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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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May 5, 2025 | 3 min read

Pause. Process. Proceed.

To navigate the emotional aftermath of traumatic patient encounters, clinicians can utilize the ALL-CLEAR framework: Accept the event, Label emotions, Learn from it, take a moment to pause for breath, and CLEAR your mind. This may enable you to bring your whole self to the next patient while honoring your emotions. 

May 14, 2024 | 1 min read

ED overcrowding: every clinician can help

By Catherine Washburn, MD, Johns Hopkins Medicine

Collaboration between healthcare professionals across the hospital is crucial to reduce ED overcrowding and improve patient care. One thing clinicians can do is help patients leave the hospital as soon as they are ready. 

Independence Monument on the Maidan Nazalezhnosti. Kyiv, Ukraine.

March 17, 2022 | 1 min read

Hope in Times of Despair

By Eugene Shenderov, MD, DPhil, Johns Hopkins Medicine

As citizens we must work toward peace; as clinicians we must strive to heal and provide hope in the despair of illness. 

July 2, 2024 | 4 min read

Seeing

By Kamna Balhara, MD, Johns Hopkins Medicine

When patients present frequently to the ED, clinicians must make an effort to validate them as individuals. It's also important to be aware of and work to change the underlying social determinants that may drive their visits.

August 22, 2018 | <1 min read

Dr. Goldstein: A CLOSLER Look

By Gretchen Miller, Managing Editor

Check out our 4-minute YouTube interview with pediatric emergency physician Dr. Mitchell Goldstein, who shares how he's guided by the Golden Rule.

January 28, 2021 | 3 min read

Purple Nail Polish

By Shauna Maty, MPH, Medical Student, St. George University

Always remember that your patient is a person with a family, friends, and a unique story. Your first responsibility as a healthcare professional is to heal your patient and your second is to learn.

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.

July 11, 2024 | 2 min read

Protecting the most vulnerable from heat-related illnesses 

By Joanna Cohen, MD, Johns Hopkins Medicine

When caring for patients during heat waves, healthcare professionals should be aware of social determinants of health—like no air conditioning at home. Clinicians should know the available resources to recommend, such as cooling centers within the communities they serve. 

April 28, 2025 | 3 min read

Spotting victims—human trafficking is not uncommon 

Healthcare professionals have a unique opportunity to identify and help victims of human and labor trafficking. Read on for practical tips for how to recognize and support these patients. 

October 23, 2024 | 2 min read

Educated lucky: Making critical decisions without all the answers 

By Edana Mann, MD, Johns Hopkins Medicine

In critical care, we often make life-saving decisions with incomplete information. Teamwork is essential, and sometimes acting on our best-educated guess is the only option. These moments remind us of life’s fragility and the importance of trusting our instincts and each other. 

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.

August 7, 2024 | 2 min read

Squish the peas 

By Jonathan Reisman, MD, Cooper University Health Care

Toddlers offer invaluable lessons for healthcare professionals. By embracing curiosity and focusing on the present, clinicians may enhance patient care, reduce burnout, and improve overall well-being.

June 22, 2018 | 2 min read

Ars Medica: The Art of Medicine

By Javier de la Maza, MD, Johns Hopkins University

Storytelling is a powerful tool that can be used to shape our reality and reconnect with our patients. Building meaningful relationships with our patients reminds us the importance of the human experience in providing clinically excellent care.

"Sunflowers," Vincent van Gogh, 1889. Philadelphia Museum of Art.

May 2, 2019 | 4 min read

Grieving Unexpected Patient Outcomes

By Stacia Dearmin, MD, Akron Children\'s Hospital

Acknowledging and processing grief can bring healing to the clinician.

June 13, 2022 | 2 min read

3 Tips from the ED For All Healthcare Professionals

By Rodney Omron, MD, MPH, Johns Hopkins Medicine

Sharing appreciations with colleagues and learners is your superpower. Use it. 

August 10, 2020 | 1 min read

Debriefing After Death

By Christopher Bennett, MD, Stanford University

Reflecting on a patient's death as a team provides an opportunity to process emotions and strengthen team dynamics.

"Corridor in the Asylum," Vincent van Gogh, 1889. The Met Museum.

March 5, 2018 | 3 min read

Demystifying Psychiatry

By Margaret Chisolm, MD, Johns Hopkins Medicine

Demystifying psychiatry for patients is the heart of my work. In its existential aspects, psychotherapy calls for the imagination of alternative possibilities.

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. 

July 11, 2022 | 5 min read

Navigating Power Relations in Healthcare

By Hailey Haffey, PhD, University of Utah

We must be aware of the power we have in relation to our patients. This imbalance must only be used in the service 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. 

March 17, 2020 | 3 min read

Medicine is Like Poker

By Scott Wright, MD, Johns Hopkins Medicine

In medicine, uncertainty abounds. Poker can teach us how to make smarter decisions when we don’t have all the facts.

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. 

"Laine," by William Stoehr.

April 17, 2025 | 1 min read

HOPE

Art can foster hope for healing for those living with substance use disorders.

May 5, 2021 | 2 min read

Empathy Instead of Judgment

By Isaiah Crum, MD, University of Pittsburgh

Through the death of an infant patient, I was reminded of how integral being compassionate and non-judgmental is to clinical care.

November 9, 2022 | 2 min read

Trust

By Joanne Shay, MD, Johns Hopkins Medicine

While caring for a four-year-old girl diagnosed with lymphoma, I learned that acknowledging and validating patient and family fears strengthens relationships.

