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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
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.

June 2, 2020 | 3 min read

“Flattening the Curve”

By Madeline Rodriguez, MD, Johns Hopkins University School of Medicine

The pandemic is breaking down the traditional hierarchy of medical education. Opportunities are emerging for faculty to learn even more from residents.

Photo of Colin. Copyright with the family.

April 13, 2021 | 2 min read

Patient as Educator

By David Reid, Co-Director, Dare Dementia, England

From my patient with dementia, I learned that patients are experts on the lived experience of their illness. We must value and acknowledge their insights and be open to learning from them.

April 15, 2019 | 1 min read

7 Things I’ve Learned About Mentoring in 51 Years

By David Levine, MD, MPH, Johns Hopkins University School of Medicine

Helping others to achieve their full potential is the most incredible, wonderful, and exhilarating role one can undertake.

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.  

October 16, 2025 | 4 min read

Prescribing humility 

Standard of care is provisional—reassess therapies as evidence evolves. Be open to changing your thinking and practice as new data emerge. 

September 20, 2022 | 2 min read

When And How to Self-disclose

By Meher Kalkat, medical student, Johns Hopkins Medicine

Sharing our own mental health experiences is often discouraged. Sometimes, disclosure may help you connect more deeply with others. 

This is from "The Spirit Catches You and You Fall Down," written by Anne Fadiman. The art copyright is believed to belong to the publisher, Farrar, Straus and Giroux, or the artist. Public domain from wikipedia.org.

November 20, 2019 | 2 min read

“The Spirit Catches You and You Fall Down”

By Laura Pugh, Medical Student, Johns Hopkins Medicine

The gap between cultural systems can be wide. Openness, curiosity, and humility will improve cross-cultural care.

May 21, 2024 | 1 min read

Time out 

By Haruka Torok, MD, MSc, University of Minnesota

When emotions run high in clinical situations, it can be helpful for everyone to take a break and come back together when feelings have cooled down.

February 3, 2022 | 2 min read

Perspective Matters

By Souvik Chatterjee, MD, Johns Hopkins Medicine

As the pandemic continues, I remind myself that my job is to give selflessly to those who are sick. It’s helpful to lean on my team when situations feel especially challenging.

November 29, 2018 | 2 min read

Management Reasoning: Diagnostic Reasoning’s Underappreciated Sibling

By David Cook, MD, MHPE

Management reasoning is primarily a task of shared decision-making and monitoring, and is inherently more complex than diagnostic reasoning. A better understanding of management reasoning will offer insights into the causes and avoidance of medical error, clinical practice quality improvement, and training and assessment of health professionals.

May 18, 2023 | 2 min read

Ballet And Medicine

By Maria Guinle, medical student, Stanford Medicine

Medicine is similar to dancing. Learning from mistakes and working as part of a team are necessary for success. 

Kau Sai Chau Public Golf Club, Hong Kong.

July 21, 2020 | 1 min read

Medicine is Like Golf

By Barry Bryant, MD, Johns Hopkins Medicine

In both medicine and golf, it's helpful to accept that much is beyond our control. Trusting our ability —grounded in thousands of hours of focused practice—may allow us to have the confidence that our best efforts will usually translate into favorable results.

"Girl with a Bamboo Earring," Awol Erizku, 2009. Used under the fair use Copyright Act.

February 18, 2021 | 2 min read

Art is Integral to Healthcare

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

Engaging with art can address some of medicine’s greatest challenges, including recognizing our common humanity.

Trichomonas vaginalis

December 12, 2024 | 3 min read

Home testing: a new era in sexual health      

By Scott Wright, MD, Johns Hopkins Medicine

At-home sexually transmitted illness (STI) testing allows easier patient access. It’s crucial for healthcare professionals to talk with patients about the limitations of these tests and discuss when follow-up care is needed.  

