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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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November 10, 2023 | 2 min read

Final journeys

By Elizabeth Gundersen, MD, University of Colorado

Today, we remember patients who have served our country. We are grateful for the honor and privilege of caring for these veterans through their final journeys.

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.   

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 11, 2025 | 6 min read

“The Tao of Medicine” 

By David Kopacz, MD, University of Washington

The clinician's mindful presence and understanding of the patient's full humanity are as crucial to healing as technical skill. Let go of using language to define your experience; instead focus on the wisdom that can be found in the empty spaces between thoughts. 

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.  

"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.

August 1, 2019 | 3 min read

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

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

February 6, 2025 | 2 min read

Code blue 

By Ursula Gately, medical student, Johns Hopkins Medicine

Extreme heat often dominates the climate change conversation, however the dangers of extreme cold may be more perilous. Support patients, particularly those who are unhoused or with housing insecurity, by making sure they know about local warming shelters and advising them to limit exposure to the elements. 

The stunning Mona "Moe" Driggs at the Boston Harbor Hotel, October 2010. Author's family photo.

November 21, 2019 | 2 min read

The Chosen One

By Ryan Chippendale, MD, Boston University School of Medicine

As a geriatrician, it was still difficult to facilitate compasstionate patient-centered end-of-life care for my grandmother. Honoring patients' goals of care can be challenging when we are intimately invested.

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.

October 21, 2025 | 2 min read

Stroke, breath, care

Swimming taught me the importance of rhythm and breath. During difficult conversations with patients and families, I make room for quiet pauses to give them time to process.

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.

March 31, 2022 | 2 min read

A Lesson in Cultural Humility

By Mengyi "Zed" Zha, MD, Othello, Washington

Working at a community health clinic serving migrant workers from Mexico, I was confronted with a pervasive stereotype that the female patients were “dramatic.” I learned how important it was for patients’ concerns to be taken seriously.   

An example of a trompe l’oeil in a geriatric hospital setting. Copyright by the author.

January 27, 2020 | 3 min read

Ethical Dilemmas in Dementia Care Design

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

Innovative dementia care designs raise moral questions about whether deception of patients is ever ethical. The clinically excellent physician tries to avoid deception at all costs.

November 24, 2021 | 4 min read

What I Learned When I Deleted my Social Media

By Tyler Mains, MD, University of California, San Francisco

When I stopped checking Twitter, Instagram, and Facebook, I created a boundary between myself and the never-ending stream of noise and emotion. I now have more bandwidth to empathize with my patients’ feelings.

February 3, 2022 | 2 min read

Perspective Matters

By Souvik Chatterjee, MD, Johns Hopkins Medicine

As the pandemic continues, I remind myself that my job is to give selflessly to those who are sick. It’s helpful to lean on my team when situations feel especially challenging.

September 8, 2020 | 1 min read

10 Ways to Cultivate Well-being During The Pandemic

It's important to make an effort to improve your sense of well-being to help prevent burnout, especially during the strain of the pandemic.

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. 

"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.  

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. 

December 3, 2025 | 3 min read

Gravity, purpose, and “Stranger Things” 

During career transitions, clarify your purpose, establish routines, and schedule regular check-ins with peers or mentors to stay grounded and focused. 

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.  

September 4, 2025 | 2 min read

To comfort always 

Providing compassionate companionship to patients can be as healing as any medicine when a cure is no longer possible. 

November 7, 2018 | 3 min read

How to Reduce Caregiver Burden

By Jessica Colburn, MD, Johns Hopkins University School of Medicine

Healthcare providers have the ability to provide support, connection, and resources that can help to reduce caregiver burden and increase caregiver joy.

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. 

November 8, 2021 | 1 min read

Lessons Learned From 30 Years of Night Shifts

By Kimberly Turner, MD, Johns Hopkins Community Physicians

Patience, stamina, and fortitude are important traits to cultivate in medicine at any and all times.

September 17, 2019 | 5 min read

Being Human First

By Kultaj Kaleka, MD, RN, Central Michigan University

Family and friends frequently ask medical trainees for their medical advice. Naturally, our recommendations are not based on medical experience, but rather our shared humanity.

Encourage caregivers to get support.

September 8, 2021 | 2 min read

How to Mitigate Caregiver Burnout

By Simone Lescott, MD, Johns Hopkins Medicine

Caring for a loved one can be emotionally exhausting. Remind caregivers to prioritize self-care and encourage them to seek support from others.

