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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 22, 2022 | 2 min read

Bittersweet holidays

By Taryn Schuelke, MS, CT, CCLS, Texas Childrens Hospital

Many experience grief during the holidays. Make sure to acknowledge your patients’ feelings and consider encouraging them to heal through ritual. 

If weather permits, advise patients to plan their feast outside this Thanksgiving,

November 12, 2020 | 1 min read

How to Have Healthy Holidays

Helping patients plan safe get-togethers can slow the spread of COVID-19. Following guidelines may allow patients to connect with their family.

March 21, 2018 | 2 min read

İnsan Olmak—Being Human

By Ezgi Ozalp Akın, MD, Ankara University

Developmental pediatrician Ezgi Ozalp Akın, MD, shares insights gleaned from "İnsan Olmak" on being human.

September 4, 2024 | 2 min read

Knowing when to step back 

Patients may need time to process their thoughts and reflect when making major decisions about their care. Having conversations in stages may help them arrive in the best place.  

March 8, 2022 | 3 min read

Tips For Assessing The Intensity of Pain

By Brian Lee, MD, PhD, Johns Hopkins Medicine, David Madder, DO, Johns Hopkins Medicine

When assessing pain, we often ask patients to assign it a number between 0 and 10. Asking about the effect of pain on behavior and functional status can often give us a more meaningful understanding. 

July 10, 2018 | 1 min read

Pause Before Hospitalizing the Elderly

By Samuel Durso, MD, Johns Hopkins Medicine

Confusion among hospitalized older adults is common and dangerous. The hospital environment should be avoided if at all possible, with a goal of managing acutely ill older adults at home.

April 27, 2021 | 2 min read

Lessons Learned From Cancer During COVID

By Catherine Ling, PhD, Johns Hopkins Medicine

Encourage and support patients to schedule preventative screenings delayed during the pandemic. These are critical to ensure your patients’ health.

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.

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. 

July 14, 2022 | 2 min read

How to Talk to Children About Gun Violence

By Carol Vidal, MD, PhD, Johns Hopkins Medicine

Give children time and space to talk about their worries and listen closely. Remember, it’s always best for children to first hear the news from a trusted adult.

"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.

July 25, 2018 | 2 min read

The Joy of Realizing You Were Wrong and the Importance of Believing in Recovery for All

By Angela Guarda, MD, Johns Hopkins Medicine

Helping patients change unhealthy behaviors can feel challenging, but what feels like today’s failure can be tomorrow’s story of recovery.

3d illustration of a simulation of the coronavirus virus floating in a prison

September 20, 2021 | 3 min read

Moving Beyond Tuskegee

By Imani McElroy, MD, MPH, Mass General

I was able to help my incarcerated brother understand the benefits of COVID vaccination. He appreciated my input and became an advocate to convince other inmates. Much was learned about interacting with those who are vaccine hesitant—read the piece for my pearls.

"“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 19, 2022 | 2 min read

Dismantling ableism in medicine

By Kerry Devlin, MMT, LPMT, MT-BC (she/her), Johns Hopkins Medicine

What does it mean to co-construct a plan of care with disabled patients? Their desires may not be what you expect.

A perfectly imperfect brown-eyed Susan.

October 29, 2020 | 2 min read

Embracing Imperfection

By Swathi Raman, MD, MPH, LifeBridge Health, Maryland

To help with imposter syndrome, practice habits that increase your confidence.

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.

September 4, 2024 | 1 min read

Validating a patient’s experience of pain

To effectively treat opioid use disorder, clinicians must consider a patient's both physical and psychological experiences.  

March 2, 2022 | 1 min read

Redefining Success

By Jennifer Eitingon, MD, Johns Hopkins Medicine

My patient on palliative radiation died in the hospital, instead of at home as she wanted. I was reminded that we must always create a treatment plan based on the patient’s goals instead of our own. 

"Nighthawks," Edward Hopper, 1942.

January 2, 2019 | 3 min read

The Human Experience of Illness

By Tina Zhang, MD, Johns Hopkins Medicine

Paintings, photographs, and poems can foster dialogue about the human experience of illness and allow learners to approach challenging topics in a more comfortable way.

August 15, 2023 | 2 min read

The Importance of Humanities in Medicine

By Mike McCarthy, MD, Johns Hopkins Medicine

Engaging with and studying the humanities can help us give better patient care. Literature, art, and history remind us that patients are whole persons with lives that exist beyond medical problems. 

April 21, 2021 | 2 min read

Opioid Monitoring in Primary Care

By Jeffrey Millstein, MD, Penn Medicine

Discussions about opioid use with patients must be approached with curiosity and concern, rather than suspicion. Implemented with sensitivity, opioid monitoring programs can strengthen the clinician-patient relationship.

Newly Renamed Black Lives Matter Plaza NW, Washington, D.C., June 2020.

June 30, 2020 | 1 min read

Learning to be Antiracist

By Ashlyn McRae, Medical Student, Johns Hopkins Medicine

We must acknowledge the ways in which we have been, and are racist. This will allow us to provide the most equitable care to all of our patients.

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. 

July 7, 2022 | 1 min read

Filial Affection

By Corliss Wong, MS4, The University of Hong Kong

We must listen closely to patients with dementia’s thoughts and feelings, even though their sense of reality may be different than our own.

