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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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December 7, 2023 | 2 min read

“I need this test.” 

By Pavitri Dwivedi, DO, MPH, Johns Hopkins Medicine

When patients request a test that you think is unnecessary, be curious and elicit why they feel this way. Then address their concerns about the condition being screened. 

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.

Dr. William Greenough teaches about best practice in homecare.

June 20, 2018 | 1 min read

Home Care: A Better Way To Care For Ventilator Patients

By William Greenough, MD, Johns Hopkins University School of Medicine

Using portable ventilator technologies in the patient’s home can provide a higher quality of life.

November 22, 2021 | 4 min read

Noticing What We’ve Seen Without Seeing

By Ekene Ojukwu, MD, Johns Hopkins Medicine

Carefully observing our patients can lead to clinically relevant insights. Sometimes what seems inconsequential at first glance may be surprisingly significant.

June 24, 2024 | 2 min read

Partnering with patients with intellectual and developmental disabilities in medical decision-making 

By Sara Mixter, MD, MPH, Johns Hopkins Medicine

When caring for patients with intellectual and developmental disabilities, explore supported decision-making options and prioritize communication needs. These steps should offer them more control over medical choices. 

The author, far right, with colleagues.

October 23, 2018 | 2 min read

Master Clinicians – The Early Years

By Vivek Murthy, MD, Johns Hopkins University School of Medicine

It’s no surprise that it takes hard work to become a great clinician. This is a glimpse of what the first steps on that road might look like.

June 29, 2020 | 2 min read

Lessons From the AIDS Epidemic

By Melinda Kantsiper, MD, Johns Hopkins Medicine

In times of crisis, it can be helpful to listen and learn from the stories of those who have come before us.

June 20, 2023 | 1 min read

The Road Not Taken 

By Antonio Forte, LMSW, Johns Hopkins Medicine, Larkin Corrigan, MSW, Portland, Oregon

If patients can’t manage on their own, clinicians and staff can help them use social support networks and other resources to find transportation to their appointments. Virtual visits can also be considered. 

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. 

January 22, 2025 | 2 min read

The ulcer: a window into a patient’s emotional distress 

By Margret Nassuuna, DCP, Innerspark Recovery, Naalya, Uganda

The body, a masterful storyteller, often reveals insights into a patient’s mental state. By deciphering its narratives, clinicians may also be able to better address both the mental and emotional aspects of care.

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."

July 7, 2021 | 1 min read

Lessons Learned During my Palliative Care Rotation

By Rayah Sawaya, MD, American University of Beirut

In the wake of disaster, I witnessed the value of palliative care firsthand. This service prioritizes patient comfort and end-of-life preferences.

December 4, 2023 | 2 min read

More than a “picture” 

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

When explaining medical procedures to patients, use straightforward terms. Also, be mindful to maintain accuracy and clearly outline any risks. 

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 27, 2022 | 2 min read

When?

By Shreya Srivastava, medical student, Albany Medical College

When my friend was struggling with her mother’s new diagnosis, she listened to the popular French song about cancer entitled, “Quand c’est?” It gave her a sense of support, empathy, and solidarity with others.

November 16, 2021 | 1 min read

Collaborating With Patients For Optimal Care

By Leslie Miller, MD, Johns Hopkins Medicine

For patients to participate in their treatment planning, clinicians must first share knowledge and insights. From this foundation, shared decision-making may be possible.

June 13, 2024 | 2 min read

Lightening the load 

By Susan Lehmann, MD, Johns Hopkins Medicine

Clinicians can prioritize patient well-being by discussing the burden of engaging in care. Collaborate with patients to ensure recommendations are feasible and consider alternative approaches if necessary. 

October 11, 2018 | 1 min read

Book Review of “Beartown”

By Tina Zhang, MD, Johns Hopkins Medicine

Medicine, much like hockey, is a team sport, where it takes the effort of many to realize success. The sacrifices required and pressures of being a hockey coach or player are similar to those that providers face. I highly recommend this book to everyone.

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.

December 17, 2020 | 4 min read

Racial Discrimination And Larger Bodies

By Kristal Brown, PhD, MSPH, Johns Hopkins Medicine

We must be aware of our own biases and prejudices in order to give excellent care to every patient.

June 6, 2023 | 3 min read

Plant Straight Rows

By Kyle Glienke, MD, Buena Vista Regional Medical Center, Iowa

In farming, as in medicine, focusing only on daily tasks may keep us from seeing the impact we have.

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 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. 

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."

June 22, 2021 | 1 min read

How You Can Take Action Beyond Pride Month

By Nat Mulkey (they/them), Medical Student, Boston University Medicine

To improve the health and well-being of LGBTQI+ patients, we must commit to being lifelong learners and teachers in this continually evolving space.

