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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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February 24, 2018 | 1 min read

Battling The System in Defense of Diagnosis

By Souvik Chatterjee, MD, Johns Hopkins Medicine

Healthcare delivery is at odds with a fundamental aspect of being a physician—strategic curriculum interventions are necessary to preserve the art of diagnosis.

February 15, 2022 | 1 min read

The Free Throw Line and Mindful Practice

By Richard Schaefer, MD, MPH, Johns Hopkins Medicine

Basketball players have a ritual followed by a pause before shooting a free throw. Clinicians can do likewise to be fully present for their next patient.     

Dingle Peninsula, County Kerry, Ireland.

March 9, 2020 | 1 min read

Embrace the Craic!

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

We would all do well to be more like the Irish!

July 10, 2018 | <1 min read

Better Dementia Care Through Music

By Michele Bellantoni, MD, Johns Hopkins University School of Medicine

Having your older patients listen to music can be an effective way to reduce dementia-related behavioral disturbances.

May 9, 2018 | 2 min read

Applying the Coaching Model to Medical Education

By Ryan Graddy, MD, AbsoluteCARE Medical Center, Atlanta, Georgia

Coaching—direct observation of learners with feedback geared toward skills development—is an important way to teach individualized medical education. Outstanding coaches across disciplines share characteristics that can be applied in clinical coaching encounters.

February 13, 2019 | 2 min read

Disparities in New Treatments

By Utibe Essien, MD, MPH, University of Pittsburgh School of Medicine

When beginning new treatments, it's important to ask patients what they understand about the medication, what their expectations are, what barriers might exist to remaining on this agent, and what they value most out of their treatment plan.

March 10, 2025 | 2 min read

The B12 fix

By Selvi Rajagopal, MD, MPH, Johns Hopkins Medicine

Clinicians should remember to watch for fatigue in patients shifting to plant-based diets; a B12 test can reveal a significant, reversible cause of feeling poorly. 

"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.

June 22, 2022 | 1 min read

Explaining The Risks of Vaping

Prioritize discussions about the long-term consequences of smoking. Be aware that just because someone has quit doesn’t mean that they won’t relapse.

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. 

January 11, 2024 | 2 min read

Book review of “Changing how we think about ‘difficult’ patients”  

By Jennifer Lycette, MD, rural oncologist in the Pacific Northwest

When caring for a patient whom I found challenging, I reminded myself that my negative reaction had less to do with the patient and more to do with me.  

August 1, 2019 | 3 min read

Mindset and the Power of Yet: A Conversation With Dr. Gurpreet Dhaliwal

Excellent clinicians are also thoughtful mentors. Mentors are like beacons as we navigate our path forward.

June 25, 2018 | 2 min read

On The Professional Formation of Doctors

By Margaret Chisolm, MD, Johns Hopkins Medicine

By getting out of the business of knowledge and skills and returning to the work of professional formation, not only will medical schools and their patients win, but doctors—and the profession of medicine as a whole—will too.

February 22, 2018 | 3 min read

Family History and Addiction Risk

By Margaret Chisolm, MD, Johns Hopkins Medicine

For some patients the risk of becoming addicted to prescription opioids is extraordinarily high and may outweigh any pain control benefit.

July 26, 2018 | 1 min read

A Taste of Their Own Medicine

By Scott Wright, MD, Johns Hopkins Medicine

Videos spreading misinformation to patients, promoting unproven therapies, can spread like wildfire on social media. We are sharing another video to fight fire with fire.

February 2, 2022 | 1 min read

Lessons in Leadership During Adversity

By Roy Ziegelstein, MD, Johns Hopkins Medicine

In difficult times, it’s helpful to understand others’ fears and concerns. Communicating clearly and regularly with those we serve is essential.

July 18, 2023 | 1 min read

Can a chatbot be a clinician’s friend?

By Adam Poliak, PhD, Bryn Mawr College, Eric Leas, PhD, Mark Dredze, PhD, Johns Hopkins University

ChatGPT can draft seemingly empathic answers to patient questions on medical portals. This may help clinicians respond more efficiently to their patients’ concerns. 

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.

The author's drawing of her heart utilizing the technique of defamiliarization.

February 14, 2019 | 3 min read

Defamiliarization

By Sarah Walser, , Penn State College of Medicine

Incorporating defamiliarization into practice builds empathy and broadens our worldview. It challenges us to expand and find confluence between different frameworks through which an experience, such as a disease, can be interpreted.

February 27, 2025 | 2 min read

Behind the mirror: teen eating disorders 

By Jasmine Reese, MD, MPH, Johns Hopkins Medicine

You don't have to be an eating disorder specialist to make a difference; every healthcare professional can play a vital role in early intervention. Knowing local resources and showing compassion can guide patients toward recovery. 

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 13, 2022 | 2 min read

3 Tips from the ED For All Healthcare Professionals

By Rodney Omron, MD, MPH, Johns Hopkins Medicine

Sharing appreciations with colleagues and learners is your superpower. Use it. 

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. 

