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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
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.

November 19, 2020 | <1 min read

Quitting Smoking During The Pandemic

Remind patients that quitting smoking is hard and takes time. This will help them take a first step toward better health.

April 24, 2023 | 1 min read

How CLOSLER Has Improved My Care of Patients: A Five-Year Retrospective

By Jeffrey Millstein, MD, Penn Medicine

Through CLOSLER, I’ve learned about the power of active listening and how better to navigate challenging conversations. It has also provided many ideas for re-energizing myself both personally and professionally. 

March 30, 2022 | 3 min read

Mitigating maternal mortality (archived piece, 2022)

By Kimberly Turner, MD, Johns Hopkins Community Physicians

A more diverse clinical workforce brings greater variety of perspectives in patient care which may improve clinical outcomes. 

December 4, 2024 | 2 min read

The complexities of middle age 

By Alicia Arbaje, MD, MPH, PhD, Johns Hopkins Medicine

Mid-life is a period marked by multifaceted challenges, including physical, emotional, and social stressors. By adopting a holistic approach that addresses the whole patient healthcare professionals can provide more comprehensive and effective care. 

January 31, 2019 | 1 min read

How to be Mindful About Infection Prevention

By Clare Rock, MBBCh, Johns Hopkins University School of Medicine

To be mindful of preventing the spread of infection, embrace change in procedures with an open mind when it is for the greater good.

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, 2021 | 2 min read

How to Support Asian American and Pacific Islander (AAPI) Patients

By James Wu, MD, Medical College of Wisconsin, Neurofourier, MD, New York, New York, Yuemei Zhang, MD, University of Washington

Currently, AAPI people are facing a wave of discrimination. Clinicians need to be sensitive to patients’ experience of racism and educate themselves on how to best offer support.

October 5, 2023 | 2 min read

When Medication is an Empty Promise (Sudafed) 

By Charles Flexner, MD, Johns Hopkins Medicine

Communicating uncertainty effectively is part of being an excellent physician. This is especially true when it comes to the medications we recommend to patients. 

April 28, 2025 | 3 min read

Spotting victims—human trafficking is not uncommon 

Healthcare professionals have a unique opportunity to identify and help victims of human and labor trafficking. Read on for practical tips for how to recognize and support these patients. 

"You Let Your Magic Tortoise Go," David Kopacz. Copyright with the artist.

August 27, 2020 | 3 min read

Finding Balance During Unbalanced Times

By David Kopacz, MD, University of Washington

Spending time “going into and opening our hearts” is healing and restorative. We can do this for ourselves as healers and guide patients through the practice. It’s as simple as slowing down, putting your hand on your heart, and taking three deep breaths.

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.

August 29, 2022 | 2 min read

Takeaways From “The Making of a Surgeon”

By Richard Schaefer, MD, MPH, Johns Hopkins Medicine

Reading this book while I was in training inspired me to pursue a surgical career. Rereading it years later, I’m reminded of the importance of treating all patients with dignity.  

October 14, 2021 | 1 min read

Caring During Death

By Vivian Altiery De Jesus, MD, MBE, Johns Hopkins Medicine

It’s a privilege to care for patients and their loved ones, especially at the end of life. Even when we can’t cure, we can always comfort.

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. 

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.

November 24, 2020 | 2 min read

Women clinicians and women’s bodies (archives, 2020)

By Colleen Christmas, MD, Johns Hopkins Medicine

Constant critiques on women’s bodies and dress means physicians who identify as female must spend energy ensuring they look as they “should” to patients and colleagues. This energy is better focused on giving clinically excellent care.

April 19, 2023 | 1 min read

A Fall Into Grace

By Emily Rodriguez, medical student, Johns Hopkins Medicine

I felt disappointed when I forgot to keep my patient at the center of care. I reminded myself that I have the chance to do better next time. 

13 Norham Gardens, the Osler's home in Oxford from 1907 until their deaths.

June 6, 2018 | 1 min read

Open Arms: The Welcoming Spirit of the Osler Residence

By Margaret Chisolm, MD, Johns Hopkins Medicine

Although we might not all live in a “substantial Victorian house” like William Osler’s, we can all embrace the welcoming spirit of “The Open Arms,” and invite more of our learners into our homes for informal meetings, mentorship, and maybe even tea.

December 2, 2024 | 4 min read

An intriguing paradox 

By Ghida Kassir, MD, University of Toronto, Canada

Because anorexia is not uncommon, it is likely that we will all encounter a patient who is suffering from this life-threatening condition. Although it may be difficult to understand self-starvation, empathy and compassion must be prioritized to establish a trusting patient-clinician relationship. 

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!

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 19, 2021 | 3 min read

Clinical Training Translating to Clinical Excellence

By Jennifer Spicer, MD, MPH, Emory University

Bias awareness achieved in teaching/learning can transfer to the clinic. Thus learners can help clinicians become aware of bias toward patients.

September 27, 2023 | 1 min read

Guardrails And Ambulances 

By Mike Fingerhood, MD, Johns Hopkins Medicine

Over 100,000 Americans die every year from overdoses, and most are preventable. Discuss with patients and loved ones the dangers of having old prescription or counterfeit pills, as well as the importance of keeping naloxone on hand.

