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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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February 12, 2025 | 1 min read

Insights from the book “Decoding Greatness”

By Scott Wright, MD, Johns Hopkins Medicine

Achieving greatness in any field is not only about talent or practice; it’s also about studying the successes of those who are exemplary. In medicine, observing and analyzing the approaches of admirable colleagues can allow us to grow and evolve toward being more clinically excellent. 

"The Doctor's Visit," Jan Steen. Philadelphia Museum of Art. Publicly shared via the Fair Use Act.

June 15, 2021 | 4 min read

How Art History Can Improve Your Care of Patients

By Siobhan Conaty, Art History Professor, La Salle University

Focusing on visual cues from our patients can help us to better understand them. Closely looking at art is one way that a clinician can improve their observation skills.

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.

Treponema pallidum Syphilis bacterium, the bacterium responsible for the dangerous sexually transmitted infection, syphilis.

January 8, 2024 | 3 min read

Combatting the syphilis epidemic 

By Zach Lorenz, MD, Johns Hopkins Medicine

Rates of syphilis and other sexually transmitted infections are skyrocketing. It’s imperative that we have candid conversations with patients about their sexual behaviors. 

October 2, 2025 | 2 min read

Don’t sleep on it  

Insomnia is a common condition that increases the risk of physical and mental health problems. Screening for it is an important part of patient care, and it can be quick and easy. 

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.

October 12, 2022 | 1 min read

Equity and Inclusion: Beyond The Recognition Phase

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

Increasing the diversity of minority clinicians is a first step in combatting racism in medicine. We must also ensure that curricula are free of stereotypes and bias. 

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.

July 9, 2024 | 3 min read

Takeaways from the book “Progress Notes” 

By Abraham Nussbaum, MD, Denver Health

Excellent clinicians understand patients not just as bodies, but also as individuals within a community. Healthcare professionals should be trained in both for a more holistic approach to patient care. 

November 19, 2020 | <1 min read

Quitting Smoking During The Pandemic

Remind patients that quitting smoking is hard and takes time. This will help them take a first step toward better health.

November 29, 2018 | 2 min read

Management Reasoning: Diagnostic Reasoning’s Underappreciated Sibling

By David Cook, MD, MHPE

Management reasoning is primarily a task of shared decision-making and monitoring, and is inherently more complex than diagnostic reasoning. A better understanding of management reasoning will offer insights into the causes and avoidance of medical error, clinical practice quality improvement, and training and assessment of health professionals.

March 30, 2022 | 3 min read

Mitigating maternal mortality (archived piece, 2022)

By Kimberly Turner, MD, Johns Hopkins Community Physicians

A more diverse clinical workforce brings greater variety of perspectives in patient care which may improve clinical outcomes. 

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. 

Kau Sai Chau Public Golf Club, Hong Kong.

July 21, 2020 | 1 min read

Medicine is Like Golf

By Barry Bryant, MD, Johns Hopkins Medicine

In both medicine and golf, it's helpful to accept that much is beyond our control. Trusting our ability —grounded in thousands of hours of focused practice—may allow us to have the confidence that our best efforts will usually translate into favorable results.

February 5, 2025 | 1 min read

Pathological hiccups

Sometimes benign symptoms can herald more serious problems. Being ready and willing to reconsider initial impressions is crucial for accurately discovering the underlying etiology.

June 7, 2021 | 2 min read

It’s Not About Weight

By Nicole Cifra, MD, MPH, University of Rochester

Approaches employed by eating disorder specialists can be applied to support all patients. This includes emphasizing healthy behaviors and acknowledging your own assumptions about weight.

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.  

October 14, 2021 | 1 min read

Caring During Death

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

It’s a privilege to care for patients and their loved ones, especially at the end of life. Even when we can’t cure, we can always comfort.

November 19, 2019 | 2 min read

Aging isn’t a dirty word

To many, "aging" and "old" are considered dirty words. Clinicians should fight ageism.

