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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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"I've learned that keeping a vegetable garden is worth a medicine cabinet full of pills."-Lucy Beneventi

May 24, 2023 | 3 min read

An Email Chain That Made me Smile 

By Scott Wright, MD, Johns Hopkins Medicine

Each year of life has lessons to teach us. The insights in this piece may serve as a reminder to seek out advice from those who are older, and to make time for reflection. 

June 3, 2024 | 2 min read

Book review: “Everything I Know About Love” by Dolly Alderton 

By Scott Wright, MD, Johns Hopkins Medicine

This page-turner about friendship reminds readers that relationships are not easy and require sustained care and attention. In medicine and life, this can lead to meaningful and loyal bonds. 

July 6, 2018 | 1 min read

Music and Coffee

By Scott Wright, MD, Johns Hopkins Medicine

If you get the sense that one of your patients is isolated or alone, ask about their support network. If they have none, ask if they would like help in being connected to community resources.

May 4, 2021 | 1 min read

Love as a social determinant of health (archived 2021)

By Scott Wright, MD, Johns Hopkins Medicine

Many feel happier and healthier when feeling loved and sharing their love. Encouraging our patients to share love through meaningful personal relationships will improve their health and well-being.

January 3, 2020 | 2 min read

Malcolm Gladwell’s “Talking to Strangers” Applied to Patient Care

By Scott Wright, MD, Johns Hopkins Medicine

Miscommunications are common, particularly with individuals that we don't know well. Five tips from Gladwell's "Talking to Strangers" are presented here that may be helpful when interacting with patients.

July 5, 2018 | 1 min read

Getting the Most Out of Your Eyes

By Scott Wright, MD, Johns Hopkins Medicine

If you look at your patients as you would a piece of art in a museum, you will notice many details that would otherwise be missed.

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.

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. 

November 14, 2018 | 2 min read

How Clinicians can use “Wait, what?”

By Scott Wright, MD, Johns Hopkins Medicine

Asking good questions is fundamental for learning about our patients. Five great questions, assembled by University of Virginia President James Ryan, can help you to connect with, understand, and serve patients better.

Encourage parents to support their teens in connecting with friends safely.

October 7, 2020 | 1 min read

CLOSLER Together

By Scott Wright, MD, Johns Hopkins Medicine

Discussing CLOSLER pieces in groups may yield more insights than simply reading on your own. Consider adding a discussion of a piece to your next staff, practice, or division meeting.

"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.

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.

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!

September 9, 2020 | 1 min read

We’re All in This Together

By Mike Fingerhood, MD, Johns Hopkins Medicine

With the added stress caused by the pandemic, make an extra effort to screen your patients for anxiety and depression. Empathizing about shared concerns may facilitate patient expression.

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.

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.

February 18, 2020 | 3 min read

4 negotiating tips from “Never Split the Difference”

By Scott Wright, MD, Johns Hopkins Medicine

We regularly negotiate with patients en route to shared decision making. Tips from Voss' book "Never Split the Difference" can improve your communications with patients.

January 5, 2023 | 1 min read

Quiet Quitting in Healthcare

By Scott Wright, MD, Johns Hopkins Medicine

The past three years have been difficult in healthcare and some are now doing less than we used to. Because this may be a temporary strategy, patience and understanding may be the most considerate approach.  

July 26, 2018 | 1 min read

A Taste of Their Own Medicine

By Scott Wright, MD, Johns Hopkins Medicine

Videos spreading misinformation to patients, promoting unproven therapies, can spread like wildfire on social media. We are sharing another video to fight fire with fire.

February 21, 2019 | 1 min read

Substance Use Disorders in Later Life

By Mike Fingerhood, MD, Johns Hopkins Medicine

Substance use disorders in older adults often go undiagnosed because screening is frequently overlooked. Key to supporting patients to make a change is developing rapport and trust.

January 4, 2024 | 1 min read

Searching for the solution

By Scott Wright, MD, Johns Hopkins Medicine

Improving clinical reasoning skills is a career-long journey where we feel like an expert one day and a novice the next. Commitment to growth and learning from mistakes are absolutely required.  

June 29, 2018 | 1 min read

Getting Into Character

By Scott Wright, MD, Johns Hopkins Medicine

Working as a primary care provider for the last 24 years, I can say without a doubt that reading fiction has expanded my capacity to connect with my patients with a greater level of empathy.

April 21, 2020 | 2 min read

“Jiro Dreams of Sushi”

By Scott Wright, MD, Johns Hopkins Medicine

Role models can be found on Netflix. Jiro, the master sushi chef, is aiming for perfection, and we must also continuously try to get better in our work with patients.

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.

March 15, 2018 | 3 min read

Imperturbability, Aequanimitas, and “In Shock”

By Tom Hutchinson, MB, McGill University

Moving towards a deeper understanding of Osler's dicta of imperturbability and aequanimitas.

April 25, 2019 | 3 min read

Diagnostic Humility

By Nathan Douthit, MD, Brookwood Baptist Health, Birmingham, Alabama

Self-awareness is critical in making accurate diagnoses.

April 2, 2019 | 5 min read

Connecting to Historical Roots

By Lee Akst, MD, Johns Hopkins University School of Medicine

There are a number of important physicians in history, and an appreciation of our past can further our quest for clinical excellence in the present.

