm.

November 13, 2019 | 4 min read

The Art of Scaffolding Conversations

By Robert Trevino, MD, PhD, Medical College of Wisconsin

Scaffolding when communicating is meeting the other person where they are in their understanding. This is essential for healthcare discussions to best meet the needs of our patients.

February 1, 2021 | 2 min read

The Emperor’s New Curtains

By Charlotte Squires, MBChB, Borders General Hospital, Scotland

Clinically excellent physicians consider the setting of private conversations with patients and families. Quiet rooms with a door that closes are ideal for sensitive discussions.

Autumn leaves

October 5, 2021 | 1 min read

The Sound of Silence

By Michelle Warncke, MBBS, MSc, North Carolina

Creating silent moments when talking with patients gives them time to process and the opportunity to share concerns that may not otherwise be spoken.

September 6, 2018 | 2 min read

Intimate Partner Violence: How to start a conversation with your patients and staff

By Michelle Patch, MSN, Johns Hopkins University School of Medicine

Preparing and coaching your healthcare team to have open, honest dialogues with patients about Intimate Partner Violence is essential. Failure to screen and address this matter is dangerous, while doing so can save lives.

Conversations

August 1, 2019 | 3 min read

Mindset and the Power of Yet: A Conversation With Dr. Gurpreet Dhaliwal

By Sam Kant, MD, Johns Hopkins University School of Medicine

Excellent clinicians are also thoughtful mentors. Mentors are like beacons as we navigate our path forward.

June 20, 2019 | 2 min read

Be Brave Enough to Start Conversations That Matter

By Manasa Ayyala, MD, Rutgers New Jersey Medical School

"Between the World and Me" is a must read. At 152 pages, it's a small investment of time that leaves a large impact. I invite you to read this book with the intent to ask curious questions, to be ok feeling uncomfortable, and to continue this important dialogue.

March 10, 2022 | 1 min read

Balanced Conversations About Weight

By Colleen Schreyer, PhD, Johns Hopkins Medicine

Clinicians can treat weight as simply one more piece of health information that they incorporate into a holistic care plans. This can mitigate stigma and foster empathy. 

August 16, 2022 | 2 min read

Outbreaks as Opportunities

By Jade Cobern, MD, Johns Hopkins Bloomberg School of Public Health

Talking about monkeypox and the return of polio can remind caregivers that vaccinating young children against other illnesses is essential.

May 12, 2020 | 1 min read

Jump-start End of Life Discussions With “Death Over Dinner”

By Katie Nelson, PhD(c), MSN, RN, Johns Hopkins University School of Nursing

The pandemic has created a sense of urgency around advance care planning and end of life preparations. Resources like "Death Over Dinner" can help broach conversations about death, dying, and the end of life in a non-threatening (and even entertaining) manner.

February 4, 2020 | 4 min read

How to Respond to Questions About CBD

By Ryan Vandrey, PhD, Johns Hopkins Medicine

With the massive expansion of interest in CBD products, clinicians need to know how to address their patients' questions.

August 26, 2020 | 6 min read

How to Discuss Minority Stress With Patients

By Chase Anderson, MD, University of California San Francisco

If your patient identifies as part of a minority group, it could be helpful to ask if they’ve experienced stress because of this. Doing so may allow you to better understand your patient’s story.

May 23, 2022 | 2 min read

Communication: A Chaplain’s-Eye View

By Peter Heikkinen, MDiv, Johns Hopkins Medicine

Hearing, acknowledging, and appreciating the patient’s perspective is central to effective communication. 

March 5, 2020 | 3 min read

How to Talk About Miracles

By Jonathan Yeh, MD, Johns Hopkins University School of Medicine

Excellent clinicians can learn and practice techniques to boost the power of hope, and to incorporate the wish for a miracle into a more realistic care plan.

February 24, 2020 | 1 min read

“StoryCorps” Moments

By Sharon Solomon, MD, Johns Hopkins Medicine

Taking the time to listen to patients' stories validates the humanity that is integral in the practice of medicine. It also can create meaning and bring joy within the patient-clinician dyad.

April 13, 2020 | 3 min read

Social Distancing, Not Emotional Distancing

By Loveleena Virk, MD, Kaiser Permanente, Oakland Medical Center, California.

Creating space to recognize and manage feelings of helplessness is critical to prevent burnout and maintain wellness during the pandemic. We share strategies in this piece to help you cope during these challenging times.

"Rinaldo and Armida," 1629, Anthony van Dyke. Public domain.

