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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 18, 2019 | 1 min read

A Tense Moment in the ER

By Danielle Ofri, MD, PhD, New York University School of Medicine

There are no easy solutions for conflicts of race, class, gender, societal roles, and economics. It’s only our individual work chipping away that will get us to a new place. It’s up to each of us to bring change.

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.

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.

August 1, 2022 | 1 min read

Keeping Children Safe

By Katherine Hoops, MD, Johns Hopkins Medicine, Monique Burke, MD, President, MD Chapter of the AAP

The new Safer Communities Act helps clinicians connect patients to mental healthcare. Hopefully, this will reduce youth gun violence, including suicide. 

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. 

April 2, 2024 | 3 min read

A dose of reality (TV)  

By Maria Fazal, MD, Baltimore, Maryland

A patient who had severe anxiety and depression told me that watching “The Great British Bake Off” was a helpful relaxation technique. She taught me that shows like this may provide a therapeutic escape.  

August 13, 2019 | 2 min read

How Does Bullying Relate to Clinical Excellence?

By Scott Wright, MD, Johns Hopkins Medicine

There is no place in medicine for bullying. It interferes with growth of individuals and collaborations among team members – both of these are critical for serving our patients.

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.

March 6, 2023 | 1 min read

Supporting Menopausal Patients

By Talia Sobel, MD, Mayo Clinic

Women often receive misinformation about menopause and even experience medical gaslighting from healthcare professionals. Clinicians should validate patients’ symptoms, and work with them to improve quality of life. 

March 1, 2018 | 2 min read

Most Physicians Sit Down at the Bedside When Entering a Patient’s Room

By Scott Wright, MD, Johns Hopkins Medicine

Choice architecture, framing, herd behavior, and feedback—how to nudge your patient towards healthier choices.

October 17, 2024 | 2 min read

Gaming for mental health 

By Barry Bryant, MD, Johns Hopkins Medicine

Understanding the therapeutic potential of video games is important. Clinicians may elect to recommend them for certain young patients struggling with mental health challenges.

September 11, 2023 | 2 min read

AI And Humanistic Care

By Daniel Brotman, MD, Johns Hopkins Medicine

In a clinical world that is increasingly algorithmic, what AI can NOT do is truly understand human emotions. Computers will never appreciate the joy and privilege of connecting with patients. 

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.

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.

"My book knowledge will allow me to recognize the pattern leading to a medical diagnosis, but I must also move beyond the mnemonic and to make time for the person seated in front of me."

July 28, 2022 | 2 min read

Passing Tests And Failing my Family

By Emily Rodriguez, medical student, Johns Hopkins Medicine

Book knowledge about addiction offered me little to support my family members and others affected by this illness. To holistically serve, we need to take the time to connect and genuinely understand each person.

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. 

March 25, 2024 | 1 min read

Graphic medicine: a picture is worth a thousand words 

By Benjamin Vipler, MD, MEd, University of Colorado

Pictures can often be a more effective way to explain complex medical concepts to trainees and patients than words alone. 

August 12, 2019 | 3 min read

Mental Illness and Mass Shootings

By Cassandra Crifasi, PhD, MPH, Emma Beth McGinty, PhD, Johns Hopkins Bloomberg School of Public Health

Most people with serious mental illness are never violent toward others. Due to the media’s misleading focus on the role of mental illness in gun violence generally and mass shootings specifically, many people are afraid that a diagnosis of a serious mental health condition like schizophrenia means they or their loved one are at high risk of hurting other people, which is not supported by the research evidence.

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 28, 2018 | 3 min read

Sacred or Stigma? A New Realm of Expression

By David Efron, MD, Johns Hopkins University School of Medicine

In 2018, do not resuscitate options are broad—distillation of the letters DNR do not provide enough guidance, and tattoos have yet to be validated as a definitive expression of this wish.

October 10, 2024 | 1 min read

Trust and truth

Nonjudgmental communication can help us understand the true nature of a patient’s condition and motivations. Connecting more deeply with a patient over time allowed us to learn more of the story. 

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.

Martin Luther King Jr. Memorial, Washington, D.C.

March 25, 2020 | 1 min read

Standing With Courage During Challenging Times

By Juliette Perzhinsky, MD, MSc, Central Michigan University

"The ultimate measure of a [person] is not where [s/he] stands in moments of comfort and convenience, but where [s/he] stands at times of challenge and controversy." -Martin Luther King Jr.

September 7, 2023 | 2 min read

“Wild Problems” Book Review

By Margaret Chisolm, MD, Johns Hopkins Medicine

When it comes to the big decisions in life, abandoning a rational, algorithmic approach—and going back to guiding principles—may be the secret to happiness. 

February 19, 2019 | 4 min read

On Feeling Helpless: A Psychiatrist Reflects on the Aftermath of a Patient Suicide

By Dinah Miller, MD, Johns Hopkins University School of Medicine

If you've been distressed by the loss of a patient to suicide, I hope my story will provide a moment of relief as you begin the process of healing; I hope that you may feel less alone.

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.

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.

