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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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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.

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. 

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.

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. 

June 4, 2018 | 2 min read

Half Baked

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

Your monthly dose of comic relief from William Osler's long lost cousin Wilma Ferthler.

January 23, 2020 | <1 min read

Close Listening

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

An excellent clinician always listens closely to their patients. This enhances their perspective on the patient's point of view.

February 3, 2021 | 3 min read

How to Cultivate a “Friendtorship”

By Jared Rubenstein, MD, Baylor College of Medicine, Liz Salmi, OpenNotes Communications, Beth Israel Deaconess Medical Center

A “friendtorship” is an informal peer-mentor relationship between two people with shared interests but different careers. “Friendtorships” can help you develop new perspectives and ideas about your own field.

April 23, 2020 | 1 min read

Bibliotherapy

By Scott Wright, MD, Johns Hopkins Medicine

Happy World Book Day! Read more fiction to broaden your perspectives. If you've never listened to an audiobook, try it! It might just change your life!

September 18, 2023 | 3 min read

Do you “need” to say it that way? 

By Gina Piscitello, MD, MS, University of Pittsburgh Medical Center

Using the word “need” to describe a treatment option may mislead patients and loved ones into believing it should be pursued. Prioritizing patient values and preferences may help reduce this risk.  

August 4, 2020 | 2 min read

3 Tips for Talking With Patients About Advance Directives

By Ambereen Mehta, MD, Johns Hopkins Medicine

ALL clinicians can and should encourage patients to document their wishes regarding medical decisions in case they’re unable to make these decisions for themselves.

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. 

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.

July 21, 2021 | 2 min read

Talking With Patients About Safe Summer Swimming

By Jade Cobern, MD, Johns Hopkins Bloomberg School of Public Health

Swimming is a summertime joy, but it is not without risk. Before patients take the plunge, they should be reminded to always swim with a buddy (never alone) and to apply sunscreen.

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.

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 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.

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 5, 2022 | 1 min read

Bringing my nursing pearls to my doctoring (archives, 2022)

By Nina Wagner-Johnston, MD, Johns Hopkins Medicine

From my experience as a nurse, I always remember the importance of engaging the whole team. Each team member provides unique insights that can optimize the care of the patient. 

January 16, 2020 | 2 min read

The Danger of Reinforcing Negative Biases

By Yolonda Wilson, PhD, 2019-2020 Fellow at the National Humanities Center and 2019-2020 Encore Public Voices Fellow

The way clinicians talk about patients publicly reinforces biases about race, gender, class, etc.

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.

February 1, 2021 | 2 min read

The Emperor’s New Curtains

By Charlotte Squires, MBChB, Borders General Hospital, Scotland

Clinically excellent physicians consider the setting of private conversations with patients and families. Quiet rooms with a door that closes are ideal for sensitive discussions.

January 10, 2019 | 3 min read

How to Improve Your Physical Diagnostic Skills With a Digital Database

By Samuel Durso, MD, Johns Hopkins Medicine

To sharpen diagnostic skill, take a minute to cross check the physical exam against images and lab results in the electronic record - if not congruent, then why?

September 13, 2023 | 1 min read

Firearm Suicides on The Rise

By Katherine Hoops, MD, Johns Hopkins Medicine, Paul Nestadt, MD, Johns Hopkins Medicine

To stem the increase in self-inflicted gun deaths, we must work toward early and accurate diagnosis of mental illness, as well as advocate for better firearm laws.

August 12, 2020 | 2 min read

Chief Complaint: Racism

By Syeachia Dennis, MD, University of Oklahoma

Patients are increasingly recognizing the impact of racism on their health. We should be prepared to help patients confront this and consider this core to our work to systemically address this public health crisis.

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. 

August 1, 2022 | 1 min read

Keeping Children Safe

By Katherine Hoops, MD, Johns Hopkins Medicine, Monique Burke, MD, President, MD Chapter of the AAP

The new Safer Communities Act helps clinicians connect patients to mental healthcare. Hopefully, this will reduce youth gun violence, including suicide. 

July 20, 2021 | 2 min read

3 lessons on clinical excellence from the oncology clinic

By Sajya Singh, Medical Student, Johns Hopkins Medicine

While shadowing clinicians in cancer care, I learned the importance of spending time to gather the family history, building trusting relationships, and balancing treatment plans with quality-of-life considerations.

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. 

April 2, 2024 | 3 min read

A dose of reality (TV)  

By Maria Fazal, MD, Baltimore, Maryland

A patient who had severe anxiety and depression told me that watching “The Great British Bake Off” was a helpful relaxation technique. She taught me that shows like this may provide a therapeutic escape.  

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. 

