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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
Topic Search
February 12, 2020 | 1 min read

Agents of Change—Learning From Gen Z Healthcare Students

By Kevin Pan, Medical Student, Ohio University School of Medicine

Excellent clinicians are committed to reducing health inequity.

March 20, 2018 | 2 min read

7 Things Clinicians Can Learn From Therapy Dogs

By Stephanie Cooper Greenberg, Johns Hopkins Pet Therapy Program

Dogs see the person in front of them only as people and not as patients.

The Rolling Stones in concert at the British Summer Time Festival in Hyde Park, July 6, 2013. Wikimedia, Public Domain.

January 2, 2020 | 1 min read

A Commonly Uncommon Patient

By Jeffrey Trost, MD, Johns Hopkins Medicine

Asking colleagues for help and re-reviewing data are essential in identifying clues to an accurate diagnosis.

December 16, 2019 | 4 min read

Top 10 Tips to be a Great Consultant

By Aline Charabaty, MD, Johns Hopkins Medicine

Read these 10 tips so that next time your pager goes off, you can be an outstanding consultant!

December 2, 2019 | 2 min read

Improving Communication Between Inpatient Teams and PCPs

By Stephen Berry, MD, Johns Hopkins Medicine

While it's not always easy, hospital-based providers need to find a way to connect with the healthcare professionals who will continue their patient's care.

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.

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.

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.

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.

October 31, 2019 | 1 min read

A Physician, a Zombie, and a Patient Walk into a Bar

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

We are more like zombies than you might think. This fact reminds us that we should be able to find commonalities with all of our patients and colleagues. Happy Halloween!

October 2, 2019 | 2 min read

Partnering With Patients to Prevent Diabetes

By Eva Tseng, MD, MPH, Johns Hopkins Medicine

Clinically excellent clinicians effectively counsel and motivate patients to prevent diabetes. Setting specific goals for lifestyle changes, referring to evidence-based Diabetes Prevention Programs, and scheduling timely follow-up visits are among the tips outlined.

September 24, 2019 | 1 min read

Counseling Patients on the Dangers of E-cigarettes

E-cigarettes pose unique health risks. Screening and informing our patients of these concerns is imperative.

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.

Window at St. Leopold’s Church, depicting the seven corporal works of mercy. Photograph by Margaret S. Chisolm

September 18, 2019 | 7 min read

August Art Museum Challenge

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

Clinical learning and practice are not removed from cultural and political realities. As clinical educators, it is our responsibility to create both humanistic learning environments that inculcate respect for the ultimate purpose of healthcare: the well-working of the human being as a whole.

August 13, 2019 | 2 min read

How Does Bullying Relate to Clinical Excellence?

By Scott Wright, MD, Johns Hopkins Medicine

There is no place in medicine for bullying. It interferes with growth of individuals and collaborations among team members – both of these are critical for serving our patients.

August 12, 2019 | 3 min read

Mental Illness and Mass Shootings

By Cassandra Crifasi, PhD, MPH, Emma Beth McGinty, PhD, Johns Hopkins Bloomberg School of Public Health

Most people with serious mental illness are never violent toward others. Due to the media’s misleading focus on the role of mental illness in gun violence generally and mass shootings specifically, many people are afraid that a diagnosis of a serious mental health condition like schizophrenia means they or their loved one are at high risk of hurting other people, which is not supported by the research evidence.

"Sun Rise," by David Kopacz.

August 8, 2019 | 2 min read

The Circle of Re-Humanizing Medicine

By David Kopacz, MD, University of Washington

We need human-based medicine in conjunction with evidence-based medicine. If we only identify as scientists and not as healers, we risk dehumanizing our patients and ourselves.

August 5, 2019 | 2 min read

Training and Identity

What parts of yourself do you want to bring back into your life that you may have lost during residency?

July 30, 2019 | 3 min read

Searching for Bicarb in July

By Camille Petri, MD, Mass General

To succeed in clinical practice, be humble and open to learning from all members of your team.

July 31, 2019 | 3 min read

The Healing Circle as a Holistic Framework

By David Kopacz, MD, University of Washington

As can be learned from a Native American healer, to heal profoundly, one must holistically integrate mental, emotional, physical, and spiritual aspects of being human.

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.

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.

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.

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.

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."

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.

June 3, 2019 | 1 min read

Every Piece of Data Matters

By Rabih Geha, MD, University of California San Francisco

Bolded, flagged, or typed in a different color, an abnormal result demands the mind’s eye in many modern EMRs, but it is equally important to direct our gaze to the quietly normal labs; not uncommonly, they may be screaming a powerful clue.

May 23, 2019 | 1 min read

The Thinking of a Clinical Problem Solver

By Reza Manesh, MD, Johns Hopkins University School of Medicine

We aren't expected to know everything. Identifying the salient features of a case can lead you to the diagnosis.