October 13, 2022 | 1 min read

Asking Hard Questions

By Thuy Ngo, DO, MEd, Johns Hopkins Medicine

In the ED, my adolescent patient shared that she was being sexually abused. It reminded me of the importance of creating a safe space for courageous conversations. 

David and John Launer in North Wales. Photo author's own.

January 7, 2020 | 3 min read

Like Father, Like Son—or Possibly Not

By John Launer, MD, London, United Kingdom

Would you advise young people to become a doctor? Reflection from a father and son below.

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.   

December 11, 2018 | 3 min read

Five Lessons From Architectural Design

By Diana Anderson, MD, MArch, Clincial Geriatrics Fellow, University of California, San Francisco

Architects are taught to respect context and design for the experience of being in a place. As providers, learning the context of our patients and their social determinants of health is key to the biopsychosocial model of care.

November 17, 2022 | 2 min read

Personalized Clinical Quality Improvement

By Jeffrey Krimmel-Morrison, MD, University of Washington

Use evidence-informed practices in your self-directed learning—build a case tracking system, work simulated cases, use quizzing, and seek new evidence efficiently. 

February 27, 2023 | 2 min read

Children Need Hospice Too

By Emily Johnson, MSN, RN, Johns Hopkins Medicine

Regularly reassessing goals of care is necessary during critical illness. This can help families maintain hope and realistic expectations. 

December 19, 2022 | 2 min read

Dismantling ableism in medicine

By Kerry Devlin, MMT, LPMT, MT-BC (she/her), Johns Hopkins Medicine

What does it mean to co-construct a plan of care with disabled patients? Their desires may not be what you expect.

June 12, 2023 | 3 min read

Art Makes Us Healthier And Happier 

By Susan Magsamen, MAS, Johns Hopkins Medicine

The arts yield measurable benefits to physical and mental health. They provide a way to slow down, experience our emotions and become more whole.

May 15, 2023 | 3 min read

Ode to Joy

By Joanne Shay, MD, Johns Hopkins Medicine

When I look for reasons to smile at work, I find them. Simple things like a hug from a colleague or listening to a patient share their story can brighten our days.

February 14, 2022 | 2 min read

Patients Admitted to Hospitals May be Sicker Than Ever 

By Scott Wright, MD, Johns Hopkins Medicine

Because of the pandemic, some patients have avoided healthcare settings and professionals. Outreach to these patients is needed. 

September 6, 2023 | 3 min read

Getting Older in Medicine

By Joanne Shay, MD, Johns Hopkins Medicine

Both of my knees need to be replaced—I already can’t wait to get back to playing pickleball. I now have renewed empathy in the OR and remind patients: “Recovery will take time. Try to be patient.” 

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,

Trichomonas vaginalis

December 12, 2024 | 3 min read

Home testing: a new era in sexual health      

By Scott Wright, MD, Johns Hopkins Medicine

At-home sexually transmitted illness (STI) testing allows easier patient access. It’s crucial for healthcare professionals to talk with patients about the limitations of these tests and discuss when follow-up care is needed.  

November 18, 2024 | 3 min read

Starting from scratch  

By Erica Richards, MD, Johns Hopkins Medicine

Eliciting detailed stories about patients’ experiences is invaluable in healthcare. Approaching history-taking in a thorough manner allowed me to discover that a brain tumor was causing a patient’s psychiatric symptoms. 

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. 

"An Orchid," Georgia O'Keefe, 1941, Museum of Modern Art.

November 13, 2018 | 2 min read

Seeing the Unseen

By Lauren Small, PhD

To start seeing the unseen, carving out five minutes to sit down and just listen to your patient can make a difference.

August 14, 2018 | 3 min read

Seeing Your Patients Through New Perspectives

By Patrick Hemming, MD, Duke University

We can enhance our patient care if we incorporate the perspectives of life story and behavior.

January 8, 2019 | 1 min read

Book Review of “Wolf Constellation”

By Deirdre Johnston, MBBCh, MD, Johns Hopkins Medicine

This novel prompts us to consider a family's story across generations and its influence on the emergence, manifestation, diagnosis, and treatment of illness in an individual. We routinely inquire about, and document, every patient's family history, but the simple listing of a diagnosis in other family members does not tell the whole story. We need to be curious about that story, because it can tell us much about our patients' strengths and vulnerabilities.

June 18, 2018 | 7 min read

Treating Every Patient How I Would Want To Be Treated

By Mitchell Goldstein, MD, Johns Hopkins University School of Medicine

A pediatric emergency department physician shares his inspiring clinical mission and values statement.

"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.

May 31, 2018 | 6 min read

Tips for Taking Care of Patients, From a Physician Who’s Been One

By Scott Vasher, MD, Johns Hopkins University School of Medicine

The lessons I learned from being hospitalized have stuck with me and guided me in all of my practice.

September 7, 2022 | 2 min read

“Hysteria”

By Tina Zhang, MD, Johns Hopkins Medicine

We need to be aware of our own gender biases that could adversely affect women. To combat this, engage in shared decision-making with patients and be a lifelong learner of female health topics.   

September 13, 2021 | 4 min read

Only Connect

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

Missing a diagnosis made me realize the value of a thorough physical exam. It can often illuminate the cause of the illness.

April 1, 2024 | 7 min read

Osler’s visit  

By Jeffrey Millstein, MD, Penn Medicine

“Every patient you see is a lesson in much more than the malady from which he suffers.”—Dr. William Osler 

January 9, 2024 | 3 min read

Dust and distrust

By Matthew Kelly, PhD, MPH, Johns Hopkins Medicine

Infection-related epidemics, like AIDS and COVID, teach us much about caring. To provide humanistic care, clinicians must continuously endeavor to assess and build trust with patients. 

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