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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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A shire in Shropshire. Author's photo.

January 29, 2019 | 7 min read

“Good Doctoring”

By Taylor Purvis, MD, St. Vincent Medical Center, Bridgeport, CT

Reflections from a medical student on the practice of medicine as captured in the novels "The Bad Doctor," by Ian Williams, and "A Fortunate Man," by John Berger & Jean Mohr.

May 26, 2022 | 3 min read

Who Was Trayvon Martin?!

By Victor Ekuta, visiting medical student, Penn Medicine

We must pay attention to current events that may be significant to our patients. Staying curious may help us to connect and build rapport with those we serve.   

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. 

Dr. Eric Howell sharing and communicating about patient care with a colleague.

May 22, 2018 | 1 min read

What My Patients Taught Me About Leadership

By Eric Howell, MD, Johns Hopkins University School of Medicine

A veteran hospitalists highlights four areas where patients have helped him become a more thoughtful leader.

July 17, 2025 | 3 min read

Cricket and the cadence of care  

Like playing cricket, the art of medicine demands patience, teamwork, and a willingness to redefine victory—not every win is a cure. Sometimes success is helping a patient find comfort and dignity. 

June 20, 2019 | 2 min read

Be Brave Enough to Start Conversations That Matter

By Manasa Ayyala, MD, Rutgers New Jersey Medical School

"Between the World and Me" is a must read. At 152 pages, it's a small investment of time that leaves a large impact. I invite you to read this book with the intent to ask curious questions, to be ok feeling uncomfortable, and to continue this important dialogue.

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.

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. 

January 25, 2022 | 1 min read

Beware The Ladder of Inference

By Jeffrey Millstein, MD, Penn Medicine

Sometimes in the care of patients, we jump to conclusions. Questioning our assumptions can improve relationships and help us make better decisions.   

Bronze sculpture of Emmanuel Kant, by sculptor Daniel Rauch, 1857.

January 29, 2026 | 3 min read

Lessons from philosophy on facing uncertainty  

Giving exceptional care requires us to be open to other perspectives, recognize the limits of medical knowledge, and respect the patient’s lived experience. 

March 22, 2018 | 7 min read

Fundamentals for Caring for Transgender Patients

By Paula Neira, JD, MSN, RN, CEN, FAAN, Johns Hopkins Medicine

Improve your skills as you work to support your transgender patients and interact with your transgender colleagues.

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. 

February 23, 2021 | 3 min read

Tips For Giving Medical Updates to Families

By Joshua Budhu, MD, Mass General

A physician’s disappointment in hearing surprises about his loved one’s condition sparked new insights on the value of regularly updating families about the patient.

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. 

January 14, 2019 | 2 min read

We’re Getting CLOSLER to the Super Bowl!

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

Football-inspired clinical pearls from Vermont family physician Dr. Wilma Ferthler teach us how to be better clinicians.

May 25, 2022 | 2 min read

Between The Lines

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

Sometimes patient questions aren’t something to answer quickly. Instead, they can create a space to explore underlying concerns. 

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. 

July 28, 2021 | 2 min read

4 Things You Can do to Support Patients Facing Hard News

By Rebekah Fenton, MD, Northwestern University

In medicine, we sometimes have to share horrible news. When doing so, hold the conversations in a private space, make sure the patient and family understand what you’re saying, acknowledge emotions, and answer questions.

The autism ribbon.

June 12, 2025 | 2 min read

The strengths of neurodiverse healthcare professionals 

Neurodivergent healthcare professionals bring unique attributes to a medical team that can enhance patient care. We can foster inclusive environments that actively support these diverse ways of thinking and working.

June 18, 2019 | 2 min read

Navigating the Uncertain: A Book Review of “The Laws of Medicine”

Siddhartha Mukherjee, MD, provides a framework to reconcile the uncertainties we constantly experience in our practice of medicine in his book, "The Laws of Medicine."

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.

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. 

January 12, 2022 | 2 min read

The Comfort of Death Rituals

By Jennifer Eitingon, MD, Johns Hopkins Medicine

In the past, I questioned the value of certain rituals. A woman from Panama showed me how these may provide comfort to those who have lost a loved one.  

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. 

March 27, 2018 | 2 min read

12 Things I Wish I’d Known 50 Years Ago

By Randy Barker, MD, Johns Hopkins Medicine, retired

Twelve things I would tell my younger self—all the things I didn’t know then, but wish I had.

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.

February 22, 2021 | 3 min read

Giving Respectful Care to All

By Danielle Prentice, DO, Penn State

Respecting patients' stories, leaving preconceived notions at the door, and avoiding insensitive comments are expected professional norms in healthcare.

March 18, 2019 | 2 min read

The Truth About Sex

By Khalil Ghanem, MD, PhD, Johns Hopkins University School of Medicine

How you phrase questions when obtaining a sexual history can mitigate the impact of social desirability bias and enhance the accuracy of the information that is obtained.

May 24, 2022 | 2 min read

The Reflexive Practitioner

By Corliss Wong, MS4, The University of Hong Kong

Our own biases and judgements inevitably affect our care of patients. Deep introspection can help us overcome our prejudices and improve clinical practice. 

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.

July 19, 2021 | 3 min read

Diversifying the clinician workforce (archives 2021)

By Pringl Miller, MD, San Francisco, California

Diversifying the clinician workforce is associated with improved patient satisfaction and outcomes. So, what are we waiting for?

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. 

Ruth and Carl J. Shapiro Gallery (Gallery 232), Museum of Fine Arts, Boston, featuring "Daughters of Edward Darley Boit," by John Singer Sargent (American, 1856–1925). Photograph by Flora Smyth Zahra.

June 6, 2019 | 7 min read

May Art Museum Challenge

By Flora Smyth Zahra, MA Clin Ed, DRestDent RCS, FHEA, Kings College London, Margaret Chisolm, MD, Johns Hopkins Medicine

The art museum is a space that has lessons to teach about clinical excellence, and fosters both the personal development and professional identity formation of clinicians.

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. 

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. 

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 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.

An example of a trompe l’oeil in a geriatric hospital setting. Copyright by the author.

January 27, 2020 | 3 min read

Ethical Dilemmas in Dementia Care Design

By Diana Anderson, MD, MArch, Clincial Geriatrics Fellow, University of California, San Francisco

Innovative dementia care designs raise moral questions about whether deception of patients is ever ethical. The clinically excellent physician tries to avoid deception at all costs.

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. 

February 17, 2021 | 1 min read

How to Talk to Patients About Unnecessary Antibiotics

By Benjamin Miller, Johns Hopkins University, Sara Keller, MD, MPH, MSPH, Johns Hopkins Medicine

When talking with patients about antibiotics that are not indicated, emphasize personal potential side effects such as yeast infections and diarrhea.

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. 

May 17, 2022 | 1 min read

Word Choice Related to Substance Use Disorders

By Beth McGinty, PhD, Johns Hopkins Medicine

Words matter; calling patients with a substance use disorder an “addict” defines them by their addiction. We need to ensure that our patients feel comfortable and supported so that they will engage in treatment.  

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.  

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 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. 

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. 

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. 

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. 

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.

January 15, 2020 | 1 min read

Extra Minutes

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

Every extra minute a clinician spends with a patient is worth it.

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