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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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September 27, 2023 | 1 min read

Guardrails And Ambulances 

By Mike Fingerhood, MD, Johns Hopkins Medicine

Over 100,000 Americans die every year from overdoses, and most are preventable. Discuss with patients and loved ones the dangers of having old prescription or counterfeit pills, as well as the importance of keeping naloxone on hand.

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.

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. 

September 9, 2021 | 2 min read

Advising Patients About Heat-Related Illness

By Shaista Ahmed, MBBS, MPH, Johns Hopkins Medicine

Many heat-related illnesses are preventable. Advise patients to avoid going outdoors in peak heat hours, drink plenty of fluids, and know where cooling centers are in their community.

August 17, 2022 | 1 min read

Lessons From “A Field Guide to Getting Lost”

By David Kopacz, MD, University of Washington

Many clinicians feel burned out at some point in their careers. While this may feel disorienting, it’s possible to learn and grow from this experience.

June 20, 2019 | 2 min read

Be Brave Enough to Start Conversations That Matter

By Manasa Ayyala, MD, Rutgers New Jersey Medical School

"Between the World and Me" is a must read. At 152 pages, it's a small investment of time that leaves a large impact. I invite you to read this book with the intent to ask curious questions, to be ok feeling uncomfortable, and to continue this important dialogue.

April 16, 2024 | 1 min read

Changing gears (archives, 2024)

By Chris Tiplady, MD, Northumbria Healthcare, England

At the start of the pandemic, I permanently switched my commute from car to bike. I'm now passionate about motivating patients to be more active.

Encourage parents to support their teens in connecting with friends safely.

October 7, 2020 | 1 min read

CLOSLER Together

By Scott Wright, MD, Johns Hopkins Medicine

Discussing CLOSLER pieces in groups may yield more insights than simply reading on your own. Consider adding a discussion of a piece to your next staff, practice, or division meeting.

March 5, 2026 | 4 min read

Navigating family conflict at the bedside

Patients' loved ones enter the room with a lengthy history of how they handle disagreements. When things feel tense, focus on making space for different coping styles rather than trying to resolve long-standing disputes. 

April 11, 2023 | 2 min read

“Can I hold my newborn baby?”

By Carolyn Sufrin, MD, PhD, Johns Hopkins Medicine

Giving birth while imprisoned usually occurs under inhumane conditions, with women remaining shackled and not being permitted to hold newborns. This is a reminder that every patient deserves our compassionate and nonjudgmental care. 

March 22, 2018 | 7 min read

Fundamentals for Caring for Transgender Patients

By Paula Neira, JD, MSN, RN, CEN, FAAN, Johns Hopkins Medicine

Improve your skills as you work to support your transgender patients and interact with your transgender colleagues.

November 12, 2024 | 2 min read

DIY drugs: a risky prescription 

Healthcare professionals need to know about the growing trend of do-it-yourself (DIY) medicine. By asking open-ended questions about medication sources, clinicians can prevent adverse health outcomes. 

April 26, 2022 | 1 min read

The Power of Beliefs

By Stephanie Trudeau, PhD, The Thrive Center For Human Development

Explore your patient’s beliefs that invite healing, as well as those that are causing them to suffer. By understanding this, you can guide them to do more of the former and less of the latter. 

A shire in Shropshire. Author's photo.

January 29, 2019 | 7 min read

“Good Doctoring”

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

Reflections from a medical student on the practice of medicine as captured in the novels "The Bad Doctor," by Ian Williams, and "A Fortunate Man," by John Berger & Jean Mohr.

July 18, 2018 | 2 min read

The Bell Curve

By Lee Akst, MD, Johns Hopkins University School of Medicine

The difference between a 99.5% and 99.95% success rate isn't necessarily in knowledge or training, but in physician attitudes towards adapting and changing to evolving information.

“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 15, 2022 | 2 min read

Role Modeling Vulnerability

By Daniel Saddawi-Konefka, MD, MBA, Massachusetts General Hospital

When a patient dies, sharing your emotions with trainees normalizes this response and highlights our shared humanity.  

June 18, 2019 | 2 min read

Navigating the Uncertain: A Book Review of “The Laws 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."

July 30, 2018 | 1 min read

What’s a book club doing at a medical conference?

By Scott Wright, MD, Johns Hopkins Medicine

Join a book club or start a book club - in either your professional or personal context. You'll be glad you did!

February 27, 2026 | 2 min read

Self-forgiveness in the practice of medicine 

Mistakes happen. To move forward, reflect, speak with trusted colleagues and loved ones, and make amends where you can. 

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.”

April 10, 2023 | 1 min read

Sips And Gulps

By Judy Ashley, patient

Patients may need a clinician’s help with things that seem easy or obvious, like how to swallow pills.

March 27, 2018 | 2 min read

12 Things I Wish I’d Known 50 Years Ago

By Randy Barker, MD, Johns Hopkins Medicine, retired

Twelve things I would tell my younger self—all the things I didn’t know then, but wish I had.

November 7, 2024 | 2 min read

Following my own rules  

By Julie Caffrey, DO, MS, Johns Hopkins Medicine

Having my own set of guidelines has helped me to continuously improve. One of my favorites is consciously learning something new every day.