September 4, 2019 | 7 min read

From Frameside to Bedside: Pauses and Perspective

By Kamna Balhara, MD, Johns Hopkins Medicine

The art of medicine must balance stillness and motion. Making time to reflect can infuse more meaning in our interactions with patients.

March 11, 2020 | 3 min read

Saturdays With Mr. Hargett

By Yolonda Wilson, PhD, 2019-2020 Fellow at the National Humanities Center and 2019-2020 Encore Public Voices Fellow

Loneliness is an epidemic. Being aware of this, asking about it, and empathizing can make a world of difference.

July 9, 2019 | 5 min read

Pain, Opioids, and the Constant Shadow of Stigma

By Travis Rieder, PhD, Johns Hopkins Berman Institute of Bioethics

When a patient reports pain, their words need to be met with listening, compassion, and a discussion of how best to address the pain.

Dr. Susan Harvey

July 10, 2019 | <1 min read

Dr. Susan Harvey, A CLOSLER Look

By Gretchen Miller, Managing Editor

When talking with patients, sitting down at the same level that they are sitting can help them relax.

April 14, 2022 | 2 min read

“Explainaholics”

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

Sometimes patients and caregivers feel overwhelmed when clinicians provide too much information. When you sense this to be the case, offering clear recommendations can be helpful.

July 9, 2018 | <1 min read

On Clipping Nails

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

Making a moment for foot care creates an opportunity to bond with my patient and strengthen our relationship.

April 5, 2022 | 1 min read

Playing “Out of Book”

By Jeffrey Millstein, MD, Penn Medicine

Unexpected statements from patients can force clinicians to improvise. As in chess, it helps to view these as challenges with potential rewards.   

January 24, 2023 | 2 min read

Blueberry Bushes

By Marcus Maier, PA, University of Wisconsin-Madison

A patient’s main concern is sometimes not medical. It can be helpful to ask, “Is there anything we didn’t cover that you’d like to talk about?”  

September 29, 2020 | 4 min read

Respecting All Patients

By Chase Anderson, MD, University of California San Francisco

Using your patient’s correct pronoun at all times is critical to supporting their mental well-being.

April 26, 2019 | 2 min read

Building Authentic Rapport

By Leslie Ordal, MSc, CGC

Building rapport is about meeting patients where they are and showing that you’re putting their concerns first. Strong rapport transforms a clinical interaction into a human interaction, which is the heart of patient-partnered care.

June 21, 2021 | 2 min read

Seen But Not Heard

By Nick Sawyer, MD, MBA, University of California, Davis

Some patients sense that their stories aren’t appreciated. Taking the time to sit and listen to patients can build trust and begin to restore their faith in the healthcare system.

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.

November 18, 2021 | 3 min read

Adequate Bandwith

By Jennifer Eitingon, MD, Johns Hopkins Medicine

Recently, a patient dying of cancer requested CPR despite many clinicians advising against it. When it feels challenging to understand a patient’s decision, I remind myself to consider the situation from a different perspective.

February 28, 2022 | 4 min read

To Our Interpreters: Gracias, Shukriyah, Todah, Danyavad, Merci, Danke

By Cecilia Murach, Medical Interpreter, Johns Hopkins Medicine, Kamna Balhara, MD, Johns Hopkins Medicine, Nathan Irvin, MD, Johns Hopkins Medicine

When working with an interpreter, remember that they’re a person, not a machine. Saying “thank you” makes them feel like a valued member of the healthcare team. 

November 16, 2020 | 5 min read

Breaking Bad on Video

By Mark Taubert, MD, Cardiff University, Wales

Traditionally, grave medical news is shared in person; we're now having to do so virtually. During such conversations, try to infuse as much warmth and compassion as possible.

"Imperial Purple," by Spencer Finch. Photo copyright with the authors.

July 20, 2020 | 6 min read

Art and Connection During COVID-19

By Kamna Balhara, MD, Johns Hopkins Medicine, Sarah Clever, MD, Johns Hopkins Medicine

In a time of physical distancing, stepping out of our comfort zone to find creative and unconventional ways to connect with patients and colleagues can bring us together.

A crowd organized by the Student Non-Violent Coordinating Committee sang “We Shall Overcome” in Farmville, Virginia, in 1966, after a speech by Stokely Carmichael.

January 18, 2019 | 9 min read

From Clinic to Senate

By Kali Cyrus, MD, MPH, Johns Hopkins Medicine

Advocacy does not have to mean changing legal precedents; it can also be taking a mentee out for coffee, giving feedback about your colleague’s stereotyping of a patient, or not patronizing restaurants with unfair wage practices.

Now is the perfect time to seek collaborators for an idea you’ve had brewing. While your idea might not result in a masterpiece like da Vinci's "Vitruvian Man" (~1490), it will reduce feelings of social isolation.