August 19, 2024 | 3 min read

Patient-powered research 

Clinicians can empower patients through transparency, involvement, and ownership in the research process. This can foster a deeper connection with scientific discovery, enhance dignity, and advance health outcomes for all. 

January 10, 2019 | 3 min read

How to Improve Your Physical Diagnostic Skills With a Digital Database

By Samuel Durso, MD, Johns Hopkins Medicine

To sharpen diagnostic skill, take a minute to cross check the physical exam against images and lab results in the electronic record - if not congruent, then why?

May 6, 2021 | 3 min read

Plus ça Change: The Rise And Rise of Syphilis

By Matthew Hamill, MBChB, PhD, Johns Hopkins Medicine

Syphilis cases have reached an all-time high. To turn the tide, the first thing we need to do is ask patients an open-ended question about sexual activity, like "When was the last time you had sex?"

American Huey military helicopter formation flying over the jungle at sunset during the Vietnam War.

November 19, 2024 | 2 min read

Fellow humans: lessons from Dr. White’s “Seeing patients” 

By Richard Schaefer, MD, MPH, Johns Hopkins Medicine

Providing humanistic, equitable care benefits patients, medical practitioners, and society.  Reminding ourselves that we are all in this together may help decrease stigma and bias in clinical settings.

December 17, 2019 | 4 min read

Stop, Look, and Listen

By Chase Webber, DO, Vanderbilt University Medical Center

From a young age, children learn to “Stop, Look, and Listen” when crossing the street. Clinicians would do well to live by these words in the realm of clinical reasoning.

"L'Atelier au mimosa," Pierre Bonnard.

May 13, 2019 | 7 min read

April Art Museum Challenge

By Flora Smyth Zahra, MA Clin Ed, DRestDent RCS, FHEA, Kings College London, Margaret Chisolm, MD, Johns Hopkins Medicine

Slow looking can enable clinicians to see more deeply, think more critically, and engage more meaningfully in patient care. Time spent in a museum supports clinician wellness and nurtures student professional identity formation.

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. 

May 2, 2024 | 2 min read

Resilience in the face of setbacks

By James Black, MD, Johns Hopkins Medicine

Treating aortic dissections has taught me the importance of staying positive, both in communicating with families and in my own approach. 

July 22, 2020 | 4 min read

Virtue Ethics

By Awais Aftab, MD, Case Western Reserve University

Virtue ethics emphasizes the importance of self-knowledge and can help us to understand our patients in the context of the totality of their whole lives.

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. 

January 23, 2024 | 1 min read

Book review of “The algorithm will see you now”

By Joan Naidorf, DO

In this medical thriller set in the not-too-distant future, diagnosis and treatment are performed entirely by AI. The novel serves as a reminder that AI must be used thoughtfully and responsibly.  

May 18, 2020 | 2 min read

Remembering Our Call to Medicine

By Aidan Crowley, Medical Student, University of Pennsylvania

Remembering why we chose a career in medicine can perhaps bolster our sense of well-being and mitigate burnout.

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.

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, 2018 | 5 min read

Deep and Active Listening

By Susan Lehmann, MD, Johns Hopkins Medicine

The essence of good doctoring is to listen attentively and respectfully to the concerns of your patient.

White Mountains, New Hampshire.

July 6, 2023 | 3 min read

Peaks And Patients

By Rishab Ramapriyan, medical student, Harvard Medical School

In medicine, as in hiking, learning to be comfortable with uncertainty is one of the most important lessons I’ve learned in my medical training. 

October 6, 2022 | 2 min read

Repairing Trust

By Fiona Miller, medical student, UCSF, Pringl Miller, MD, San Francisco, California

Establishing rapport with each patient includes asking about previous experiences with the healthcare system. If there was a negative experience, understand that rebuilding trust may take time and commitment.  

September 26, 2022 | 3 min read

Concerning Hobbits: On Middle-earth and Medicine

By Tina Zhang, MD, Johns Hopkins Medicine, Zach Lorenz, MD, Johns Hopkins Medicine

J.R.R. Tolkein’s beloved trilogy offers lessons for life and medicine, including journeying with our patients through dark times and effectively engaging in teamwork. 

October 10, 2019 | 2 min read

Our Greatest Teachers

By Vivek Murthy, MD, Johns Hopkins University School of Medicine

To find meaning in your clinical work, search for the words and moments that affirm your shared humanity with patients.

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.

May is Mental Health Awareness Month.

May 4, 2022 | 1 min read

Clinicians Who Need Mental Healthcare

By Eileen Barrett, MD, MPH

Clinicians give their best patient care when they are feeling well, both mentally and physically. Encourage colleagues to seek mental health care if they need it. 

A shire in Shropshire. Author's photo.

January 29, 2019 | 7 min read

“Good Doctoring”

By Taylor Purvis, MD, St. Vincent Medical Center, Bridgeport, CT

Reflections from a medical student on the practice of medicine as captured in the novels "The Bad Doctor," by Ian Williams, and "A Fortunate Man," by John Berger & Jean Mohr.

April 5, 2021 | 2 min read

Slowing Down at The Bedside

By Sanjana Mathur, MBBS, University of Central Florida

Physically examining your patient takes time and cannot be rushed. Having a methodical approach will help you make accurate assessments when examining patients.

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