June 10, 2019 | 4 min read

Lessons learned from my journey through depression

By Shannon Scott-Vernaglia, MD, Mass General

Being a patient has taught me patience, with myself, with those I care about, and with those I care for as physician. 

"The Starry Night," Vincent Van Gogh, 1889, Museum of Modern Art.

May 16, 2019 | 5 min read

Starry, Starry Night

By Juliette Perzhinsky, MD, MSc, Central Michigan University

There are times that as clinicians we become patients ourselves, needing compassionate care for injuries entirely unrelated to our chief complaint.

"L'Atelier au mimosa," Pierre Bonnard.

May 13, 2019 | 7 min read

April Art Museum Challenge

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

Slow looking can enable clinicians to see more deeply, think more critically, and engage more meaningfully in patient care. Time spent in a museum supports clinician wellness and nurtures student professional identity formation.

"Blue Rider," Franz Marc, 1911.

May 14, 2019 | 4 min read

Review of “Critical Crash”

By Andre Lijoi, MD, York, Pennsylvania

We all have our woundedness, and our own story is important in the context of caring for our patients. These stories and wounds operate in the background of our consciousness and we must recognize and manage them.

"Wheat Field with Cypresses," Vincent van Gogh, 1889. Metropolitan Museum of Art.

May 7, 2019 | 2 min read

Finding Balance

By Danielle Johnson, MD, Lindner Center of HOPE, University of Cincinnati

Small gestures while supporting patients through trauma and grief can make a big difference.

April 16, 2019 | 2 min read

4 Lessons From 12 Years as a Patient-Doctor

By Julia Michie Bruckner, MD, MPH, Children\'s Hospital Colorado, University of Colorado School of Medicine

Our white coats are not shields; they could be traded in for a flimsy hospital gown at any moment. Keeping this in mind, we can think of how we want to be cared for when our time comes, and then give this level of care to others. We can honor our shared humanity and vulnerability in our practice.

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.

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!

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.

March 28, 2019 | 6 min read

Integrating Psychology and Primary Care

By Benjamin Bensadon, PhD, University of Florida College of Medicine

Person-centeredness holds great potential to maximize healing in the way Osler envisioned more than a century ago. But to translate this concept clinically, psychology and medicine must come closer together. The closer we can come together, the closer we can come to Osler.  

Guanyin, Bodhisattva of Compassion, Honolulu Museum of Art. Photo by Margaret Chisolm, MD.

March 7, 2019 | 5 min read

On Looking: February Museum Visit

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

The more lessons on clinical excellence we look for in art, the more we find.

March 5, 2019 | 3 min read

From Film School to Medical School (Part 3 of 3)

By Margaret Chisolm, MD, Johns Hopkins Medicine

Using both words and images, John Berger and Jean Mohr's photo-essay, "A Fortunate Man," provides an intimate glimpse into the role of the doctor: "To cure sometimes, to relieve often, and to comfort always."

Wye Valley, Wales, by Taylor Purvis, October 2018.

February 28, 2019 | 2 min read

From Film School to Medical School, (Part 2 of 3)

By Margaret Chisolm, MD, Johns Hopkins Medicine

Using both words and images, John Berger and Jean Mohr's photo-essay, "A Fortunate Man," provides an intimate glimpse into the role of the doctor: "To cure sometimes, to relieve often, and to comfort always."

April 9, 2019 | 1 min read

Being Yourself as a Professional

By Kim Stokes, MHS, PA-C, East Carolina University

Be kind, be humble - and be yourself!

February 18, 2019 | 1 min read

A Tense Moment in the ER

By Danielle Ofri, MD, PhD, New York University School of Medicine

There are no easy solutions for conflicts of race, class, gender, societal roles, and economics. It’s only our individual work chipping away that will get us to a new place. It’s up to each of us to bring change.

February 19, 2019 | 4 min read

On Feeling Helpless: A Psychiatrist Reflects on the Aftermath of a Patient Suicide

By Dinah Miller, MD, Johns Hopkins University School of Medicine

If you've been distressed by the loss of a patient to suicide, I hope my story will provide a moment of relief as you begin the process of healing; I hope that you may feel less alone.

March 19, 2019 | 3 min read

Reversing the Backslide: Sexually Transmitted Infections in the US

By Matthew Hamill, MBChB, PhD, Johns Hopkins Medicine

Open, non-judgmental, respectful, medically-relevant conversations need to be the cornerstone of all therapeutic relationships. As long as patients feel valued and at the center of their care, patients are willing to engage in discussions about sexually transmitted infections.

MERIT Health Leadership Academy students, Baltimore, Maryland, author's photo.

February 27, 2019 | 2 min read

The Need for Diversity

By Tyler Mains, MD, University of California, San Francisco

Our future healthcare workforce must be as diverse as the communities it serves.

February 11, 2019 | 5 min read

The Dots We Connect – An Interview with Dan Pink

Dan Pink distills pearls of wisdom for health professionals from his bestselling books "A Whole New Mind" and "When."

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'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.

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.

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

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