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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 10, 2018 | 3 min read

Truly Listen: Clinical Excellence in Nephrology

By Edward Kraus, MD, Johns Hopkins University School of Medicine

Listen to your patient, try to understand what they're saying, and think beyond policies and protocols to be the best advocate possible.

Dingle Peninsula, County Kerry, Ireland.

March 9, 2020 | 1 min read

Embrace the Craic!

By Michelle Gyenes, MS, Columbia Mailman School of Public Health

We would all do well to be more like the Irish!

August 28, 2023 | 2 min read

Travelers on an Unfamiliar Road

By Daniel Pomerantz, MD, Montefiore New Rochelle Hospital, New York

A rabbi once taught me the distinction between curing and caring. As I accompany patients on the rough road of illness, I consider ways to make their journey a little smoother. 

January 16, 2025 | 2 min read

Talk to her 

By Uma Balachandran, medical student, Ichan School of Medicine at Mount Sinai

My blind aunt's encounter with a clinician highlighted the problem of ableism in medicine. Her experience is a reminder to always communicate directly with disabled patients and ask about their preference for identity-first or person-first language. 

April 21, 2020 | 2 min read

“Jiro Dreams of Sushi”

By Scott Wright, MD, Johns Hopkins Medicine

Role models can be found on Netflix. Jiro, the master sushi chef, is aiming for perfection, and we must also continuously try to get better in our work with patients.

February 13, 2019 | 2 min read

Disparities in New Treatments

By Utibe Essien, MD, MPH, University of Pittsburgh School of Medicine

When beginning new treatments, it's important to ask patients what they understand about the medication, what their expectations are, what barriers might exist to remaining on this agent, and what they value most out of their treatment plan.

The author discusses patient sleep with a colleague.

June 18, 2018 | 2 min read

How To Help Your Patients Get Better Sleep, Part I

A sleep specialist reminds us of the importance of asking patients about their sleep.

“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.

March 14, 2024 | 3 min read

Why sexual orientation and gender identity in the EMR matters 

By Tyler Cornell, MSN/MPH, CRNP (she/her), Johns Hopkins Medicine  

Always ask patients about their gender identity, preferred name, pronouns, and how they define their sexual orientation. This builds trust and helps your patients feel safe to return for follow-up. 

October 22, 2025 | 3 min read

Coordination with compassion 

To build an exceptional care team: foster psychological safety, model humility, and solicit input from every person. Daily rituals of respect can sustain excellent patient care. 

July 23, 2019 | 3 min read

Engaging Care Partners in Communication

By Antonio Wolff, MD, Johns Hopkins University School of Medicine, Jennifer Aufill, BA, Johns Hopkins Bloomberg School of Public Health, Jennifer Wolff, PhD, Johns Hopkins Bloomberg School of Public Health

Families and friends are valuable resources. These partners in care can help clinicians improve quality of care and patient outcomes.

January 25, 2023 | 2 min read

All in The Family

In my general internal medicine practice, I’ve learned that getting to know a patient’s family gives a unique window into their lives.  

Reverse Waterfall, Nasik, Maharashtra, India.

February 16, 2022 | 1 min read

Mentorship in Reverse

By Rayah Sawaya, MD, American University of Beirut

If you find a mentor who’s helpful and generous, consider reciprocating with “reverse mentoring.”

September 26, 2024 | 3 min read

Under the influencers 

By Adam Schiavi, MD, PhD, Johns Hopkins Medicine

The social media "Black out challenge" promotes asphyxia that can result in irreversible brain damage or death. Healthcare professionals should warn patients and caregivers to be cautious about social media trends and provocations. 

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.

May 9, 2018 | 2 min read

Applying the Coaching Model to Medical Education

By Ryan Graddy, MD, AbsoluteCARE Medical Center, Atlanta, Georgia

Coaching—direct observation of learners with feedback geared toward skills development—is an important way to teach individualized medical education. Outstanding coaches across disciplines share characteristics that can be applied in clinical coaching encounters.