"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.

September 13, 2021 | 4 min read

Only Connect

By Susrutha “Sus” Kotwal, MBBS, MD, Johns Hopkins Medicine

Missing a diagnosis made me realize the value of a thorough physical exam. It can often illuminate the cause of the illness.

January 12, 2026 | 3 min read

Optimizing interdisciplinary care 

Healthcare is a team sport. When working through conflict within your care team, integrate perspectives to deliver better care. 

December 19, 2022 | 2 min read

Female Leaders in Surgery

By Ming-Hsien Wang, MD, Johns Hopkins Medicine

More women surgeons will increase the diversity of ideas and perspectives needed for excellent patient care. 

October 19, 2020 | 2 min read

Book Review of “One by One by One”

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

Never underestimate the power of teamwork in caring for patients. What can feel impossible for one person may be accomplished with the collaboration and support of others.

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.

September 3, 2024 | 1 min read

More than hot flashes

By Wen Shen, MD, Johns Hopkins Medicine

When thinking about menopause, hot flashes are frequently the first thing that come to mind. But clinically excellent care requires recognizing the full spectrum of symptoms.  

February 28, 2022 | 4 min read

To Our Interpreters: Gracias, Shukriyah, Todah, Danyavad, Merci, Danke

By Cecilia Murach, Medical Interpreter, Johns Hopkins Medicine, Kamna Balhara, MD, Johns Hopkins Medicine, Nathan Irvin, MD, Johns Hopkins Medicine

When working with an interpreter, remember that they’re a person, not a machine. Saying “thank you” makes them feel like a valued member of the healthcare team. 

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.

Parting gift for every customer—homemade pistachio granola.

August 7, 2023 | 3 min read

Insights from the book “Unreasonable Hospitality”  

By Scott Wright, MD, Johns Hopkins Medicine

Healthcare delivery is complex, and hospitality may not be prioritized. As individuals and teams, small changes in behavior may improve patient experience. 

April 20, 2021 | 3 min read

Listening to Every Patient

By Pringl Miller, MD, San Francisco, California

To give clinically excellent care to the patient in front of you, ask yourself: “Am I carefully listening to what the patient is telling me? Am I incorporating what I’ve heard into the care plan?”

Mahabharata. Published by Geeta Press in Gorakhpur. Public domain, Library of Congress.

July 13, 2020 | 2 min read

Eklavya and the Power of Online Learning

By Mrinali Shetty, MD, University of Chicago, Yuvraj Chowdhury, MD, SUNY Downstate Medical Center

During the pandemic, there has been an increase in educational offerings that can enhance our clinical skills. This expansion of virtual learning opportunities, (like open-access Zoom lectures and grand rounds, and #MedTwitter #tweetorials on countless topics), can be a boon for all.

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. 

July 6, 2022 | 1 min read

Any Side Effects?

By Jeffrey Millstein, MD, Penn Medicine

Teaching my patients to ask questions helps address their worries about medications. 

February 5, 2024 | 1 min read

When patients emphatically question the diagnosis

By Will Frye, PhD, Johns Hopkins All Childrens, St. Petersburg, Florida

Sometimes patients and families struggle when processing a new diagnosis. Embracing open communication, education, and collaboration may transform disagreements into understanding. 

December 22, 2025 | 2 min read

BREATHE better at home 

To improve indoor air quality, counsel patients to combine source control with filtration. This includes eliminating smoking/vaping and avoiding fragrances like scented candles/incense. Recommend air cleaners with HEPA and carbon filters. 

December 1, 2022 | 1 min read

World Cup Fever

By Scott Wright, MD, Johns Hopkins Medicine

As you watch lots of “The Beautiful Game” this month, there are lessons for healthcare professionals. All members of our teams are important and diversity drives success.  

October 12, 2020 | 2 min read

Advising Parents on a Safe Halloween

By Jade Cobern, MD, Johns Hopkins Bloomberg School of Public Health, Peyton Pike, MS, CCLS, Johns Hopkins Medicine, Rosemary Hawkins, MS, CCLS, Johns Hopkins Medicine

By being creative, everyone can safely celebrate Halloween this year. Beyond your household, consider holding a neighborhood physically distanced costume parade.

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.

August 26, 2024 | 1 min read

The medical Tower of Babel  

Immigrant patients often face challenges when accessing healthcare because of language and cultural barriers. Certified medical interpreters can help reduce the likelihood of inequities in care. 

February 24, 2022 | 3 min read

New dad and healthcare professional

By Ben Roberts, CRNP, AGACNP-BC, ACHPN, Johns Hopkins Medicine

Placing my child’s and my patients’ needs before my own gives me purpose. These responsibilities help mitigate burnout and allow me to give excellent care.

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!

August 1, 2023 | 2 min read

Psychological First Aid

By Albert Wu, MD, MPH, Johns Hopkins Medicine, Matt Norvell, DMin, Johns Hopkins Medicine

Healthcare professionals experience traumatic events that may exceed their ability to cope. Timely emotional support can help maintain their well-being. 

March 30, 2021 | 2 min read

Leveraging Your Professional Network For Your Growth

By Kevin Frick, PhD, Johns Hopkins Carey Business School

In your professional network, include those who challenge and question you. Peer feedback and coaching can help improve your care of patients.

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.

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