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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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April 14, 2022 | 4 min read

Talking About Climate Change With Patients

By Dean Chien, CLOSLER team, Baltimore, Maryland

Climate change affects the health of everyone. When talking with patients about climate change, meet them where they are and listen nonjudgmentally. 

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. 

September 20, 2023 | 2 min read

Sharing Our Stories

By Hailey Haffey, PhD, University of Utah

Stories we’ve internalized about healing may direct our approach to patient care. Find the one that resonates most with you.

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.

August 26, 2021 | 1 min read

Destigmatizing Addiction: The Power of Words

By Namrata Walia, MD, Baylor College of Medicine

Please use the term 'person with substance use disorder’ instead of ‘addict’!

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.

October 21, 2025 | 2 min read

Stroke, breath, care

Swimming taught me the importance of rhythm and breath. During difficult conversations with patients and families, I make room for quiet pauses to give them time to process.

April 11, 2024 | 1 min read

Takeaways from Adam Grant’s “Think Again” 

By Gretchen Miller, Managing Editor

Healthcare professionals can benefit from adopting a growth mindset that emphasizes rethinking existing beliefs and approaches. A key strategy is questioning assumptions and biases, which can lead to better decision-making. 

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.     

March 30, 2023 | 2 min read

Cultivating a Beginner’s Mind

By Clara Watkins, student, Emory University School of Nursing, Colleen Christmas, MD, Johns Hopkins Medicine

Remember when you were a new learner? Approach situations with that open, creative, and nonjudgmental mind that you may have had when you started training. 

The colors of the transgender flag.

March 25, 2026 | 3 min read

Feeling seen 

To build trust and help patients feel safe, use their preferred name and pronoun. Doing so consistently ensures that every patient feels recognized and respected. 

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 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.

April 14, 2022 | 2 min read

“Explainaholics”

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

Sometimes patients and caregivers feel overwhelmed when clinicians provide too much information. When you sense this to be the case, offering clear recommendations can be helpful.

September 18, 2023 | 3 min read

Do you “need” to say it that way? 

By Gina Piscitello, MD, MS, University of Pittsburgh Medical Center

Using the word “need” to describe a treatment option may mislead patients and loved ones into believing it should be pursued. Prioritizing patient values and preferences may help reduce this risk.  

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.

August 8, 2022 | 1 min read

988

By Patrick Hemming, MD, Duke University

When we identify patients who are experiencing mental illness, we need to let them know about this new resource in the U.S.

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. 

April 3, 2024 | 2 min read

Military kids serve too 

By Richard Schaefer, MD, MPH, Johns Hopkins Medicine

April is the Month of the Military Child. Clinicians caring for military family members should understand their history and stressors specific to the armed service to give the best possible care.    

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.

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.

June 26, 2018 | 1 min read

Harnessing Digital Technology for Clinical Excellence

By Margaret Chisolm, MD, Johns Hopkins Medicine

Digital technology can be leveraged for the greater good of clinically excellent patient care. Social media tools like Twitter enable you to connect with healthcare stakeholders from around the world.

March 23, 2026 | 2 min read

A dose of caution  

Pause before prescribing—consider not only the correct dosage but also the patient’s finances and home support for managing the treatment. 

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.

October 28, 2024 | 2 min read

Spark the change

By Sadiqua Sadaf, MBBS, Deccan College of Medical Sciences, Hyderabad, India

To motivate patients toward change, healthcare professionals can focus on building trust and setting achievable goals.

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. 

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.  

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.

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.

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.

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.

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.  

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.

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 19, 2026 | 3 min read

Mapping the end  

When caring for patients at the end of life, discuss the expected trajectory early on so they can make informed choices. Your guidance may help patients and families align treatment with their values and spend time where it matters most. 

"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.

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.

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.

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.

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. 

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.

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.

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.

"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. 

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."

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