July 31, 2018 | 3 min read

Waste Not, Want Not!

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

Keeping meat properly refrigerated is critical. Don’t forget to specifically ask patients if they have eaten roadkill if they present with diarrhea (especially in summer) & no other obvious source of infection is apparent.

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.

September 26, 2022 | 3 min read

Concerning Hobbits: On Middle-earth and Medicine

By Tina Zhang, MD, Johns Hopkins Medicine, Zach Lorenz, MD, Johns Hopkins Medicine

J.R.R. Tolkein’s beloved trilogy offers lessons for life and medicine, including journeying with our patients through dark times and effectively engaging in teamwork. 

November 4, 2021 | 3 min read

Dissection And Reintegration

By Aidan Crowley, Medical Student, University of Pennsylvania

We sometimes “cut” patients apart to assist in the diagnostic process. We must remember to put them back together; we’re charged with caring for their minds and spirits in addition to their bodies.

June 12, 2024 | 3 min read

Getting serious about citrus 

By Maureen Flood, NP, Johns Hopkins Medicine

In patients with chronic conditions and socially determined health risks, remember to consider vitamin C deficiency. 

October 9, 2018 | 2 min read

Five Authors to Follow

Reading for a few minutes before bedtime is a calming habit, and a great way to fit in a few words from inspiring authors to fuel your practice.

December 16, 2020 | 2 min read

The Danger of Stereotyping Specialties

By Sarah Temkin, MD, Greater Baltimore Medical Center

Clinicians must critically evaluate the stereotypes that they assign to one another. A diversity of training and backgrounds is beneficial to patient care.

May 25, 2023 | 2 min read

Fighting The Feed

By Colleen Schreyer, PhD, Johns Hopkins Medicine

Limiting social media use and being selective about what you view can help cultivate a positive body image. 

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. 

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. 

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!

June 16, 2021 | 1 min read

Why we Must Talk About E-cigarettes with Teen Patients

By Mike Fingerhood, MD, Johns Hopkins Medicine

Proactively counseling adolescents about the risks of e-cigarette use is essential. The message should acknowledge both the health implications and the pressures that they may feel from their peers.

November 21, 2023 | 2 min read

“You’ll need someone to drive you home”

By Megan Murphy, MD, Johns Hopkins Medicine

Transportation may be a barrier to healthcare, especially for procedures requiring sedation. Sometimes we need to think creatively and partner with others in order to find solutions.  

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.

September 21, 2022 | 1 min read

Helping Patients Navigate Risk in The New Normal

By David Hurwitz, MD, MBA, Johns Hopkins Medicine

Using empathic listening to give COVID-related advice will help your patients balance the risks of the pandemic with enjoying the activities in their lives that matter most. 

November 8, 2021 | 1 min read

Lessons Learned From 30 Years of Night Shifts

By Kimberly Turner, MD, Johns Hopkins Community Physicians

Patience, stamina, and fortitude are important traits to cultivate in medicine at any and all times.

May 30, 2024 | 1 min read

Transparency and trust 

By Justin Colleran, patient, Ireland, Miriam Colleran, MD, St. Brigids Hospice & Naas General Hospital, Ireland

The delayed diagnosis of my brother's appendicitis highlighted the importance of honesty and accountability when medical errors occur. By openly acknowledging mistakes, doctors can rebuild trust. 

March 1, 2018 | 2 min read

Most Physicians Sit Down at the Bedside When Entering a Patient’s Room

By Scott Wright, MD, Johns Hopkins Medicine

Choice architecture, framing, herd behavior, and feedback—how to nudge your patient towards healthier choices.

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.

"Spending time outdoors helps me cope with the stress and sadness of the job." -Dr. Jared Rubenstein

December 10, 2020 | 3 min read

Coping With Patients’ Heartbreak

By Jared Rubenstein, MD, Baylor College of Medicine

When supporting patients and their loved ones during times of great sadness and loss, cultivating a daily habit of self-care may protect against burnout.

July 5, 2018 | 1 min read

Getting the Most Out of Your Eyes

By Scott Wright, MD, Johns Hopkins Medicine

If you look at your patients as you would a piece of art in a museum, you will notice many details that would otherwise be missed.

April 14, 2022 | 2 min read

“Explainaholics”

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

Sometimes patients and caregivers feel overwhelmed when clinicians provide too much information. When you sense this to be the case, offering clear recommendations can be helpful.

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.

November 20, 2023 | 1 min read

A surgical sojourn in China

By Hanghang Wang, MD, PhD, Johns Hopkins Medicine

Engaging with healthcare professionals in other countries represents an invaluable learning opportunity. My clinician colleagues in Nanjing helped me to appreciate the value of teamwork across cultures. 

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.

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