April 9, 2020 | 3 min read

Mentoring While Social Distancing

By Ruth Gotian, EdD, MS, Weill Cornell Medicine, Weill Cornell Mentoring Academy

The pandemic is a critical time for clinically excellent role models to continue mentoring. Separation creates opportunities to connect in new ways.

The Juneteenth Star.

June 17, 2021 | 5 min read

Lessons From 1865: What Clinicians Can Learn From Juneteenth

This weekend we can work toward unlearning inaccurate history, practice critical reflection, engage in transformative conversations, and plan to take action that will promote health equity for all patients.

November 6, 2019 | 3 min read

Songs From Hospice

By J Lind, Dale Fellow and touring songwriter, Nashville, Tennesse

It's the details of the patient's story that transforms them into a person.

Hippocrates featured in the interior of the old town hall in Gõttingen, Niedersachsen, Germany. Public domain, Wikimedia Commons.

February 20, 2020 | 3 min read

“Life is short, and art long”

By Jonathan Yeh, MD, Johns Hopkins University School of Medicine

The art of honest and empathetic communication is fundamental to being an excellent clinician. And, it can be improved with intentional practice.

April 6, 2021 | 2 min read

How to Respond to Unexpected Things Your Patient Tells You

By Shireen Heidari, MD, Stanford University

When a patient shares something that really catches you by surprise, listen closely and ask open-ended questions to fully understand their perspectives.

September 17, 2020 | 3 min read

5 Tips for Talking About Autopsy Results With Your Patient’s Family

By J. Stephen Nix, MD, Johns Hopkins Medicine

Managing loved ones’ expectations before the autopsy is critical. Ensuring there's ample time to privately review and explain the results can help bring meaning and closure to their loss.

May 30, 2019 | 9 min read

Confessions of a Female Doctor who Questions Gender Equity Movements Like TIME’S UP Healthcare

By Kali Cyrus, MD, MPH, Johns Hopkins Medicine

We have to embrace humility and first accept that we have biases, prejudices, and privileges in certain contexts. We must then do the hard work of recognizing when our biases show up in interactions, examine our past experiences that contributed to the development of our biases, and acknowledge the hurt that may be caused by our biases to ourselves and others. If we truly want to stop harassment and create equity, we have to do this emotional work every day. And we should do it to stop harassment and create equity for not just women, but for everyone.

December 14, 2022 | 1 min read

Choosing The Right Words

By Jeffrey Millstein, MD, Penn Medicine, Lori Jia, medical student, Penn Medicine

Using connecting language to seek deeper understanding of patients’ concerns may add richness to clinical encounters and help them feel safe. 

February 6, 2020 | 2 min read

Navigating Masculinity in Medicine

By Kultaj Kaleka, MD, RN, Central Michigan University

The clinically excellent physician understands that male patients may need support sharing their perspectives.

June 25, 2021 | 3 min read

“Tell me About Yourself”

By Aidan Crowley, Medical Student, University of Pennsylvania

During my recent experiences interviewing for med school, I learned that the best interviewers, like the best clinicians, focused on my comfort and let our conversation flow naturally. Such prioritizations promote deeper human connections

March 19, 2019 | 3 min read

Reversing the Backslide: Sexually Transmitted Infections in the US

By Matthew Hamill, MBChB, PhD, Johns Hopkins Medicine

Open, non-judgmental, respectful, medically-relevant conversations need to be the cornerstone of all therapeutic relationships. As long as patients feel valued and at the center of their care, patients are willing to engage in discussions about sexually transmitted infections.

August 31, 2022 | 2 min read

Reducing Overdose Risk For Minority Patients 

By Brendan Saloner, PhD, Johns Hopkins Medicine, Omeid Heidari, PhD, NP, MPH, Johns Hopkins Medicine

When caring for patients with opioid and other substance use disorders, focus on using tools such as evidence-based medications, naloxone, and fentanyl test strips. 

August 25, 2022 | 3 min read

Hugs Are Medicine

By Aidan Crowley, Medical Student, University of Pennsylvania

Showing genuine warmth is a compassionate way to comfort our patients. 

November 10, 2021 | 5 min read

Reading Between The Lines

We don’t always say what we’re thinking, particularly in difficult conversations. Sharing and exploring unspoken thoughts can lead to stronger connections with our patients and better care.

October 24, 2019 | 1 min read

The Art of Talking About Death

By Michelle Gyenes, MS, Columbia Mailman School of Public Health

The clinically excellent clinician engages in honest conversations about death and dying with patients and their families.

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