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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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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.   

October 25, 2018 | 1 min read

Stepping Over the Curb

By Khalil Ghanem, MD, PhD, Johns Hopkins University School of Medicine

While curbsiding a colleague may get you a quick answer and spare the consultant from needing to complete a formal consultation, there are certainly perils with this practice. Buyer beware!

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. 

March 10, 2022 | 2 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. 

March 17, 2025 | 7 min read

Caring and uncaring in medicine and beyond 

By David Kopacz, MD, University of Washington

Every moment in medicine, and in life, we have the choice to base our actions in caring.  

The Bluebird Cafe, Nashville, Tennessee. Copyright by the author.

May 11, 2020 | 3 min read

Redefining Rounds—Will The Circle be Unbroken?

By Chase Webber, DO, Vanderbilt University Medical Center

A patient care team performs best when all voices harmonize and creative approaches are applauded.

September 1, 2021 | 2 min read

What’s The Problem?

By Ben Roberts, CRNP, AGACNP-BC, ACHPN, Johns Hopkins Medicine

Systematically formulating a clear statement of the patient’s problem can be incredibly helpful. This may improve your diagnostic reasoning and ability to formulate more effective therapeutic plans.

January 9, 2025 | 2 min read

Caution: red tape ahead  

By Katharine Russo, PharmD, Johns Hopkins Medicine

Holistically caring for patients includes helping them navigate healthcare systems. Take time to support already stressed patients through the frustrating and opaque processes of insurance and prior authorizations. 

March 12, 2020 | 4 min read

What I learned from my primary care mentors

By Colleen Farrell, MD, New York University

All of us can learn from primary care clinicians, who know that listening, compassion, and connection are the foundations of clinical excellence.

August 16, 2021 | 3 min read

The Heart of Clinical Reasoning

By Susrutha “Sus” Kotwal, MBBS, MD, Johns Hopkins Medicine

Making a diagnostic error reminded me that connecting with patients on a personal level is necessary for optimal clinical reasoning.

October 3, 2024 | 2 min read

Patient time 

By Katherine Majzoub Morgan, MD, Brigham and Womens Hospital

Ask patients if they are concerned about the amount of time it takes to engage with health care systems. For those who are, include time as a factor in shared decision-making conversations. 

June 7, 2021 | 2 min read

It’s Not About Weight

By Nicole Cifra, MD, MPH, University of Rochester

Approaches employed by eating disorder specialists can be applied to support all patients. This includes emphasizing healthy behaviors and acknowledging your own assumptions about weight.

May 3, 2018 | 5 min read

Challenges, Choices, and Changes

By Catherine Parrish, MD, Johns Hopkins Community Physicians

CHALLENGE yourself to be a lifelong learner—make CHOICES in your career that make you HAPPY, and use the CHANGES in your personal life to inform and enrich your work.

August 7, 2024 | 3 min read

“Far from the madding crowd” 

By Kittane "Vishnu" Vishnupriya, MBBS, Johns Hopkins Medicine

Every extra hour that a patient spends in the ER worsens mortality. Clinicians can make changes to address this problem, like reorganizing rounding to see potential discharge-ready patients first.

May 16, 2024 | 2 min read

Two coats in one small room: caring for another clinician 

Caring for another clinician is complicated and requires special thoughtfulness; false assumptions about what the “clinician-patient” understands may result in suboptimal care.    

July 1, 2019 | 1 min read

Looking Under the Hood

By Daniel Minter, MD, University of California, San Francisco

Promoting a culture of thinking out loud can demystify the process of clinical reasoning and make it accessible to all learners.

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. 

June 18, 2019 | 2 min read

Navigating the Uncertain: A Book Review of “The Laws of Medicine”

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

Siddhartha Mukherjee, MD, provides a framework to reconcile the uncertainties we constantly experience in our practice of medicine in his book, "The Laws of Medicine."

March 20, 2019 | 4 min read

Social History as Story

By Colleen Farrell, MD, New York University

We cannot understand our patients’ bodies if we do not understand something about who they are as human beings,

July 10, 2018 | 1 min read

Pause Before Hospitalizing the Elderly

By Samuel Durso, MD, Johns Hopkins Medicine

Confusion among hospitalized older adults is common and dangerous. The hospital environment should be avoided if at all possible, with a goal of managing acutely ill older adults at home.

March 13, 2019 | <1 min read

Dr. Elliot Fishman, A CLOSLER Look

By Gretchen Miller, Managing Editor

Artificial intelligence (AI) will drastically alter all of medicine, with the potential to enhance patient care through improved diagnoses.

August 15, 2023 | 2 min read

The Importance of Humanities in Medicine

By Mike McCarthy, MD, Johns Hopkins Medicine

Engaging with and studying the humanities can help us give better patient care. Literature, art, and history remind us that patients are whole persons with lives that exist beyond medical problems. 

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.

May 30, 2023 | 2 min read

Artificial Intelligence: Artificial? Intelligent? Neither or Both?

By Matthew Peters, MD, Johns Hopkins Medicine

AI can complement the work of mental health professionals, in addition to performing clerical tasks and analyzing big data for insightful trends.

February 12, 2019 | 6 min read

The Balancing Act: Learning to Thrive in Multipatient Environments

By Alim Pardhan, MD, McMaster University, Ken Van Dewark, MD, University of British Columbia, Teresa Chan, MD, McMaster University

We must ensure junior doctors can give one patient excellent care before asking them to balance caring for more than one patient.

February 2, 2023 | 2 min read

We Just Disagree

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

When colleagues offer a conflicting opinion, remember to always put the patient first, check your facts, and be open to learning.  

February 11, 2019 | 5 min read

The Dots We Connect – An Interview with Dan Pink

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

Dan Pink distills pearls of wisdom for health professionals from his bestselling books "A Whole New Mind" and "When."

April 10, 2018 | 3 min read

Finding Beauty In Your Inbox

By Scott Wright, MD, Johns Hopkins Medicine

Sometimes, beauty and inspiration are inches away from our eyes, glowing at us from the blue light of our screen. Dr. Wright shares a moving story from a recent email exchange between a resident and attending.

October 7, 2024 | 1 min read

The science and art of medicine 

By David Hellman, MD, Johns Hopkins Medicine

Clinical excellence is the first kindness a physician can offer a patient. A foundational pillar of outstanding clinical care is arriving at the accurate diagnosis. 

July 16, 2019 | 3 min read

3 Lessons in Hospitality From my Patient

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

Hospitality is a human connection through the gift of attention and care. When hospitality becomes our modus operandi, care is transformed from transactional to sacred.

March 20, 2024 | 2 min read

“HEARTS”  

Creating and appreciating art as part of professional development can foster connection, promote well-being, and cultivate empathy. It can also provide opportunities for self-reflection. 

Painting by David Kopacz, copyright with the artist.

July 11, 2023 | 5 min read

Partial Listening is Partial Medicine

By David Kopacz, MD, University of Washington

Sometimes we hear only what we're listening for, and if we divide attention, we can miss critical information. We must strive to Iisten with the "third ear" to hear not only what's said, but also what's unsaid. 

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