June 19, 2018 | 2 min read

Sleep solutions (archives, 2018)

People see sleep as a luxury, but it's a basic human need. As clinicians, we should ask patients how they're sleeping. Here are nine things you can recommend to help them feel more rested.

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. 

March 21, 2024 | 2 min read

Young LGBTQ+ patients deserve more 

By Brady Hanshaw, medical student, Harvard Medical School, Thara Nagarajan, MD, UCSF

36% of LGBTQ+ youth are unsure they’ll live until the age of 35. These mental health outcomes are even more severe for LGBTQ+ youth of color. It’s critical that clinicians create a safe space to talk about anxiety, depression, self-harm, and suicidal ideation. 

"Sun Rise," by David Kopacz.

August 8, 2019 | 2 min read

The Circle of Re-Humanizing Medicine

By David Kopacz, MD, University of Washington

We need human-based medicine in conjunction with evidence-based medicine. If we only identify as scientists and not as healers, we risk dehumanizing our patients and ourselves.

September 27, 2018 | <1 min read

Knowing the Patient as a Person in Precision Medicine

By Roy Ziegelstein, MD, Johns Hopkins Medicine

We must consider each person’s life experiences – so-called Personomics – alongside the many “-omics” that are essential components of Precision Medicine. Personomonics contributes to how illness is expressed, and ideally how it should be diagnosed and treated.

October 3, 2024 | 2 min read

Patient time 

By Katherine Majzoub Morgan, MD, Brigham and Womens Hospital

Ask patients if they are concerned about the amount of time it takes to engage with health care systems. For those who are, include time as a factor in shared decision-making conversations. 

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.

Alfred Nobel, The Nobel Peace Center, Oslo, Norway.

March 18, 2020 | 2 min read

A nobel cause: an interview with Dr. Gregg Semenza

Mentors are invaluable. Whether pursuing excellence in research or clinical medicine, reach out to mentors so that you can grow efficiently.

August 30, 2023 | 2 min read

Containing Chaos Through Dance

By Shreya Srivastava, medical student, Albany Medical College

The strength, stamina, emotional understanding, and situational awareness that dancers develop over time can also benefit healthcare professionals.  

March 19, 2019 | 3 min read

Reversing the Backslide: Sexually Transmitted Infections in the US

By Matthew Hamill, MBChB, PhD, Johns Hopkins Medicine

Open, non-judgmental, respectful, medically-relevant conversations need to be the cornerstone of all therapeutic relationships. As long as patients feel valued and at the center of their care, patients are willing to engage in discussions about sexually transmitted infections.

August 17, 2020 | 1 min read

Top Tips For Starting a New Phase in Your Career

By Christle Nwora, MD, Johns Hopkins Medicine

Making time to care for yourself, asking questions, and letting go of perfection can help you successfully navigate a new chapter in your life.

August 9, 2021 | 4 min read

Hiding in Plain Sight: Just Ask, or You’ll Miss Most Eating Disorders

By Angela Guarda, MD, Johns Hopkins Medicine

Although five percent of the population has a clinically significant eating disorder, most aren't detected because clinicians don’t ask. Simply asking,“What is the MOST you would be comfortable weighing?” can help identify a restrictive eating disorder.

July 26, 2022 | 2 min read

Sharing One More Pint

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

When caring for a cancer patient who lived days longer than expected, I learned to be humble in my prognostications and to help patients receive “extra” moments of life as gift. 

September 18, 2025 | 3 min read

Continuity in ADHD care

Life transitions, such as starting college, can be especially challenging for patients with ADHD. Ensuring continuity of care during these times is essential.

March 19, 2024 | 2 min read

Caring for transgender and gender-expansive patients, Part 2

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

Transgender and gender-expansive patients often feel uncomfortable in healthcare settings and avoid care. Be sure to use every patient’s chosen name/pronoun and take care not to misgender.

August 5, 2019 | 2 min read

Training and Identity

What parts of yourself do you want to bring back into your life that you may have lost during residency?

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.    

February 2, 2023 | 2 min read

We Just Disagree

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

When colleagues offer a conflicting opinion, remember to always put the patient first, check your facts, and be open to learning.  

August 23, 2018 | 4 min read

How To Incorporate Students Effectively Into Clinic

Making the time and effort to integrate students into clinic cohesively can be associated with both improved clinical productivity and educational value.

"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.

August 29, 2023 | 1 min read

Music and Medicine: The Same Melody 

By Tara Rajendran, MBBS, MFA, Annamalai University, Annamalai Nagar, Chidambaram, Tamil Nadu, India 

My training in classical Indian music helped me to become better at focused listening and recognizing the importance of teamwork in medicine. 

MERIT Health Leadership Academy students, Baltimore, Maryland, author's photo.

February 27, 2019 | 2 min read

The Need for Diversity

By Tyler Mains, MD, University of California, San Francisco

Our future healthcare workforce must be as diverse as the communities it serves.

August 10, 2020 | 2 min read

Debriefing after death (archives, 2020)

By Christopher Bennett, MD, Stanford University

Reflecting on a patient's death as a team provides an opportunity to process emotions and strengthen team dynamics.

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