August 17, 2023 | 3 min read

The Hospital Playlist 

By Kerry Devlin, MMT, LPMT, MT-BC (she/her), Johns Hopkins Medicine

Consider the hospital soundscape and how it may impact patients’ well-being. To create a more soothing stay, silence or turn down monitors if possible. 

January 15, 2025 | 2 min read

A spray away from the answer 

This clinical conundrum, related to hypoxia, underscores the importance of meticulous history-taking and the potential for unexpected complications with seemingly benign medications. 

The author's drawing of her heart utilizing the technique of defamiliarization.

February 14, 2019 | 3 min read

Defamiliarization

By Sarah Walser, , Penn State College of Medicine

Incorporating defamiliarization into practice builds empathy and broadens our worldview. It challenges us to expand and find confluence between different frameworks through which an experience, such as a disease, can be interpreted.

July 18, 2022 | 2 min read

How to have effective discussions about alcohol 

By Beth McGinty, PhD, Johns Hopkins Medicine, Mike Fingerhood, MD, Johns Hopkins Medicine

Talking with patients about the risks of heavy alcohol consumption and the benefits of change can have a positive impact on their health. 

August 26, 2021 | 1 min read

Destigmatizing Addiction: The Power of Words

By Namrata Walia, MD, Baylor College of Medicine

Please use the term 'person with substance use disorder’ instead of ‘addict’!

March 4, 2024 | 2 min read

Getting the diagnosis right 

By Colleen Christmas, MD, Johns Hopkins Medicine

After arriving at what you think is the diagnosis, pause and consider alternative explanations. For patient populations at high risk for misdiagnosis (women and historically marginalized groups), examine how biases might be influencing your conclusions. 

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.

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.

January 9, 2023 | 2 min read

Questions Raised by “There, There” 

By Mike Fingerhood, MD, Johns Hopkins Medicine

Reflecting on our own “there” (the place where we grew up) can trigger conversation that helps us to understand our patients’ “there.” This can strengthen the patient-clinician relationship.

February 15, 2022 | 1 min read

The Free Throw Line and Mindful Practice

By Richard Schaefer, MD, MPH, Johns Hopkins Medicine

Basketball players have a ritual followed by a pause before shooting a free throw. Clinicians can do likewise to be fully present for their next patient.     

August 21, 2018 | 1 min read

Talking With Young Adult Patients About Alcohol

By Mike Fingerhood, MD, Johns Hopkins Medicine

Clinicians need to be vigilant to discuss alcohol use with patients and remember that the legal drug, alcohol, causes more morbidity and mortality than opioids.

The colors of the transgender flag.

March 25, 2026 | 3 min read

Feeling seen 

To build trust and help patients feel safe, use their preferred name and pronoun. Doing so consistently ensures that every patient feels recognized and respected. 

Photo of Colin. Copyright with the family.

April 13, 2021 | 2 min read

Patient as Educator

By David Reid, Co-Director, Dare Dementia, England

From my patient with dementia, I learned that patients are experts on the lived experience of their illness. We must value and acknowledge their insights and be open to learning from them.

Hobbit holes, Hobbiton, Matamata, New Zealand. Photo by Jackie Ick, flickr.com, public domain, wikimedia.org.

February 21, 2020 | 2 min read

Hobbits of Healthcare

By David Shih Wu, MD, Johns Hopkins Medicine

The excellent clinician demonstrates hobbit-like bravery by leaning into hard conversations.

August 16, 2023 | 1 min read

The Other Medical History

By Jeffrey Millstein, MD, Penn Medicine

Learning about the history of medicine can help put current health system challenges in perspective. I was especially struck by the enduring primacy of the patient-doctor relationship. 

April 6, 2020 | 1 min read

Addiction Recovery During the Pandemic

By Mike Fingerhood, MD, Johns Hopkins Medicine

We are all stressed by the great uncertainty related to COVID-19, but for our patients with addiction, it is much greater. Check in with your patients and support them in finding healthy ways to cope.