July 2, 2024 | 4 min read

Seeing

By Kamna Balhara, MD, Johns Hopkins Medicine

When patients present frequently to the ED, clinicians must make an effort to validate them as individuals. It's also important to be aware of and work to change the underlying social determinants that may drive their visits.

November 24, 2020 | 2 min read

Women clinicians and women’s bodies (archives, 2020)

By Colleen Christmas, MD, Johns Hopkins Medicine

Constant critiques on women’s bodies and dress means physicians who identify as female must spend energy ensuring they look as they “should” to patients and colleagues. This energy is better focused on giving clinically excellent care.

November 12, 2018 | 3 min read

Insights From “A Whole New Mind”

Daniel Pink's "A Whole New Mind" highlights the importance of cultivating empathy, humor, and the ability to create meaning.

13 Norham Gardens, the Osler's home in Oxford from 1907 until their deaths.

June 6, 2018 | 1 min read

Open Arms: The Welcoming Spirit of the Osler Residence

By Margaret Chisolm, MD, Johns Hopkins Medicine

Although we might not all live in a “substantial Victorian house” like William Osler’s, we can all embrace the welcoming spirit of “The Open Arms,” and invite more of our learners into our homes for informal meetings, mentorship, and maybe even tea.

July 3, 2023 | 1 min read

Pronouns Matter

By Kevin Frick, PhD, Johns Hopkins Carey Business School

A reminder to try to use a person’s preferred pronouns. This can help people feel more welcome and comfortable.

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. 

May 27, 2021 | 2 min read

How to Support Asian American and Pacific Islander (AAPI) Patients

By James Wu, MD, Medical College of Wisconsin, Neurofourier, MD, New York, New York, Yuemei Zhang, MD, University of Washington

Currently, AAPI people are facing a wave of discrimination. Clinicians need to be sensitive to patients’ experience of racism and educate themselves on how to best offer support.

April 1, 2019 | 3 min read

Practicing Medicine and Having a Ball

By Wilma Ferthler, MD, Rural Country Doctor, Northeast Kingdom, Vermont

Hope our 2019 April Fool's piece makes you chuckle!

December 12, 2023 | 2 min read

“CARE”

By Kelly Buckholdt, PhD, Veterans Health Administration, William Laurento II, MEdL

There’s no more dramatic way to understand patient-centered care than being a patient. 

September 18, 2025 | 3 min read

Continuity in ADHD care

Life transitions, such as starting college, can be especially challenging for patients with ADHD. Ensuring continuity of care during these times is essential.

October 12, 2021 | 2 min read

Unshackle The Mind

By Kittane "Vishnu" Vishnupriya, MBBS, Johns Hopkins Medicine

When caring for a man in handcuffs, I was reminded that every patient must be shown empathy and compassion.

Dr. William Greenough teaches about best practice in homecare.

June 20, 2018 | 1 min read

Home Care: A Better Way To Care For Ventilator Patients

By William Greenough, MD, Johns Hopkins University School of Medicine

Using portable ventilator technologies in the patient’s home can provide a higher quality of life.

November 12, 2019 | 2 min read

The Early Bird Special

By Rebecca Hamburger, Medical Student, Central Michgan University College of Medicine

Timing is everything. Doing our best to optimize access to healthcare is a first step to serving our patients.

June 24, 2024 | 2 min read

Partnering with patients with intellectual and developmental disabilities in medical decision-making 

By Sara Mixter, MD, MPH, Johns Hopkins Medicine

When caring for patients with intellectual and developmental disabilities, explore supported decision-making options and prioritize communication needs. These steps should offer them more control over medical choices. 

November 17, 2020 | 4 min read

Allyship and Upstanding

By Geoff Stetson, MD, UCSF

It’s critical to promote a culture of emotional safety in your clinical setting. Offer support and speak up when you witness hurtful incidents.

