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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 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.

May 10, 2022 | 2 min read

Supporting Underrepresented Trainees

By Vivian Altiery De Jesus, MD, MBE, Johns Hopkins Medicine

When witnessing racism, we must support those affected to foster an environment of safety and respect.

January 8, 2020 | 1 min read

Medical Overuse: When the Care we Give Doesn’t Help

By Daniel Morgan, MD, University of Maryland

The clinically excellent clinician must commit to reducing overuse.

June 21, 2022 | 2 min read

“Can’t you put him down?”

By Ivor Berkowitz, MBBCh, MBA, Johns Hopkins Medicine

Medical decision making for critically ill patients is complicated and difficult for everyone involved. It is our responsibility to ensure that patients and families are adequately informed to make choices that align with their values.   

"Dreamscape." Painting by the author.

September 30, 2024 | <1 min read

Approaching the horizon 

By Jessica Berry, PhD, clinical psychologist

My painting, “Dreamscape,” represents the importance of acknowledging and addressing patients' feelings about aging and mortality.  

January 9, 2020 | 3 min read

Top Tips to Support Yourself While Pregnant and Working in Healthcare

You yourself or clinician colleagues will undoubtedly take parental leave at some point. Clinically excellent clinicians and practices use this as an opportunity to enhance continuity and ensure high quality care.

April 4, 2023 | 1 min read

Insurance Denial Fatigue

By Justin McArthur, MBBS, MPH, Johns Hopkins Medicine

After spending hours with patients deciding what tests or treatments are most appropriate, guess how many seconds it takes for an insurance doctor to reject the claim? 

February 7, 2024 | 2 min read

Vacations: a “how-to” guide 

Vacations have been shown to reduce burnout, but sometimes it can feel hard to take time off. Blocking vacation time at the start of the year and getting coverage in place early may help. 

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.  

August 17, 2020 | 1 min read

Top Tips For Starting a New Phase in Your Career

By Christle Nwora, MD, Johns Hopkins Medicine

Making time to care for yourself, asking questions, and letting go of perfection can help you successfully navigate a new chapter in your life.

November 13, 2025 | 2 min read

Cognitive shuffle 

For patients with insomnia, coach them to visualize vivid, unrelated images to disrupt rumination and promote sleep onset. You can try it yourself, too! 

September 25, 2024 | 2 min read

Seasons of my mother 

By Lisa Young, medical student, Johns Hopkins Medicine

My mother had cancer while I was a pre-med student. In caring for her, I learned that it’s important for healthcare professionals to extend empathy not only to patients, but to their loved ones and caregivers as well. 

June 11, 2019 | 2 min read

Burnt out on Burnout: how to understand what burnout means to you

By Hannah Wilson, MBBS, Harvard Medical School

In order to truly understand and prevent burnout, we must first define what it is that burnout means to each of us.

April 19, 2018 | 3 min read

Becoming a Mindful Clinician

By Patricia Dobkin, PhD, McGill University Department of Medicine

Most healthcare professionals maintain high standards, perfectionistic tendencies, and critical minds. This appears to be an advantage in a high stakes-high risk work environment. However, these habits of mind may backfire when held too tightly and lead to emotional exhaustion. Being mindful can offset this problem.

June 2, 2020 | 3 min read

“Flattening the Curve”

By Madeline Rodriguez, MD, Johns Hopkins University School of Medicine

The pandemic is breaking down the traditional hierarchy of medical education. Opportunities are emerging for faculty to learn even more from residents.

March 2, 2022 | 1 min read

Redefining Success

By Jennifer Eitingon, MD, Johns Hopkins Medicine

My patient on palliative radiation died in the hospital, instead of at home as she wanted. I was reminded that we must always create a treatment plan based on the patient’s goals instead of our own. 

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. 

