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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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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. 

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.

April 12, 2022 | 2 min read

Describing the Scribe: How We Help Clinicians

By Dean Chien, CLOSLER team, Baltimore, Maryland

Medical scribes allow clinicians to focus more fully on the patient in front of them. 

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.

September 13, 2023 | 1 min read

Firearm Suicides on The Rise

By Katherine Hoops, MD, Johns Hopkins Medicine, Paul Nestadt, MD, Johns Hopkins Medicine

To stem the increase in self-inflicted gun deaths, we must work toward early and accurate diagnosis of mental illness, as well as advocate for better firearm laws.

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. 

Juneteenth Flag

July 2, 2020 | 4 min read

3 Tips for Dismantling Anti-Black Racism in Academic Medicine

By LaShyra Nolen, Medical Student, Harvard University

White educators and learners must commit to doing the work and educating themselves on how to be antiracist. Black colleagues should not be responsible for educating those around them.

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.

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. 

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.  

October 27, 2021 | 4 min read

Digital Media Addiction: It’s Complicated

By Natalie Gukasyan, MD, Johns Hopkins Medicine

It’s tempting to resort to simple explanations for complex behaviors like digital media use. Deep relationships with patients can help you understand what’s behind the behavior. 

November 13, 2025 | 2 min read

Cognitive shuffle 

For patients with insomnia, coach them to visualize vivid, unrelated images to disrupt rumination and promote sleep onset. You can try it yourself, too! 

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.

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. 

"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.

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.

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. 

"The Doctor's Visit," Jan Steen. Philadelphia Museum of Art. Publicly shared via the Fair Use Act.

June 15, 2021 | 4 min read

How Art History Can Improve Your Care of Patients

By Siobhan Conaty, Art History Professor, La Salle University

Focusing on visual cues from our patients can help us to better understand them. Closely looking at art is one way that a clinician can improve their observation skills.

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. 

Newly Renamed Black Lives Matter Plaza NW, Washington, D.C., June 2020.

June 30, 2020 | 1 min read

Learning to be Antiracist

By Ashlyn McRae, Medical Student, Johns Hopkins Medicine

We must acknowledge the ways in which we have been, and are racist. This will allow us to provide the most equitable care to all of our patients.

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.  

"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.

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. 

November 2, 2021 | 2 min read

What All Clinicians Must Know About End-of-Life Care

By Pringl Miller, MD, San Francisco, California

Initiating and withdrawing life-sustaining medical treatment is the patient’s or their surrogate's decision, not ours. We must always honor their wishes.

November 10, 2025 | 1 min read

Takeaways from the book “Bankroll your mind”  

Attention invested in small moments—like a few screen‑free minutes at the start of a patient encounter—can compound into a trusting patient-clinician relationship. 

October 31, 2019 | 1 min read

A Physician, a Zombie, and a Patient Walk into a Bar

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

We are more like zombies than you might think. This fact reminds us that we should be able to find commonalities with all of our patients and colleagues. Happy Halloween!

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.

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 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. 

November 1, 2018 | 2 min read

Lessons From ‘The Giving Body’

By Adam P. Stern, MD, Harvard Medical School

Little by little, chronic disease can eat away at a patient’s sense of self. The best antidote can be a doctor who empathizes with the patient’s subjective experience.

May 12, 2020 | 1 min read

Jump-start End of Life Discussions With “Death Over Dinner”

By Katie Nelson, PhD(c), MSN, RN, Johns Hopkins University School of Nursing

The pandemic has created a sense of urgency around advance care planning and end of life preparations. Resources like "Death Over Dinner" can help broach conversations about death, dying, and the end of life in a non-threatening (and even entertaining) manner.

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. 

June 7, 2021 | 2 min read

It’s Not About Weight

By Nicole Cifra, MD, MPH, University of Rochester

Approaches employed by eating disorder specialists can be applied to support all patients. This includes emphasizing healthy behaviors and acknowledging your own assumptions about weight.

February 5, 2025 | 1 min read

Pathological hiccups

Sometimes benign symptoms can herald more serious problems. Being ready and willing to reconsider initial impressions is crucial for accurately discovering the underlying etiology.

Mahabharata. Published by Geeta Press in Gorakhpur. Public domain, Library of Congress.

July 13, 2020 | 2 min read

Eklavya and the Power of Online Learning

By Mrinali Shetty, MD, University of Chicago, Yuvraj Chowdhury, MD, SUNY Downstate Medical Center

During the pandemic, there has been an increase in educational offerings that can enhance our clinical skills. This expansion of virtual learning opportunities, (like open-access Zoom lectures and grand rounds, and #MedTwitter #tweetorials on countless topics), can be a boon for all.

Guanyin, Bodhisattva of Compassion, Honolulu Museum of Art. Photo by Margaret Chisolm, MD.

March 7, 2019 | 5 min read

On Looking: February Museum Visit

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

The more lessons on clinical excellence we look for in art, the more we find.

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.

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. 

October 2, 2019 | 2 min read

Partnering With Patients to Prevent Diabetes

By Eva Tseng, MD, MPH, Johns Hopkins Medicine

Clinically excellent clinicians effectively counsel and motivate patients to prevent diabetes. Setting specific goals for lifestyle changes, referring to evidence-based Diabetes Prevention Programs, and scheduling timely follow-up visits are among the tips outlined.

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.  

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.

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.

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.

The author, far right, with colleagues.

October 23, 2018 | 2 min read

Master Clinicians – The Early Years

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

It’s no surprise that it takes hard work to become a great clinician. This is a glimpse of what the first steps on that road might look like.

June 29, 2020 | 2 min read

Lessons From the AIDS Epidemic

By Melinda Kantsiper, MD, Johns Hopkins Medicine

In times of crisis, it can be helpful to listen and learn from the stories of those who have come before us.

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.  

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.

January 27, 2025 | 2 min read

The green hospital 

By Nick Dalesio, MD, MPH, Johns Hopkins Medicine

Recognize the significant environmental impact of your healthcare practices. Advocate for and implement sustainable solutions, such as optimizing workflow to reduce waste and improve resource utilization. 

Serena Williams playing mixed doubles at Wimbledon, 2019. Public domain, Wikipedia. Photo by Brian Minkoff, London Pixels.

June 24, 2020 | 1 min read

3 Things You Can do to Fight Racism

By Christle Nwora, MD, Johns Hopkins Medicine

We must each take personal responsibility for educating ourselves about racism. Increasing our understanding will allow us to improve health outcomes for all of our patients.

March 5, 2019 | 3 min read

From Film School to Medical School (Part 3 of 3)

By Margaret Chisolm, MD, Johns Hopkins Medicine

Using both words and images, John Berger and Jean Mohr's photo-essay, "A Fortunate Man," provides an intimate glimpse into the role of the doctor: "To cure sometimes, to relieve often, and to comfort always."

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