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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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“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.

"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.

November 17, 2022 | 2 min read

Personalized Clinical Quality Improvement

By Jeffrey Krimmel-Morrison, MD, University of Washington

Use evidence-informed practices in your self-directed learning—build a case tracking system, work simulated cases, use quizzing, and seek new evidence efficiently. 

January 28, 2026 | 4 min read

A model mentor 

Effective clinical teaching pairs rigor with kindness. Building psychological safety can accelerate learning, reduce burnout, and improve patient care. 

August 7, 2024 | 2 min read

Wait! Is that a zebra?

Common things are common, but occasionally unusual conditions are seen. To improve diagnostic accuracy, clinicians should consider alternative explanations and challenge their own assumptions.

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.”

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.

July 24, 2023 | 2 min read

Prince of Yonkers

By Carey Roesler, PA-C, Johns Hopkins Medicine

When my car broke down, a mechanic went above and beyond to make sure I made it to my aunt’s funeral. This reminded me of how lucky I am to be able to help my patients through challenging times. 

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.

December 27, 2018 | 2 min read

“Charm City” Movie Review

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.

June 23, 2022 | 2 min read

Reflections at The End of a Busy Clinical Year

By Madeline Rodriguez, MD, Johns Hopkins University School of Medicine

Outstanding clinicians are humble, curious, and nonjudgmental. 

June 9, 2025 | 3 min read

When care hurts 

Patients’ past healthcare experiences influence their ability to engage in care. Taking time to learn about their life stories builds trust and empowers them to participate in their healing. 

Serena Williams playing mixed doubles at Wimbledon, 2019. Public domain, Wikipedia. Photo by Brian Minkoff, London Pixels.

June 24, 2020 | 1 min read

3 Things You Can do to Fight Racism

By Christle Nwora, MD, Johns Hopkins Medicine

We must each take personal responsibility for educating ourselves about racism. Increasing our understanding will allow us to improve health outcomes for all of our patients.

January 17, 2024 | 1 min read

“I’m not comfortable”

By Jeffrey Millstein, MD, Penn Medicine

Patients sometimes ask for interventions that conflict with clinical best practice. The most effective responses are ones that focus on patients’ needs and level of understanding rather than on the clinician’s discomfort with their requests. 

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’!

January 27, 2026 | 3 min read

Mindset matters 

Adopt a growth mindset—treat setbacks and mistakes as data for learning. Ask “What can we learn?” rather than “Who failed?” to help build psychological safety within your healthcare team.

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.     

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.

July 10, 2018 | <1 min read

Better Dementia Care Through Music

By Michele Bellantoni, MD, Johns Hopkins University School of Medicine

Having your older patients listen to music can be an effective way to reduce dementia-related behavioral disturbances.

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.

November 28, 2018 | <1 min read

Dr. Jim Black, A CLOSLER Look

By Gretchen Miller, Managing Editor

A favorite part of my job is telling patients when they, in fact, do NOT need surgery!

June 22, 2022 | 1 min read

Explaining The Risks of Vaping

Prioritize discussions about the long-term consequences of smoking. Be aware that just because someone has quit doesn’t mean that they won’t relapse.

May 27, 2025 | 2 min read

Whose knowledge counts?  

Listening closely builds patient trust, which is fundamental to effective care. Dismissing a patient's self-reported observations, even unintentionally, erodes this trust and can prevent you from truly understanding their concerns. 

January 11, 2024 | 2 min read

Book review of “Changing how we think about ‘difficult’ patients”  

By Jennifer Lycette, MD, rural oncologist in the Pacific Northwest

When caring for a patient whom I found challenging, I reminded myself that my negative reaction had less to do with the patient and more to do with me.  

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.

June 25, 2018 | 2 min read

On The Professional Formation of Doctors

By Margaret Chisolm, MD, Johns Hopkins Medicine

By getting out of the business of knowledge and skills and returning to the work of professional formation, not only will medical schools and their patients win, but doctors—and the profession of medicine as a whole—will too.

