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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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January 30, 2025 | 3 min read

If bias is unconscious, what can I do about it? 

By Som Saha, MD, MPH, Johns Hopkins Medicine

We all have biases that are mostly unresectable. By practicing mindfulness, being self-aware, and building connections with patients, we can reduce the harm they might otherwise cause. 

July 1, 2019 | 1 min read

Looking Under the Hood

By Daniel Minter, MD, University of California, San Francisco

Promoting a culture of thinking out loud can demystify the process of clinical reasoning and make it accessible to all learners.

October 16, 2023 | 1 min read

Clinging to Hope

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine, Nitin Narayan, medical student, Gujarat, India

A patient’s family wasn’t ready to accept that their loved one wouldn’t recover. From the encounter, I learned that sometimes it may be appropriate to delay such conversations for a little while. 

Clinically excellent healthcare professionals maintain a growth mindset.

January 6, 2025 | 2 min read

Defining exemplary care 

By Kristopher Keppel, medical student, Johns Hopkins Medicine

Exceptional patient care requires "pragmatic empathy"—the artful blend of compassion and candor—combined with a holistic approach that considers the patient's broader life context. 

June 18, 2019 | 2 min read

Navigating the Uncertain: A Book Review of “The Laws of Medicine”

By Sam Kant, MD, Johns Hopkins University School of Medicine

Siddhartha Mukherjee, MD, provides a framework to reconcile the uncertainties we constantly experience in our practice of medicine in his book, "The Laws of Medicine."

December 16, 2024 | 2 min read

Navigating vaccine discussions  

By Erica Prochaska, MD, Johns Hopkins Medicine

By understanding and addressing patients' concerns about vaccination, healthcare professionals can foster trust and promote informed decision-making. Every conversation is a chance to educate and empower. 

“Imagine your baby’s lungs are a tree,” she said. “A pleural effusion would be a puddle around the tree while pulmonary edema is water on the leaves.” The mother seemed to follow along, nodding her head. I was grateful to hear this metaphor that inspired me to utilize pictorial representations more.

August 19, 2021 | 2 min read

The Power of Pictures

By Rebekah Fenton, MD, Northwestern University

When educating patients about their illness, it’s often helpful to include pictures and visual descriptions to improve understanding.

August 30, 2022 | 2 min read

Hope in The Hospital: a Lesson From “The Sandman”

By Joshua Briscoe, MD, Durham VA Health Care System

Accepting the hopes and dreams of our patients is a way to show compassionate presence.  

September 12, 2023 | 2 min read

The Gift of Time

By Meshulam Twerski, medical student, Penn Medicine

Medical students have more time than doctors to get to know patients as people and uncover unspoken fears about their illness and treatment. 

August 18, 2021 | 2 min read

Helping Students Transition to Wards

By Howard Chang, Medical Student, Johns Hopkins Medicine

I was nervous taking care of my first patient as a student on the medical wards. I felt more comfortable when I realized that even experienced clinicians don’t know everything, and of course they did not expect me to have all the answers.

December 10, 2018 | 3 min read

Immigrants Should Not Have to Choose Between Health and a Green Card

By Lochan Shah, Neha Anand, Priyal Gandhi

We urge you to leverage your voice as an agent of change by submitting a comment opposing the proposed rule to the U.S. Department of Homeland Security before the deadline, TODAY, December 10, 2018. Make your voice heard so that families across the country do not have to choose between their health and their immigration status.

August 1, 2023 | 2 min read

Psychological First Aid

By Albert Wu, MD, MPH, Johns Hopkins Medicine, Matt Norvell, DMin, Johns Hopkins Medicine

Healthcare professionals experience traumatic events that may exceed their ability to cope. Timely emotional support can help maintain their well-being. 

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.

August 23, 2021 | 1 min read

The Boomerang of Disparaging Remarks

By Harisa Spahic, Medical Student, Johns Hopkins University

Negative remarks about other specialities can discourage students from pursuing these fields. Instead, focus on sharing the positive aspects of your discipline.

Dr. Barry Solomon and his team work to create a safe space for teens at their practice.

April 12, 2018 | 3 min read

Creating a Safe Space For Teen Well Visits

By Barry Solomon, MD, MPH, Johns Hopkins University School of Medicine

Providing excellent care for adolescents includes creating a safe space for confidential discussions. The clinically excellent pediatrician is able to help support the teen to share sensitive concerns with parents and caregivers.