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.

April 14, 2022 | 3 min read

Afraid to Tell The Truth

By Kirsten Elin Smith, PhD, National Institute on Drug Abuse

When I shared with my clinician that I had previously been a heroin user, she made me feel ashamed. This taught me the importance of listening to patients with nonjudgmental curiosity. 

January 14, 2019 | 2 min read

We’re Getting CLOSLER to the Super Bowl!

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

Football-inspired clinical pearls from Vermont family physician Dr. Wilma Ferthler teach us how to be better clinicians.

April 18, 2018 | 6 min read

How To Reclaim Boredom From Your Smartphone

By Timothy Plante, MD, MHS, The University of Vermont Larner College of Medicine

Boredom brings mind wandering; mind wandering brings creativity. Here’s how I reclaimed boredom in my life.

September 2, 2025 | 3 min read

Gambling with health 

Gambling disorder frequently goes unrecognized in clinical settings despite its significant impact on mental and physical health. Clinicians can routinely screen for it using validated tools and refer at-risk patients to resources. 

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’!

Ruth and Carl J. Shapiro Gallery (Gallery 232), Museum of Fine Arts, Boston, featuring "Daughters of Edward Darley Boit," by John Singer Sargent (American, 1856–1925). Photograph by Flora Smyth Zahra.

June 6, 2019 | 7 min read

May Art Museum Challenge

By Flora Smyth Zahra, MA Clin Ed, DRestDent RCS, FHEA, Kings College London, Margaret Chisolm, MD, Johns Hopkins Medicine

The art museum is a space that has lessons to teach about clinical excellence, and fosters both the personal development and professional identity formation of clinicians.

April 11, 2024 | 1 min read

Takeaways from Adam Grant’s “Think Again” 

By Gretchen Miller, Managing Editor

Healthcare professionals can benefit from adopting a growth mindset that emphasizes rethinking existing beliefs and approaches. A key strategy is questioning assumptions and biases, which can lead to better decision-making. 

February 26, 2026 | 3 min read

Cutting costs, not corners 

Some patients need to find cheaper prescription medications online. When they do, help them verify sourcing and dosing to keep them safe. 

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.     

March 30, 2023 | 2 min read

Cultivating a Beginner’s Mind

By Clara Watkins, student, Emory University School of Nursing, Colleen Christmas, MD, Johns Hopkins Medicine

Remember when you were a new learner? Approach situations with that open, creative, and nonjudgmental mind that you may have had when you started training. 

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.

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.

April 14, 2022 | 4 min read

Talking About Climate Change With Patients

By Dean Chien, CLOSLER team, Baltimore, Maryland

Climate change affects the health of everyone. When talking with patients about climate change, meet them where they are and listen nonjudgmentally. 

March 18, 2019 | 2 min read

The Truth About Sex

By Khalil Ghanem, MD, PhD, Johns Hopkins University School of Medicine

How you phrase questions when obtaining a sexual history can mitigate the impact of social desirability bias and enhance the accuracy of the information that is obtained.

September 20, 2023 | 2 min read

Sharing Our Stories

By Hailey Haffey, PhD, University of Utah

Stories we’ve internalized about healing may direct our approach to patient care. Find the one that resonates most with you.

September 3, 2020 | 3 min read

See Something, Say Something

By Kali Cyrus, MD, MPH, Johns Hopkins Medicine

Being an ally for justice to patients and colleagues requires taking action. Doing or saying something, literally anything, when someone is mistreated is better than nothing.

August 21, 2025 | 2 min read

Academic medical departments can learn much from Department Q

Warning, if you begin the “Dept Q” series, you won’t be able to stop! By the time you finish reading these books, you’ll be a more compassionate person and a better healthcare professional. 

August 8, 2022 | 1 min read

988

By Patrick Hemming, MD, Duke University

When we identify patients who are experiencing mental illness, we need to let them know about this new resource in the U.S.

April 3, 2024 | 2 min read

Military kids serve too 

By Richard Schaefer, MD, MPH, Johns Hopkins Medicine

April is the Month of the Military Child. Clinicians caring for military family members should understand their history and stressors specific to the armed service to give the best possible care.    

February 22, 2018 | 3 min read

Family History and Addiction Risk

By Margaret Chisolm, MD, Johns Hopkins Medicine

For some patients the risk of becoming addicted to prescription opioids is extraordinarily high and may outweigh any pain control benefit.

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.

June 26, 2018 | 1 min read

Harnessing Digital Technology for Clinical Excellence

By Margaret Chisolm, MD, Johns Hopkins Medicine

Digital technology can be leveraged for the greater good of clinically excellent patient care. Social media tools like Twitter enable you to connect with healthcare stakeholders from around the world.

January 15, 2020 | 1 min read

Extra Minutes

By Scott Newsome, DO, Johns Hopkins University School of Medicine

Every extra minute a clinician spends with a patient is worth it.

October 28, 2024 | 2 min read

Spark the change

By Sadiqua Sadaf, MBBS, Deccan College of Medical Sciences, Hyderabad, India

To motivate patients toward change, healthcare professionals can focus on building trust and setting achievable goals.

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.

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

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