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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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April 30, 2018 | 4 min read

The 15 Values of a Pediatric Anesthesiologist

By Ivor Berkowitz, MBBCh, MBA, Johns Hopkins Medicine

A pediatric anesthesiologist shares the 15 values that have guided his career.

July 28, 2021 | 2 min read

4 Things You Can do to Support Patients Facing Hard News

By Rebekah Fenton, MD, Northwestern University

In medicine, we sometimes have to share horrible news. When doing so, hold the conversations in a private space, make sure the patient and family understand what you’re saying, acknowledge emotions, and answer questions.

July 27, 2021 | 3 min read

Lessons From My Experience as a Grandpa And Clinician

By Ivor Berkowitz, MBBCh, MBA, Johns Hopkins Medicine

My experience of feeling helpless through my grandchild’s illness reminded me that kindness, empathy, and honesty are central to giving clinically excellent care.

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.   

May 2, 2022 | 3 min read

The Alarming Rise in Pediatric Suicide

By Elizabeth Reynolds, PhD, Johns Hopkins Medicine

Rates of childhood suicide have been rising steadily and this is now the second leading cause of death for youth. It's critical to screen children for suicidal thoughts and behaviors.   

May 21, 2019 | 3 min read

Telling People Terrible Things

By Amy Caruso Brown, MD, SUNY Upstate Medical University

Learning to break bad news gently takes time and practice, with the goal of telling the most terrible things to our patients a little bit less terrible.

March 14, 2018 | 2 min read

The Power of Acknowledging Feelings

By Michael Crocetti, MD, MPH, Johns Hopkins Community Physicians

Recognizing and acknowledging feelings can diffuse a patient’s anxiety.

September 19, 2019 | 2 min read

The Importance of Partnering With Patients

By Michael Crocetti, MD, MPH, Johns Hopkins Community Physicians

What patients and families need is a clinician advocate who is available to listen, translate complex medical language, and support both the physical and mental health of the patient.

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. 

May 20, 2021 | 2 min read

Alleviating Your Patients’ Worries

By April Sharp, MD, Johns Hopkins Medicine

During hospitalizations, patients and families have lots of time to worry. Asking about the concerns and empathizing may be especially helpful.

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. 

A child playing with a parent's gun that wasn't safely stored.

October 15, 2020 | 3 min read

How to Talk About Firearm Safety During the Pandemic

By Katherine Hoops, MD, Johns Hopkins Medicine

With a surge in gun sales during the pandemic, exposure to firearms has increased for all. It’s imperative that clinicians give comprehensive firearm safety counseling to patients during these challenging times.

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.

May 18, 2021 | 2 min read

A Question That Transformed my Care of Patients

By Rebekah Fenton, MD, Northwestern University

Asking patients, “What are you most worried about?” can bring to light unspoken concerns and allow fears to be addressed.

January 12, 2021 | 2 min read

6 Ways to Engage Families to Support Child Mental Health

By Barbara Robles, MD, University of Texas

Strong relationships with clinicians can empower children and their families to engage more fully in their mental health treatment.

November 30, 2022 | 2 min read

Anger

By Joanne Shay, MD, Johns Hopkins Medicine

When patients or loved ones express anger, honest and sincere communication may help address their feelings and underlying concerns. 

“We often jump to reassure, fix, and plan. If we can be still for a moment, we can remain present and let compassion guide our actions.”

December 8, 2020 | 3 min read

The Messy

By Cassie Ferguson, MD, Medical College of Wisconsin

Caring for children in the pediatric ED is both rewarding and exhausting. Cultivating compassion for patients and ourselves can help to sustain our practice and our well-being.

October 27, 2022 | 2 min read

Connections Accelerated

By Jamie Schwartz, MD, Johns Hopkins Medicine

Some clinical encounters require establishing a patient-doctor connection quickly. Providing emotional support may improve your ability to create trusting relationships. 

October 25, 2022 | 4 min read

Just Breathe

By Jillian Bybee, Michigan State University

When my patients experience pre-procedural anxiety, I normalize the emotion and suggest ways to feel calm. Taking deep breaths together is often mutually beneficial for patients and clinicians.