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 18, 2021 | 2 min read

Helping Students Transition to Wards

By Howard Chang, Medical Student, Johns Hopkins Medicine

I was nervous taking care of my first patient as a student on the medical wards. I felt more comfortable when I realized that even experienced clinicians don’t know everything, and of course they did not expect me to have all the answers.

October 13, 2025 | 2 min read

The word “want” may leave patients wanting 

When prior notes document that a patient doesn’t “want” a specific intervention, elicit the patient’s desired outcome and acceptable trade-offs. Then determine whether “I don’t want X” is absolute or conditional and align the care plan accordingly. 

November 19, 2019 | 2 min read

Aging isn’t a dirty word

To many, "aging" and "old" are considered dirty words. Clinicians should fight ageism.

May 16, 2024 | 2 min read

Two coats in one small room: caring for another clinician 

Caring for another clinician is complicated and requires special thoughtfulness; false assumptions about what the “clinician-patient” understands may result in suboptimal care.    

January 31, 2022 | 2 min read

Lessons in Medicine From Running a Marathon

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

As a trainee who also competes in races, I’ve learned the importance of leaning on others to reach the finish line.  

November 12, 2018 | 3 min read

Insights From “A Whole New Mind”

Daniel Pink's "A Whole New Mind" highlights the importance of cultivating empathy, humor, and the ability to create meaning.

May 2, 2023 | 2 min read

Treating all patients with compassion (archives, 2023)

By Keisha Ray, PhD, McGovern Medical School

Physician bias is one driver of poor health outcomes among Black patients. A commitment to compassion and active listening can combat this trend. 

Ask your patients, "Are you concerned about how expensive the treatment is?" You don't need to know your patients' income or out-of-pocket costs, but you can think about starting with less expensive but effective treatments.

March 16, 2021 | 3 min read

Best Practices in Shared Decision-Making

By Kevin Frick, PhD, Johns Hopkins Carey Business School

Giving exceptional care includes honoring your patient’s goals and addressing any challenges they might have with the care plan. Be mindful of the financial costs that your patients may face and discuss alternatives when possible.

December 10, 2024 | 1 min read

A breath of fresh air

By Mike Fingerhood, MD, Johns Hopkins Medicine

Healthcare professionals can prioritize ongoing conversations about the risks of smoking and vaping with young patients, tailoring their approach to address specific concerns and misconceptions.

April 1, 2019 | 3 min read

Practicing Medicine and Having a Ball

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

Hope our 2019 April Fool's piece makes you chuckle!

October 19, 2023 | 2 min read

Healthcare for every body

By Stephanie Pham Van, MD, Johns Hopkins Medicine

To make healthcare more welcoming, be sensitive to how patients prefer to be described. Also, find out what tools they might need to access information, for example, voice to text transcriptions. 

August 23, 2021 | 1 min read

The Boomerang of Disparaging Remarks

By Harisa Spahic, Medical Student, Johns Hopkins University

Negative remarks about other specialities can discourage students from pursuing these fields. Instead, focus on sharing the positive aspects of your discipline.

October 7, 2025 | 2 min read

The compass of care 

When the path is grey, reach out to your ethics committee for perspective. They help clarify options and provide guidance, which can improve communication with patients, families, and colleagues. 

September 13, 2022 | 2 min read

Psychedelics and Health

By Mary Yaden, MD, Johns Hopkins Medicine

Psychedelic therapies have long been feared and avoided. We must acknowledge that there are clinical indications where these treatments are profoundly beneficial.   

November 12, 2019 | 2 min read

The Early Bird Special

By Rebecca Hamburger, Medical Student, Central Michgan University College of Medicine

Timing is everything. Doing our best to optimize access to healthcare is a first step to serving our patients.

May 14, 2024 | 1 min read

ED overcrowding: every clinician can help

By Catherine Washburn, MD, Johns Hopkins Medicine

Collaboration between healthcare professionals across the hospital is crucial to reduce ED overcrowding and improve patient care. One thing clinicians can do is help patients leave the hospital as soon as they are ready. 

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. 