November 28, 2022 | 2 min read

What to Know About RSV

By Shannon Scott-Vernaglia, MD, Mass General

Let caregivers know that if symptoms are mild, they can watch children at home and encourage fluid intake. If having trouble breathing, the child should be seen right away. 

January 5, 2019 | 2 min read

Acceptance

By Neda Gould, PhD, Johns Hopkins Medicine

When we practice acceptance in the present moment, we free up energy to see more possibilities. We may notice some clarity in our minds and even less tension in the body. There is freedom in acceptance.

December 4, 2019 | 1 min read

The Power of Petite

By Kimberly Turner, MD, Johns Hopkins Community Physicians

Your  unique qualities and attributes allow you to interact with each of your patients in a way that only you can. Embrace what sets you apart.

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.

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.

September 16, 2020 | 1 min read

Music For Stress Reduction

By Chris Dingman, vibraphonist and composer

Spend time each day doing something you enjoy, like listening to music. Just a few minutes can help you remain balanced, avoid burnout, and give better care to patients.

December 8, 2021 | 2 min read

Hitting Home Runs in Healthcare

By Colin West, MD, PhD, Mayo Clinic

Clinicians often struggle with errors and imposter syndrome. Just like in sports, coaching helps clinical performance and promotes well-being.

Clouds at sunset, Paliambella, Greece. Photo by the author.

November 6, 2018 | 1 min read

Lessons From Paliambella, Greece

Working to cultivate community cohesiveness in the neighborhoods where we work and where our patients live could help community health achieve its fullest potential. Here are a few simple ways to get started.

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.

This is from "The Spirit Catches You and You Fall Down," written by Anne Fadiman. The art copyright is believed to belong to the publisher, Farrar, Straus and Giroux, or the artist. Public domain from wikipedia.org.

November 20, 2019 | 2 min read

“The Spirit Catches You and You Fall Down”

By Laura Pugh, Medical Student, Johns Hopkins Medicine

The gap between cultural systems can be wide. Openness, curiosity, and humility will improve cross-cultural care.

May 3, 2023 | 1 min read

Love And Loss

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

When a patient is unresponsive, loved ones may have differing ideas about the patient’s condition. We can hold these contradictions with compassion and see them as expressions of love.

October 27, 2025 | 1 min read

Confounding malaise

Lead with trauma-informed, dignity-first care: clarify the patient’s priorities and take the time to build a trusting relationship.

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, 2023 | 2 min read

Listening for meaning

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

In my palliative care career, I’ve learned that aligning care with patient goals is one of the most important parts of clinical excellence. To do this, I listen to truly understand what the patient wants. 

Artwork by Megan Gerber. Copyright by Megan Gerber.

February 3, 2020 | 5 min read

Joyful Deficiencies

By Megan Gerber, MD, MPH, Albany Medical College

Creative expression can provide needed counterbalance to the outcomes-driven world of medicine.

March 30, 2020 | 1 min read

Serving the Socially Vulnerable During the Pandemic

By Deidra Crews, MD, Johns Hopkins Medicine

Excellent clinicians must think of creative ways to serve all of our patients during this time of crisis, and keep the most vulnerable at the front of our minds.

April 1, 2025 | 1 min read

The PICC line 

By Miriam Colleran, MD, St. Brigids Hospice & Naas General Hospital, Ireland

As a clinician, writing this poem about my daughter’s PICC line was a reminder to focus on optimizing patients’ quality of life. While a medical device can alleviate a patient’s health problem, its presence is a constant reminder of illness.  

October 21, 2024 | 2 min read

Micro-kindness, macro-impact

By Sadiqua Sadaf, MBBS, Deccan College of Medical Sciences, Hyderabad, India

To make others feel like they belong, practice small acts of kindness—for example, offering a warm greeting. Such efforts can significantly contribute to another's well-being.

June 13, 2018 | 1 min read

Behavioral Change Bolstered By Human Touch

By Souvik Chatterjee, MD, Johns Hopkins Medicine

A human doctor is a critical component of creating change in patient behavior and health.