January 20, 2022 | 2 min read

Reflecting on Boundaries During Times of Loss

By Leslie Miller, MD, Johns Hopkins Medicine

Recently, my eyes filled with tears upon learning of a death in my patient’s family. Empathizing with patients who have suffered a loss can bring up strong feelings. How much of this is ok for clinicians to reveal?

April 11, 2019 | 2 min read

A Band of Sisters and Brothers

By Ivor Berkowitz, MBBCh, MBA, Johns Hopkins Medicine

It is difficult for new members to join an established tightly-knit team that has shared intense, life-altering, emotionally charged experiences with each other for many years.

December 9, 2021 | 4 min read

3 Lessons From Coach Ted Lasso

By Claire Crawford, MSW, PhD, Texas Childrens , Jared Rubenstein, MD, Baylor College of Medicine, pediatric

Apple TV’s “Ted Lasso” shares a simple message—be kind. We can never truly know what it’s like to walk in another person’s shoes. Curiosity, instead of judgment, helps us give better patient care.

November 1, 2021 | 1 min read

“Routine Visits”

By Eliana Perrin, MD, MPH, Johns Hopkins Medicine

Taking the time to explicitly welcome new patients to your clinic may help them feel comfortable. This can dramatically influence their experience.

June 25, 2018 | 2 min read

Trust The Diagnostic Process

By Michael Crocetti, MD, MPH, Johns Hopkins Community Physicians

Clinicians use a diagnostic process to guide their actions when faced with a medical problem. Hypothesis generation provides an efficient reliable framework to focus the clinical workup and come to the correct diagnosis and treatment plan.

September 25, 2018 | 1 min read

Teaching Maintains Clinical Excellence

By Michael Crocetti, MD, MPH, Johns Hopkins Community Physicians

Engaging with learners keeps you dedicated to lifelong learning, and teaching helps to maintain clinical excellence and the joy of medicine.

November 29, 2021 | 3 min read

Being Your Patient’s Advocate

By Sabrina Chen, medical student, New York University

Some supervising physicians may occasionally seem annoyed by medical students’ questions. As a trainee, I’ve learned to speak up anyways, as my question can make the difference between life and death.

July 21, 2021 | 2 min read

Talking With Patients About Safe Summer Swimming

By Jade Cobern, MD, Johns Hopkins Bloomberg School of Public Health

Swimming is a summertime joy, but it is not without risk. Before patients take the plunge, they should be reminded to always swim with a buddy (never alone) and to apply sunscreen.

"Spending time outdoors helps me cope with the stress and sadness of the job." -Dr. Jared Rubenstein

December 10, 2020 | 3 min read

Coping With Patients’ Heartbreak

By Jared Rubenstein, MD, Baylor College of Medicine

When supporting patients and their loved ones during times of great sadness and loss, cultivating a daily habit of self-care may protect against burnout.

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.

January 17, 2023 | 2 min read

Finding Meaning

By Jamie Jump, DO, Texas Childrens Hospital

When my seven-month-old-patient suffered severe neurological damage, despite having little to offer medically, I remembered I could still support her mother through this tragedy. Taking solace in this helps me to be present for my other patients. 

June 19, 2019 | <1 min read

Dr. William Ravekes, A CLOSLER Look

By Gretchen Miller, Managing Editor

Taking the time to build trusting relationships with kids and their families is essential.

November 5, 2018 | 2 min read

Providing Holistic Care

By Nancy Hutton, MD, Johns Hopkins University School of Medicine

Excellence in clinical care requires intellectual rigor, keen observation, empathic communication, an understanding of the context in which the patient lives, and consideration of the individual patient as the center of care. 

Audrey Hepburn. Photo by Bud Fraker, 1956. Public Domain.

August 24, 2020 | 4 min read

A Calling to Medicine From Hollywood

By Jade Cobern, MD, Johns Hopkins Bloomberg School of Public Health

Who ever thought watching Turner Classics could inspire a career in medicine? Reflecting on what drew you to healthcare may restore your sense of purpose.

February 9, 2023 | 1 min read

Firearm Safe Storage

By Katherine Hoops, MD, Johns Hopkins Medicine

Child access prevention laws and safe storage of firearms prevent injuries. We must advocate for stronger safety laws to prevent the death of children in our communities. 