November 14, 2019 | 3 min read

Medicine, Music, and Ministry

By Kimberly Turner, MD, Johns Hopkins Community Physicians

With the demands of healthcare, it is essential that you practice the ministry of self-care. Remember to nurture your passion for something you love, something you do, and something that’s bigger than you.

The author hiking on the Pacific Crest Trail. Copyright by the author.

November 17, 2023 | 5 min read

Hike Your Own Hike

By Lillian Hayes, Medical Student, Johns Hopkins University

Medical training and practice are marked by constant change, which can feel uncomfortable. Embracing discomfort as an opportunity for growth can help us to improve our care of patients.

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.

September 27, 2022 | 2 min read

When?

By Shreya Srivastava, medical student, Albany Medical College

When my friend was struggling with her mother’s new diagnosis, she listened to the popular French song about cancer entitled, “Quand c’est?” It gave her a sense of support, empathy, and solidarity with others.

March 21, 2023 | 1 min read

Co-Reader

By Randy Barker, MD, Johns Hopkins Medicine, retired

When we, or someone close to us, have a disease that we see in our patients, it’s an opportunity to more deeply understand the illness experience.  

March 2, 2018 | 4 min read

The Joy of Mentoring

By Ivor Berkowitz, MBBCh, MBA, Johns Hopkins Medicine

Making time to mentor a high school student can be refreshing and rejuvenating for all clinicians.

February 25, 2021 | 2 min read

How You Can Help With Intimate Partner Violence

By Lisa Geller, MPH, Educational Fund to Stop Gun Violence

Intimate partner violence (IPV) is a public health crisis and most deadly when a gun is involved. Clinicians should screen patients for IPV, ask about firearm possession, and refer those at risk of IPV to appropriate services.

August 25, 2020 | 4 min read

A Real Hero and a Real Human Being

By Andrew Philip, PhD, Primary Care Development Corporation

The pandemic has created more stress for everyone, including healthcare professionals. Finding a relaxing activity to practice regularly can help you persevere.

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.

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 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.

The author and her husband dancing to live music at their wedding. Photo courtesy of the author.

June 25, 2019 | 3 min read

The Shared Experience

By Mariah Robertson, MD, Johns Hopkins Medicine

Part of my history-taking in the future will include a music history to better understand the role music plays in my patient’s day-to-day lives. I am hopeful that this added information about them will strengthen our connection and understanding of one another as humans.

September 30, 2025 | 1 min read

More time

It is best for goals-of-care conversations to happen as early as possible. Clinicians can use these discussions to help guide shared decision making around end-of-life care.  

June 18, 2025 | 1 min read

Lewy-body diary 

This poem describes the profound loss of autonomy experienced by patients with dementia. It’s a call to truly see the person grappling with the reality of their diminishing faculties. 

December 22, 2021 | 4 min read

Maintaining well-being during the holidays 

The holidays can intensify feelings of sadness. Ask patients about mood, sleep, and social support. Offer concrete guidance like maintaining regular sleep and exercise routines and limiting substance use.

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.  

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. 

December 27, 2018 | 2 min read

“Charm City” Movie Review

The upcoming film "Charm City" emphasizes that the struggles of each patient who comes to clinic extend far beyond a medical diagnosis. We must be conscious of our patients' many challenges and mindful to address them. Making time to ask about your patient's day-to-day concerns, worries, and fears about their homes, neighborhoods, and communities can help you to get a fuller perspective of their medical and social determinants of health. This will allow you to reach relevant goals of care together.

February 25, 2018 | 1 min read

Diagnostic Excellence Starts With an Incessant Watch

By Reza Manesh, MD, Johns Hopkins University School of Medicine

Feedback is the key to improvement of any craft. No one is born an expert. It is earned through deliberate practice and an incessant thirst for progress.

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.   

August 29, 2019 | 2 min read

Mindful Doctoring in the EHR Era

By Irene Estores, MD, University of Florida College of Medicine

Mindfulness is essential in clinical excellence. Consider these five tips while working with the EHR.

August 11, 2025 | 5 min read

The push, the pull, and the leap 

Major career transitions can bring up complex emotions; reflection can guide you toward choices that honor your values. Embrace these changes as opportunities to rediscover purpose and help you better care for patients. 

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