July 16, 2025 | 2 min read

Bowls of care 

Respecting patients’ cultural traditions—like families bringing food to loved ones in the hospital—can provide emotional comfort and strengthen the therapeutic alliance.  

March 13, 2023 | 2 min read

Hands

By Drea Burbank, MD, Putumayo, Colombia

Before entering medical school, paramedic school taught me how to comfort patients with a calm and reassuring touch.  

October 15, 2024 | 3 min read

Finding healing in the wound  

By David Kopacz, MD, University of Washington

In caring for patients, embrace the paradox of the wound. Recognize that illness can be an opportunity for their growth and personal transformation. Support them in exploring the spiritual and emotional dimensions of the experience. 

November 7, 2022 | 2 min read

Suggestions For Coping With Grief

By Justin Jeffers, MD, MEHP, Johns Hopkins Medicine

When you or others are grieving, give permission to be vulnerable and accept help. It may sometimes be helpful to work with a therapist. 

March 24, 2020 | 1 min read

Exercising for Wellness During the Pandemic

By Erica Leonard, MD, Johns Hopkins University School of Medicine

With the drastic changes to our lives due to COVID-19, we can still stay active. Exercise during this challenging time can help improve everyone's emotional well-being and physical health.

"You Let Your Magic Tortoise Go," David Kopacz. Copyright with the artist.

August 27, 2020 | 3 min read

Finding Balance During Unbalanced Times

By David Kopacz, MD, University of Washington

Spending time “going into and opening our hearts” is healing and restorative. We can do this for ourselves as healers and guide patients through the practice. It’s as simple as slowing down, putting your hand on your heart, and taking three deep breaths.

February 24, 2018 | 1 min read

Battling The System in Defense of Diagnosis

By Souvik Chatterjee, MD, Johns Hopkins Medicine

Healthcare delivery is at odds with a fundamental aspect of being a physician—strategic curriculum interventions are necessary to preserve the art of diagnosis.

April 21, 2023 | 2 min read

There’s No AI in Touch

By Drea Burbank, MD, Putumayo, Colombia

Sometimes innovations can make our jobs easier. Rather than competing with AI, embracing it thoughtfully can allow us to spend more time connecting with patients.   

November 2, 2022 | 2 min read

Psychedelics to Quit Smoking?

By Matthew Johnson, PhD, Johns Hopkins Medicine

Patients may ask about using psilocybin to stop smoking. While being actively studied, please remind them that it’s still illegal and not necessarily risk-free. 

WWI Battle of Verdun Cemetery, Verdun, France.

March 23, 2020 | 4 min read

Finding the Right Words—Lessons From Nurse Mary Borden

By Iro Filippaki, PhD, Johns Hopkins University School of Medicine

WWI Nurse Mary Borden's autobiography provides inspiration to search for the right words to describe our experience, and perhaps, find solace as we face the challenges of medicine.

January 27, 2025 | 2 min read

The green hospital 

By Nick Dalesio, MD, MPH, Johns Hopkins Medicine

Recognize the significant environmental impact of your healthcare practices. Advocate for and implement sustainable solutions, such as optimizing workflow to reduce waste and improve resource utilization. 

April 25, 2024 | 1 min read

The night owl

By M. Carolina Musri, MD, Johns Hopkins Medicine

Working nights can be challenging. I've found that prioritizing sleep and prepping healthy foods helps a great deal. 

November 11, 2021 | 3 min read

Dying Alone

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

Caring for a patient dying of AIDS reminded me that—while it's necessary to be fully present and listen attentively to all patients—those who are alone need even more of our time. 

October 28, 2020 | 1 min read

Preventing Dry Eye in the Zoom Era

By Sharon Solomon, MD, Johns Hopkins Medicine

Increased online activities during the pandemic has caused higher rates of dry eye for many. All clinicians should encourage their patients to take regular short breaks from screens.

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