February 25, 2018 | 1 min read

Diagnostic Excellence Starts With an Incessant Watch

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

Feedback is the key to improvement of any craft. No one is born an expert. It is earned through deliberate practice and an incessant thirst for progress.

July 26, 2018 | 1 min read

A Taste of Their Own Medicine

By Scott Wright, MD, Johns Hopkins Medicine

Videos spreading misinformation to patients, promoting unproven therapies, can spread like wildfire on social media. We are sharing another video to fight fire with fire.

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.

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!

July 18, 2023 | 1 min read

Can a chatbot be a clinician’s friend?

By Adam Poliak, PhD, Bryn Mawr College, Eric Leas, PhD, Mark Dredze, PhD, Johns Hopkins University

ChatGPT can draft seemingly empathic answers to patient questions on medical portals. This may help clinicians respond more efficiently to their patients’ concerns. 

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.

June 13, 2022 | 2 min read

3 Tips from the ED For All Healthcare Professionals

By Rodney Omron, MD, MPH, Johns Hopkins Medicine

Sharing appreciations with colleagues and learners is your superpower. Use it. 

May 13, 2025 | 2 min read

The unseen front line: lessons from my military deployment  

In a field hospital, one learns quickly about clear communication and thoughtful decision making. These behaviors and working collaboratively with others are just as critical across all clinical settings. 

June 2, 2020 | 3 min read

“Flattening the Curve”

By Madeline Rodriguez, MD, Johns Hopkins University School of Medicine

The pandemic is breaking down the traditional hierarchy of medical education. Opportunities are emerging for faculty to learn even more from residents.

January 9, 2024 | 3 min read

Dust and distrust

By Matthew Kelly, PhD, MPH, Johns Hopkins Medicine

Infection-related epidemics, like AIDS and COVID, teach us much about caring. To provide humanistic care, clinicians must continuously endeavor to assess and build trust with patients. 

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.

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 2, 2022 | 2 min read

Psychedelics to Quit Smoking?

By Matthew Johnson, PhD, Johns Hopkins Medicine

Patients may ask about using psilocybin to stop smoking. While being actively studied, please remind them that it’s still illegal and not necessarily risk-free. 

January 22, 2026 | 2 min read

Coaching patients to thrive

When caring for patients, listen closely, ask thoughtful questions, and partner with them to achieve better health outcomes. 

July 11, 2024 | 2 min read

Protecting the most vulnerable from heat-related illnesses (archives, 2024)

By Joanna Cohen, MD, Johns Hopkins Medicine

When caring for patients during heat waves, healthcare professionals should be aware of social determinants of health—like no air conditioning at home. Clinicians should know the available resources to recommend, such as cooling centers within the communities they serve. 

February 3, 2022 | 2 min read

Perspective Matters

By Souvik Chatterjee, MD, Johns Hopkins Medicine

As the pandemic continues, I remind myself that my job is to give selflessly to those who are sick. It’s helpful to lean on my team when situations feel especially challenging.

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.

July 17, 2023 | 3 min read

Choreographing Clinical Care

By Hanghang Wang, MD, PhD, Johns Hopkins Medicine

Exceptional patient care is akin to a ballet performance. Synergistic team interactions, thoughtful decisions, and deliberate actions are all critical steps in the dance of patient care. 

"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.

June 28, 2019 | 1 min read

How to Improve Outpatient Handoffs

Consider performing outpatient handoffs and preparing patients when you will be away. This will make your time away easier for your covering colleagues and for your patients.

June 13, 2022 | 3 min read

On Wondering

By Crystal Favorito, pre-med, Johns Hopkins Medicine

To wonder is to acknowledge possibility and open the door for progress. As a pre-med, it will help me become a lifelong learner on my professional journey. 

May 6, 2025 | 2 min read

Healing from the emotional toll of a medical error  

Mistakes in patient care are not uncommon. Clinicians can lean on their support systems to recover from stressful events at work. Taking care of yourself enables you to continue giving compassionate care. 

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.

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. 

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