Bagels & Cream Cheese

April 28, 2020 | 2 min read

Cream Cheese and Kindness

By Ivor Berkowitz, MBBCh, MBA, Johns Hopkins Medicine

“I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.” -Maya Angelou

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. 

Helen Brooke Taussig (May 24, 1898 - May 20, 1986), American cardiologist who founded the field of pediatric cardiology. Photograph taken for the cover of Modern Medicine, January 21, 1963. Wikipedia, public domain.

April 1, 2020 | 4 min read

Strength in Vulnerability

By Kamna Balhara, MD, Johns Hopkins Medicine, Sarah Clever, MD, Johns Hopkins Medicine

There is strength in acknowledging our fears individually and facing them collectively.

November 25, 2020 | 2 min read

Naming Chickens

By Claire Crawford, MSW, PhD, Texas Childrens

Incorporate laughter and joy where you can, giving yourself, your patients, and their families, moments of respite.

October 21, 2020 | 3 min read

Show Me

By Jared Rubenstein, MD, Baylor College of Medicine

Asking patients to share photos and videos can give clinicians a deeper understanding of their lives. This may allow us to give better person-centered care.

August 1, 2022 | 1 min read

Keeping Children Safe

By Katherine Hoops, MD, Johns Hopkins Medicine, Monique Burke, MD, President, MD Chapter of the AAP

The new Safer Communities Act helps clinicians connect patients to mental healthcare. Hopefully, this will reduce youth gun violence, including suicide. 

November 15, 2021 | 1 min read

Healthy Social Media Use

By Nicole Cifra, MD, MPH, University of Rochester

Talk with patients about their social media use. Remind them to limit screen time before bed in order to sleep well and stay healthy.

Illustration from "Jasper and Tabitha Play a Trick on the Coronas." Copyright by the author.

May 6, 2020 | 1 min read

Talking With Children About COVID-19 Using Stories

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

In times of heightened anxiety for children, parents turn to clinicians for help. Sharing COVID-19 resources for children, including stories, can help them make sense of the pandemic.

A shared client-therapist drawing created in a teletherapy session on Zoom whiteboard. Copyright with the authors.

May 4, 2020 | 2 min read

Connecting With Teens Via Telemedicine

By Michelle Munson, LMSW, PhD, Nadia Jenefsky, MPS, LCAT

Suspending judgement is critical to building a trusting relationship, especially with teens.

March 10, 2020 | 1 min read

Observing and Acknowledging Family Dynamics

By Kimberly Zeren, NP, Johns Hopkins Community Physicians

During your next patient encounter, take the time to observe the family dynamics. Don't be afraid to ask the difficult questions.

February 11, 2020 | 2 min read

Moving Mountains

By Susan Huff, RN, MSN, Johns Hopkins Homecare Group

In end of life care, excellent clinicians can and should move mountains to get patients home if that's where they want and need to be.

July 2, 2019 | 5 min read

Shock, Grief, and Arrival

By Paulo Selber, MD, Columbia University

In the process of decisions regarding children’s welfare, listening to the parent’s feelings will always be the right thing to do.

February 15, 2023 | 2 min read

Speaking From my Heart

By Leslie Miller, MD, Johns Hopkins Medicine

When deeply worried about the mental health of patients, make sure they feel heard, validated, and empowered.  

January 31, 2023 | 1 min read

Brain Candy

By Carol Vidal, MD, PhD, Johns Hopkins Medicine

Because we don't know yet how social media affects our brain, it needs to be consumed in moderation. Scheduling times to spend time with friends and family may make it easier to get offline. 

January 4, 2023 | 2 min read

Intergenerational Connections

By Susan Lehmann, MD, Johns Hopkins Medicine

We can benefit from relationships with those of different ages. Encourage patients to consider joining a community group with people from across generations. 

November 15, 2022 | 1 min read

Will I lose my hair?

By Lauren Rissman, MD, Advocate Childrens Hospital

Talking with my young patient about his cancer, he shared being most afraid of going bald. I learned that it’s important to acknowledge and validate all worries, including those that are not life-threatening.

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