Georgia O'Keeffe, Series 1, Number 8.

November 20, 2018 | 2 min read

The Healing Power of Words

By Helen Bradshaw, MD, Johns Hopkins University School of Medicine

What we say to patients has the power to promote healing.

July 5, 2023 | 3 min read

What brought you in today?

By Hailey Haffey, PhD, University of Utah

Asking my patients open-ended questions about how they physically traveled to the appointment can reveal important information.

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.

Evening Star, Number III, Georgia O'Keefe, 1917, Museum of Modern Art

November 21, 2018 | 1 min read

Asking Difficult Questions

By Julia Ross, MD, Johns Hopkins University School of Medicine

Asking probing questions is difficult, but can make a difference in understanding your patient.

"Ángel M. Felicísimo from Mérida, España," Pablo Picasso, 1923. Creative Commons via Wikimedia. Public domain.

June 27, 2023 | 3 min read

Book Review of “Wanting: The Power of Mimetic Desire in Everyday Life” 

By Margaret Chisolm, MD, Johns Hopkins Medicine

Wanting what others desire contributes to dissatisfaction and rivalry. Learning how to separate your wants from those of the crowd will bring you greater happiness and life satisfaction. 

July 15, 2020 | 5 min read

5 Steps to Regulate Our Emotions

By William Wright, DO, MPH, Johns Hopkins Medicine

Sometimes our feelings are difficult to manage. When working with patients and colleagues, recognizing, understanding, and labeling our emotions can help us to respond more thoughtfully.

April 10, 2019 | <1 min read

Dr. Steven Frank, A CLOSLER Look

By Gretchen Miller, Managing Editor

Enjoy a three-minute video interview with anesthesiologist Steven Frank, MD, on what he learned from being a patient himself, and his gratitude for his entire team.

April 15, 2019 | 1 min read

7 Things I’ve Learned About Mentoring in 51 Years

By David Levine, MD, MPH, Johns Hopkins University School of Medicine

Helping others to achieve their full potential is the most incredible, wonderful, and exhilarating role one can undertake.

November 5, 2019 | 3 min read

A Series of Biases: Murphy’s Law at Play

By Sonal Gandhi, MBBS, MD, Johns Hopkins Medicine

Biases get in the way of our clinical reasoning. When the data doesn't fit, clinically excellent providers re-examine their assumptions.

June 10, 2020 | 2 min read

6 Lessons Learned From One Month as a Journalist

By Heather Kagan, MD, Johns Hopkins Medicine

Clinicians—like journalists— must communicate in an open and straightforward manner.

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.

March 25, 2021 | 1 min read

How to Mitigate Imposter Syndrome

By Namrata Walia, MD, Baylor College of Medicine

Imposter syndrome can interfere with your ability to care for patients. If these feelings become overwhelming, consider working with a mental health professional.

September 19, 2018 | <1 min read

Dr. Raf Llinas: A CLOSLER Look

By Gretchen Miller, Managing Editor

I try to teach using humor. I start by sharing with residents funny mistakes I made during my own training, so that they remember and learn from these poignant stories.

March 11, 2021 | 1 min read

How to Create Sanctuaries for Patients

By Michelle Ogunwole, MD, Johns Hopkins Medicine

To create safe spaces for historically marginalized patients, slow down and gather more information when conflicts arise. Be aware of your biases and give patients the benefit of the doubt.

November 22, 2021 | 4 min read

Noticing What We’ve Seen Without Seeing

By Ekene Ojukwu, MD, Johns Hopkins Medicine

Carefully observing our patients can lead to clinically relevant insights. Sometimes what seems inconsequential at first glance may be surprisingly significant.

December 12, 2022 | 5 min read

Room 441

By Alicia Zellmer, MD, George Washington University

Although humanized care can sometimes be more time-consuming, sharing detailed information and ensuring patient’s understanding is essential for clinical excellence. 

Many healthcare professionals make the sacrifice of quarantining from their families during the pandemic.

March 3, 2021 | 3 min read

Understanding the Sacrifices we Make in Medicine

By James Aluri, MD, Johns Hopkins Medicine

Giving excellent care to every patient requires you to make significant sacrifices. Acknowledging this can help you understand, and even accept, these sacrifices.

May 7, 2025 | 1 min read

Little things   

Kind gestures, like routinely saying hello to all members of the healthcare team, can foster a sense of belonging that enhances collective well-being and promotes collaboration in caring for patients. 