April 23, 2025 | 3 min read

Teamwork Rx

Medical team huddles are a powerful practice to foster unity. This routine promotes teamwork, collaboration, and respect. 

August 31, 2020 | 2 min read

4 Tips for Using Neo and Gender-Neutral Pronouns

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

Becoming familiar and fluent with neo and gender-neutral pronouns takes practice. It is essential to providing affirming care for transgender, genderqueer, and non-binary patients.

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. 

August 17, 2022 | 1 min read

Lessons From “A Field Guide to Getting Lost”

By David Kopacz, MD, University of Washington

Many clinicians feel burned out at some point in their careers. While this may feel disorienting, it’s possible to learn and grow from this experience.

October 12, 2021 | 2 min read

Unshackle The Mind

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

When caring for a man in handcuffs, I was reminded that every patient must be shown empathy and compassion.

April 16, 2024 | 1 min read

Changing gears (archives, 2024)

By Chris Tiplady, MD, Northumbria Healthcare, England

At the start of the pandemic, I permanently switched my commute from car to bike. I'm now passionate about motivating patients to be more active.

December 15, 2025 | 2 min read

Pause, pattern, plan 

Turn gut feelings into patient-centered next steps. Instincts may guide you, but confirm each step with the patient’s goals, evidence, and team input. 

November 17, 2020 | 4 min read

Allyship and Upstanding

By Geoff Stetson, MD, UCSF

It’s critical to promote a culture of emotional safety in your clinical setting. Offer support and speak up when you witness hurtful incidents.

April 11, 2023 | 2 min read

“Can I hold my newborn baby?”

By Carolyn Sufrin, MD, PhD, Johns Hopkins Medicine

Giving birth while imprisoned usually occurs under inhumane conditions, with women remaining shackled and not being permitted to hold newborns. This is a reminder that every patient deserves our compassionate and nonjudgmental care. 

March 22, 2022 | 1 min read

Navigating my First Patient Death

By Elissa Abou Khalil, MD, University of Pittsburgh Medical Center

Acknowledging feelings and asking for support may help when dealing with loss.  

November 12, 2024 | 2 min read

DIY drugs: a risky prescription 

Healthcare professionals need to know about the growing trend of do-it-yourself (DIY) medicine. By asking open-ended questions about medication sources, clinicians can prevent adverse health outcomes. 

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?

"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 13, 2021 | 2 min read

Talking with patients who are vaccine-hesitant (archives, 2021)

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

We must listen without judgment to patients who are vaccine-hesitant. We need to hear their worries and concerns to address them appropriately.

July 18, 2018 | 2 min read

The Bell Curve

By Lee Akst, MD, Johns Hopkins University School of Medicine

The difference between a 99.5% and 99.95% success rate isn't necessarily in knowledge or training, but in physician attitudes towards adapting and changing to evolving information.

April 8, 2025 | 3 min read

“Can you help me die?” 

By Carolyn Rennels, MD, University of San Francisco

When a patient asks about medical assistance in dying, prioritize deep listening and exploration of fears and hopes over immediate procedural responses. This can help reassure them that you’ll accompany them to the end. 

August 19, 2020 | 2 min read

6 ways to address Black mistrust in medicine

By Biosha Jones, MD, Loma Linda University

We must work toward establishing trust with all of our patients instead of assuming it already exists.

"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.

August 15, 2022 | 2 min read

Role Modeling Vulnerability

By Daniel Saddawi-Konefka, MD, MBA, Massachusetts General Hospital

When a patient dies, sharing your emotions with trainees normalizes this response and highlights our shared humanity.  

October 11, 2021 | 2 min read

Helping Patients Share Disappointing Diagnoses With Loved Ones

By Ambereen Mehta, MD, Johns Hopkins Medicine, Michelle McWhirter, LCSW-C, Johns Hopkins Medicine

Patients often want to share significant health news with loved ones. You can help them choose when and how to disclose this information.

July 30, 2018 | 1 min read

What’s a book club doing at a medical conference?

By Scott Wright, MD, Johns Hopkins Medicine

Join a book club or start a book club - in either your professional or personal context. You'll be glad you did!

December 4, 2025 | 3 min read

Winter humbles the leaves 

Balance diagnostic exhilaration with goals-of-care conversations centered on the values of the patient and family. 

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.

April 24, 2018 | 2 min read

Equality v. Equity

Working towards giving equitable care, not equal care, should be our focus, especially if we’re aiming to shrink the health disparities gap.

April 10, 2023 | 1 min read

Sips And Gulps

By Judy Ashley, patient

Patients may need a clinician’s help with things that seem easy or obvious, like how to swallow pills.

March 23, 2022 | <1 min read

Keeping The Readers in Mind

By Vivian Altiery De Jesus, MD, MBE, Johns Hopkins Medicine

When documenting in the medical record, we must use respectful language. Both our patients and colleagues will appreciate and benefit from our thoughtfulness. 

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