March 22, 2022 | 1 min read

Navigating my First Patient Death

By Elissa Abou Khalil, MD, University of Pittsburgh Medical Center

Acknowledging feelings and asking for support may help when dealing with loss.  

June 20, 2023 | 1 min read

The Road Not Taken 

By Antonio Forte, LMSW, Johns Hopkins Medicine, Larkin Corrigan, MSW, Portland, Oregon

If patients can’t manage on their own, clinicians and staff can help them use social support networks and other resources to find transportation to their appointments. Virtual visits can also be considered. 

The Bluebird Cafe, Nashville, Tennessee. Copyright by the author.

May 11, 2020 | 3 min read

Redefining Rounds—Will The Circle be Unbroken?

By Chase Webber, DO, Vanderbilt University Medical Center

A patient care team performs best when all voices harmonize and creative approaches are applauded.

January 22, 2025 | 2 min read

The ulcer: a window into a patient’s emotional distress 

By Margret Nassuuna, DCP, Innerspark Recovery, Naalya, Uganda

The body, a masterful storyteller, often reveals insights into a patient’s mental state. By deciphering its narratives, clinicians may also be able to better address both the mental and emotional aspects of care.

May 19, 2021 | 3 min read

Clinical Training Translating to Clinical Excellence

By Jennifer Spicer, MD, MPH, Emory University

Bias awareness achieved in teaching/learning can transfer to the clinic. Thus learners can help clinicians become aware of bias toward patients.

March 13, 2019 | <1 min read

Dr. Elliot Fishman, A CLOSLER Look

By Gretchen Miller, Managing Editor

Artificial intelligence (AI) will drastically alter all of medicine, with the potential to enhance patient care through improved diagnoses.

December 7, 2023 | 2 min read

“I need this test.” 

By Pavitri Dwivedi, DO, MPH, Johns Hopkins Medicine

When patients request a test that you think is unnecessary, be curious and elicit why they feel this way. Then address their concerns about the condition being screened. 

September 15, 2025 | 6 min read

How to support LGBTQ+ patients

Amid increasing anti-LGBTQ+ legislation, clinicians have an ethical duty to provide inclusive care. Read on for how to create welcoming environments in clinic and connect LGBTQ+ patients with appropriate resources. 

October 11, 2021 | 2 min read

Helping Patients Share Disappointing Diagnoses With Loved Ones

By Ambereen Mehta, MD, Johns Hopkins Medicine, Michelle McWhirter, LCSW-C, Johns Hopkins Medicine

Patients often want to share significant health news with loved ones. You can help them choose when and how to disclose this information.

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.

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.

June 13, 2024 | 2 min read

Lightening the load 

By Susan Lehmann, MD, Johns Hopkins Medicine

Clinicians can prioritize patient well-being by discussing the burden of engaging in care. Collaborate with patients to ensure recommendations are feasible and consider alternative approaches if necessary. 

April 24, 2018 | 2 min read

Equality v. Equity

Working towards giving equitable care, not equal care, should be our focus, especially if we’re aiming to shrink the health disparities gap.

"The Persistence of Memory," Salvador Dali, 1931, The Museum of Modern Art.

November 19, 2018 | 2 min read

Learning from Learners

By Margaret Chisolm, MD, Johns Hopkins Medicine

Teaching is the best way to learn. In the end, I am not only a teacher and my residents are not only learners, but we are both a little of each.

March 23, 2022 | <1 min read

Keeping The Readers in Mind

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

When documenting in the medical record, we must use respectful language. Both our patients and colleagues will appreciate and benefit from our thoughtfulness. 

June 6, 2023 | 3 min read

Plant Straight Rows

By Kyle Glienke, MD, Buena Vista Regional Medical Center, Iowa

In farming, as in medicine, focusing only on daily tasks may keep us from seeing the impact we have.

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Stimulating healthcare professionals and trainees to reflect on giving exceptional care to every patient.

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