March 6, 2023 | 1 min read

Supporting Menopausal Patients

By Talia Sobel, MD, Mayo Clinic

Women often receive misinformation about menopause and even experience medical gaslighting from healthcare professionals. Clinicians should validate patients’ symptoms, and work with them to improve quality of life. 

December 21, 2021 | 4 min read

How to Make New Habits Stick, Part 2 

By Howard Chang, Medical Student, Johns Hopkins Medicine

We can build good habits in our own lives and help patients do the same by implementing the four laws of behavior change: make it obvious, make it attractive, make it easy, and make it satisfying. 

October 17, 2024 | 2 min read

Gaming for mental health 

By Barry Bryant, MD, Johns Hopkins Medicine

Understanding the therapeutic potential of video games is important. Clinicians may elect to recommend them for certain young patients struggling with mental health challenges.

January 27, 2021 | 2 min read

Gin And Tonic—Cultural Footprints of Disease

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

To mitigate incorrect assumptions about patients who have been infected with COVID-19, we must work to spread truths and to minimize inaccuracies—particularly those that may be shameful or demeaning.

January 7, 2019 | 2 min read

Helping Your Patient Get Better Sleep During Hospital Stays

Sleep is important during hospitalization, and we need to maximize quality and quantity the best we can for our patients. Asking about your patient’s sleep and identifying ways to improve it when possible is one way to start.

September 11, 2023 | 2 min read

AI And Humanistic Care

By Daniel Brotman, MD, Johns Hopkins Medicine

In a clinical world that is increasingly algorithmic, what AI can NOT do is truly understand human emotions. Computers will never appreciate the joy and privilege of connecting with patients. 

"Imperial Purple," by Spencer Finch. Photo copyright with the authors.

July 20, 2020 | 6 min read

Art and Connection During COVID-19

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

In a time of physical distancing, stepping out of our comfort zone to find creative and unconventional ways to connect with patients and colleagues can bring us together.

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. 

"My book knowledge will allow me to recognize the pattern leading to a medical diagnosis, but I must also move beyond the mnemonic and to make time for the person seated in front of me."

July 28, 2022 | 2 min read

Passing Tests And Failing my Family

By Emily Rodriguez, medical student, Johns Hopkins Medicine

Book knowledge about addiction offered me little to support my family members and others affected by this illness. To holistically serve, we need to take the time to connect and genuinely understand each person.

July 22, 2021 | <1 min read

Responding Instead of Reacting

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

When confronted publicly by a colleague, I learned that it is helpful to respond calmly instead of reacting defensively. This strategy will allow us to move forward.

"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.

March 25, 2024 | 1 min read

Graphic medicine: a picture is worth a thousand words 

By Benjamin Vipler, MD, MEd, University of Colorado

Pictures can often be a more effective way to explain complex medical concepts to trainees and patients than words alone. 

"“Hanging in there” with patients in the face of uncertainty, adversity, and conditions that are difficult to diagnose or treat is challenging for us but so appreciated by patients."

January 13, 2026 | 2 min read

Reflections on 40 years of clinical practice 

Patients notice and appreciate when we’re thorough, go the extra mile, and stick with them through the twists and turns of their medical journey. These behaviors build trust.

December 20, 2021 | 1 min read

What Patients With Serious Illness Want to Know Most

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

After receiving a terminal diagnosis, many patients especially want to know how long they have to live, what symptoms to expect, and how to cope with impending decline.  

January 28, 2020 | 3 min read

Racism From Patients—an Ethical Dilemma

By Sonal Gandhi, MBBS, MD, Johns Hopkins Medicine

A cornerstone of clinical excellence is treating all patients with respect and dignity. This is true even when treating those patients who are not respectful to you.

October 10, 2024 | 1 min read

Trust and truth

Nonjudgmental communication can help us understand the true nature of a patient’s condition and motivations. Connecting more deeply with a patient over time allowed us to learn more of the story. 

September 7, 2023 | 2 min read

“Wild Problems” Book Review

By Margaret Chisolm, MD, Johns Hopkins Medicine

When it comes to the big decisions in life, abandoning a rational, algorithmic approach—and going back to guiding principles—may be the secret to happiness. 

Juneteenth Flag

July 2, 2020 | 4 min read

3 Tips for Dismantling Anti-Black Racism in Academic Medicine

By LaShyra Nolen, Medical Student, Harvard University

White educators and learners must commit to doing the work and educating themselves on how to be antiracist. Black colleagues should not be responsible for educating those around them.

April 30, 2025 | 2 min read

Aging and autonomy 

Many older patients struggle with losing independence. Healthcare professionals can partner with them and their loved ones to ease challenging transitions. 

June 19, 2018 | 2 min read

Sleep solutions (archives, 2018)

People see sleep as a luxury, but it's a basic human need. As clinicians, we should ask patients how they're sleeping. Here are nine things you can recommend to help them feel more rested.

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