November 2, 2021 | 2 min read

What All Clinicians Must Know About End-of-Life Care

By Pringl Miller, MD, San Francisco, California

Initiating and withdrawing life-sustaining medical treatment is the patient’s or their surrogate's decision, not ours. We must always honor their wishes.

August 23, 2018 | 4 min read

How To Incorporate Students Effectively Into Clinic

By Rachel Salas, MD, Johns Hopkins Medicine

Making the time and effort to integrate students into clinic cohesively can be associated with both improved clinical productivity and educational value.

November 14, 2023 | 3 min read

Authenticity

By Charlene Gamaldo, MD, Johns Hopkins Medicine, Rachel Salas, MD, Johns Hopkins Medicine

Bringing your full self to work is a purposeful strategy for flourishing. This may also allow you to connect more deeply with patients and colleagues. 

September 8, 2020 | 1 min read

10 Ways to Cultivate Well-being During The Pandemic

By Rachel Salas, MD, Johns Hopkins Medicine

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.

June 19, 2018 | 2 min read

Sleep solutions (archives, 2018)

By Rachel Salas, MD, Johns Hopkins Medicine

People see sleep as a luxury, but it's a basic human need. As clinicians, we should ask patients how they're sleeping. Here are nine things you can recommend to help them feel more rested.

January 21, 2020 | 2 min read

A Daily Dose of Shakespeare

By Rachel Salas, MD, Johns Hopkins Medicine

Making time to read even just a few lines of timeless words can remind us of the complexity of being human, and facilitate clinicians' reflection upon connecting more genuinely with their patients.

August 22, 2019 | 3 min read

Leveraging Your Patient’s Strength

By Keri Bischoff, MA, WellBeing Coach partnering with Johns Hopkins, Rachel Salas, MD, Johns Hopkins Medicine

Excellent clinicians discover their patients talents to best deliver both recommendations and personalized care.

January 7, 2019 | 2 min read

Helping Your Patient Get Better Sleep During Hospital Stays

By Rachel Salas, MD, Johns Hopkins Medicine

Sleep is important during hospitalization, and we need to maximize quality and quantity the best we can for our patients. Asking about your patient’s sleep and identifying ways to improve it when possible is one way to start.

November 26, 2018 | 1 min read

You are special – but not when it comes to sleep!

By Rachel Salas, MD, Johns Hopkins Medicine

Healthcare providers are no different than anyone else - if you shortchange your sleep, there will be consequences!

March 1, 2023 | 2 min read

Moving Past Debt 

By Laura Hanyok, MD, Johns Hopkins Medicine

With my student loans forgiven, financial pressures were substantially allayed. With this stress removed, I feel more focused on serving my patients.  

January 18, 2023 | 2 min read

Finding a PCP

By Laura Hanyok, MD, Johns Hopkins Medicine

Finding a primary care physician can take time, but it’s worth it to find a personal physician for longitudinal care. Suggest patients ask their family and friends for PCP recommendations. 

December 27, 2018 | 2 min read

“Charm City” Movie Review

By Panagis Galiatsatos, MD, Johns Hopkins Medicine

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.

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.

December 13, 2023 | 1 min read

Micro-acts of joy 

By Laura Hanyok, MD, Johns Hopkins Medicine

Focusing on your own wellness doesn’t take a lot of time. A simple practice like listing three things you’re grateful for each day can reduce burnout. 

January 9, 2020 | 3 min read

Top Tips to Support Yourself While Pregnant and Working in Healthcare

By Laura Hanyok, MD, Johns Hopkins Medicine

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.

Miami, FL, USA - March 23, 2024: Passing out Narcan nasal spray at the Ultra Music Festival Miami.

April 23, 2024 | 1 min read

Outside the clinic walls: making Narcan accessible to everyone

By Panagis Galiatsatos, MD, Johns Hopkins Medicine

Addiction is a chronic disease that requires a combined approach of medical treatment and community engagement. Clinicians must work to educate their community about addiction and provide them with resources like Narcan.

"Jazzed about teaching others? Volunteer for a few hours to teach K-12 students about medicine or science."

May 1, 2023 | 2 min read

Choose Your Own Adventure

By Laura Hanyok, MD, Johns Hopkins Medicine

When choosing and leading well-being initiatives, consider what would most meaningfully help you and your colleagues thrive. 

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