January 30, 2019 | <1 min read

Dr. David Wu, A CLOSLER Look

By Gretchen Miller, Managing Editor

Palliative care is an approach to medicine that focuses on quality of life. My hope is that every clinician learns basic palliative skills to lead family conversations when there is a critically ill patient. It's a precious privilege to be able to enter people's lives at their most vulnerable time, and help them find some kind of peace.

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.

February 29, 2024 | 1 min read

“It could happen to you”

By Hayley Sparks, MD, Johns Hopkins Medicine

When talking with vaccine-hesitant patients, I bring up the recent measles outbreaks. It can be effective to use current events to motivate better compliance with immunization guidelines. 

October 16, 2025 | 4 min read

Prescribing humility 

Standard of care is provisional—reassess therapies as evidence evolves. Be open to changing your thinking and practice as new data emerge. 

February 2, 2022 | 1 min read

Lessons in Leadership During Adversity

By Roy Ziegelstein, MD, Johns Hopkins Medicine

In difficult times, it’s helpful to understand others’ fears and concerns. Communicating clearly and regularly with those we serve is essential.

September 17, 2024 | 1 min read

Navigating drug shortages

By Carmen Lopez-Arvizu, MD, Johns Hopkins Medicine

In the face of drug shortages, clinicians must become proactive resource navigators. By staying informed, collaborating with patients, and exploring alternative solutions, clinicians can help mitigate the negative impact of shortages.

March 23, 2026 | 2 min read

A dose of caution  

Pause before prescribing—consider not only the correct dosage but also the patient’s finances and home support for managing the treatment. 

"Girl with a Bamboo Earring," Awol Erizku, 2009. Used under the fair use Copyright Act.

February 18, 2021 | 2 min read

Art is Integral to Healthcare

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

Engaging with art can address some of medicine’s greatest challenges, including recognizing our common humanity.

February 25, 2020 | 2 min read

5 Things Clinicians can do to Reduce Drug Prices

By Justin McArthur, MBBS, MPH, Johns Hopkins Medicine

Excellent clinicians prescribe thoughtfully—pruning medication lists, advising patients on how to save money, and advocating for change.

July 10, 2018 | 1 min read

Pause Before Hospitalizing the Elderly

By Samuel Durso, MD, Johns Hopkins Medicine

Confusion among hospitalized older adults is common and dangerous. The hospital environment should be avoided if at all possible, with a goal of managing acutely ill older adults at home.

Trichomonas vaginalis

December 12, 2024 | 3 min read

Home testing: a new era in sexual health      

By Scott Wright, MD, Johns Hopkins Medicine

At-home sexually transmitted illness (STI) testing allows easier patient access. It’s crucial for healthcare professionals to talk with patients about the limitations of these tests and discuss when follow-up care is needed.  

Martin Luther King Jr. Memorial, Washington, D.C.

March 25, 2020 | 1 min read

Standing With Courage During Challenging Times

By Juliette Perzhinsky, MD, MSc, Central Michigan University

"The ultimate measure of a [person] is not where [s/he] stands in moments of comfort and convenience, but where [s/he] stands at times of challenge and controversy." -Martin Luther King Jr.

January 28, 2019 | 3 min read

Reflections on “Healing Alone”

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

In defense of the practice of pimping, though the term is a regrettable word choice, I learned from having questions directed at me. And my frequently incorrect responses were usually met with thoughtful explanations.

July 14, 2022 | 2 min read

How to Talk to Children About Gun Violence

By Carol Vidal, MD, PhD, Johns Hopkins Medicine

Give children time and space to talk about their worries and listen closely. Remember, it’s always best for children to first hear the news from a trusted adult.

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.

Colorectal Cancer Awareness

February 19, 2024 | 2 min read

Mitigating colon cancer in young patients

By Ekta Gupta, MBBS, Johns Hopkins Medicine

There's and increasing risk of colon cancer in younger patients. Clinicians need to be diligent in considering the possibility of colon cancer.

October 13, 2025 | 2 min read

The word “want” may leave patients wanting 

When prior notes document that a patient doesn’t “want” a specific intervention, elicit the patient’s desired outcome and acceptable trade-offs. Then determine whether “I don’t want X” is absolute or conditional and align the care plan accordingly. 

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.

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