January 9, 2024 | 3 min read

Dust and distrust

By Matthew Kelly, PhD, MPH, Johns Hopkins Medicine

Infection-related epidemics, like AIDS and COVID, teach us much about caring. To provide humanistic care, clinicians must continuously endeavor to assess and build trust with patients. 

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.

November 2, 2022 | 2 min read

Psychedelics to Quit Smoking?

By Matthew Johnson, PhD, Johns Hopkins Medicine

Patients may ask about using psilocybin to stop smoking. While being actively studied, please remind them that it’s still illegal and not necessarily risk-free. 

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.

July 11, 2024 | 2 min read

Protecting the most vulnerable from heat-related illnesses (archives, 2024)

By Joanna Cohen, MD, Johns Hopkins Medicine

When caring for patients during heat waves, healthcare professionals should be aware of social determinants of health—like no air conditioning at home. Clinicians should know the available resources to recommend, such as cooling centers within the communities they serve. 

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.

Hobbit holes, Hobbiton, Matamata, New Zealand. Photo by Jackie Ick, flickr.com, public domain, wikimedia.org.

February 21, 2020 | 2 min read

Hobbits of Healthcare

By David Shih Wu, MD, Johns Hopkins Medicine

The excellent clinician demonstrates hobbit-like bravery by leaning into hard conversations.

July 17, 2023 | 3 min read

Choreographing Clinical Care

By Hanghang Wang, MD, PhD, Johns Hopkins Medicine

Exceptional patient care is akin to a ballet performance. Synergistic team interactions, thoughtful decisions, and deliberate actions are all critical steps in the dance of patient care. 

"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.

January 30, 2019 | <1 min read

Dr. David Wu, A CLOSLER Look

By Gretchen Miller, Managing Editor

Palliative care is an approach to medicine that focuses on quality of life. My hope is that every clinician learns basic palliative skills to lead family conversations when there is a critically ill patient. It's a precious privilege to be able to enter people's lives at their most vulnerable time, and help them find some kind of peace.

February 12, 2025 | 1 min read

Insights from the book “Decoding Greatness”

By Scott Wright, MD, Johns Hopkins Medicine

Achieving greatness in any field is not only about talent or practice; it’s also about studying the successes of those who are exemplary. In medicine, observing and analyzing the approaches of admirable colleagues can allow us to grow and evolve toward being more clinically excellent. 

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.

June 13, 2022 | 3 min read

On Wondering

By Crystal Favorito, pre-med, Johns Hopkins Medicine

To wonder is to acknowledge possibility and open the door for progress. As a pre-med, it will help me become a lifelong learner on my professional journey. 

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. 

Treponema pallidum Syphilis bacterium, the bacterium responsible for the dangerous sexually transmitted infection, syphilis.

January 8, 2024 | 3 min read

Combatting the syphilis epidemic 

By Zach Lorenz, MD, Johns Hopkins Medicine

Rates of syphilis and other sexually transmitted infections are skyrocketing. It’s imperative that we have candid conversations with patients about their sexual behaviors. 

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.

July 1, 2019 | 1 min read

Looking Under the Hood

By Daniel Minter, MD, University of California, San Francisco

Promoting a culture of thinking out loud can demystify the process of clinical reasoning and make it accessible to all learners.

October 17, 2022 | 2 min read

Working With The Media For The Public Good

By Maria Simbra, MD

Clinicians can communicate health messages effectively by using memorable stories to share the main message and understanding the reporter’s constraints.  

"“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.

July 10, 2024 | 2 min read

Lessons from earlier in life: bagging groceries 

The service industry principles I learned while working in a grocery store apply to medicine. These include prioritizing customer needs, actively listening, and appreciating colleagues. 

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.  

February 25, 2020 | 2 min read

5 Things Clinicians can do to Reduce Drug Prices

By Justin McArthur, MBBS, MPH, Johns Hopkins Medicine

Excellent clinicians prescribe thoughtfully—pruning medication lists, advising patients on how to save money, and advocating for change.

July 13, 2023 | 2 min read

5 More Ways Social Workers Can Help Patients

By Abbey Becker, LMSW, Johns Hopkins Medicine

Hospital social workers can gather missing information essential to patient care. They can also assist patients in completing advance directives.  

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.

January 28, 2019 | 3 min read

Reflections on “Healing Alone”

By Helen Bradshaw, MD, Johns Hopkins University School of Medicine

In defense of the practice of pimping, though the term is a regrettable word choice, I learned from having questions directed at me. And my frequently incorrect responses were usually met with thoughtful explanations.

Three common zebras (Equus quagga), Kruger National Park, South Africa.

August 18, 2020 | 2 min read

Zebras Are Out There

By Eric Last, DO, Northwell Health, Wantagh, New York

Looking at the big picture and verifying details will help you consider diagnoses that may be unlikely, but still possible.

June 7, 2022 | 2 min read

“What’s Your Name Again?”

By Simone Lescott, MD, Johns Hopkins Medicine

Those who are underrepresented in medicine experience increased discrimination. It’s important to speak up against micro and macro aggressions.   

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