The Bluebird Cafe, Nashville, Tennessee. Copyright by the author.

May 11, 2020 | 3 min read

Redefining Rounds—Will The Circle be Unbroken?

By Chase Webber, DO, Vanderbilt University Medical Center

A patient care team performs best when all voices harmonize and creative approaches are applauded.

March 10, 2021 | 2 min read

Communication PEARLS

By Catherine Washburn, MD, Johns Hopkins Medicine

When speaking with patients and colleagues, use a respectful tone and convey empathy. Clear communication is the basis for effective and trusting relationships with patients and coworkers.

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. 

March 13, 2019 | <1 min read

Dr. Elliot Fishman, A CLOSLER Look

By Gretchen Miller, Managing Editor

Artificial intelligence (AI) will drastically alter all of medicine, with the potential to enhance patient care through improved diagnoses.

October 17, 2023 | 1 min read

Partnering With Pharmacists in Ambulatory Care

By Heather Folz, PharmD, Notre Dame of Maryland University

Clinicians and pharmacists can work together to give holistic and comprehensive patient care. This requires understanding each other’s expertise. 

August 16, 2021 | 3 min read

The Heart of Clinical Reasoning

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

Making a diagnostic error reminded me that connecting with patients on a personal level is necessary for optimal clinical reasoning.

September 19, 2019 | 2 min read

The Importance of Partnering With Patients

By Michael Crocetti, MD, MPH, Johns Hopkins Community Physicians

What patients and families need is a clinician advocate who is available to listen, translate complex medical language, and support both the physical and mental health of the patient.

October 2, 2025 | 2 min read

Don’t sleep on it  

Insomnia is a common condition that increases the risk of physical and mental health problems. Screening for it is an important part of patient care, and it can be quick and easy. 

September 7, 2022 | 2 min read

“Hysteria”

By Tina Zhang, MD, Johns Hopkins Medicine

We need to be aware of our own gender biases that could adversely affect women. To combat this, engage in shared decision-making with patients and be a lifelong learner of female health topics.   

October 10, 2019 | 2 min read

Our Greatest Teachers

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

To find meaning in your clinical work, search for the words and moments that affirm your shared humanity with patients.

January 26, 2022 | 1 min read

Talking With Older Patients About Winter Hazards

By Shaista Ahmed, MBBS, MPH, Johns Hopkins Medicine

Be sure your geriatric patients are aware of winter hazards and provide guidance on how to avoid the risk of falls and hypothermia.    

"The Persistence of Memory," Salvador Dali, 1931, The Museum of Modern Art.

November 19, 2018 | 2 min read

Learning from Learners

By Margaret Chisolm, MD, Johns Hopkins Medicine

Teaching is the best way to learn. In the end, I am not only a teacher and my residents are not only learners, but we are both a little of each.

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. 

May 26, 2020 | 1 min read

Accelerating Adaptation in Healthcare

By Lia Logio, MD, Drexel University College of Medicine

Efficiency erodes our ability to respond to the uncertainty of life. The messy world of clinical care requires time, patience, and creative experimentation.

"The practitioners who surround the student during his or her transition into the clinical world show the student how to live out out his or her oath. During this stage of formation, the trainee is simultaneously a sponge and a clay sculpture, soaking up the minutiae of the clinical environment while honing the skills that will shape his or her character as a physician."

March 1, 2021 | 4 min read

How to be an Excellent Clinical Mentor

By Aidan Crowley, Medical Student, University of Pennsylvania

Mentorship is essential to healthcare teaching, learning, and practice. Excellent mentors lead by example and guide mentees, informed by empathic listening and reflections on their own journeys.

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. 

March 28, 2019 | 6 min read

Integrating Psychology and Primary Care

By Benjamin Bensadon, PhD, University of Florida College of Medicine

Person-centeredness holds great potential to maximize healing in the way Osler envisioned more than a century ago. But to translate this concept clinically, psychology and medicine must come closer together. The closer we can come together, the closer we can come to Osler.  

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