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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
June 4, 2018 | 2 min read

Half Baked

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

Your monthly dose of comic relief from William Osler's long lost cousin Wilma Ferthler.

February 17, 2021 | 1 min read

How to Talk to Patients About Unnecessary Antibiotics

By Benjamin Miller, Johns Hopkins University, Sara Keller, MD, MPH, MSPH, Johns Hopkins Medicine

When talking with patients about antibiotics that are not indicated, emphasize personal potential side effects such as yeast infections and diarrhea.

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.

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.

May 24, 2022 | 2 min read

The Reflexive Practitioner

By Corliss Wong, MS4, The University of Hong Kong

Our own biases and judgements inevitably affect our care of patients. Deep introspection can help us overcome our prejudices and improve clinical practice. 

If a patient doesn’t appear to understand what you’re saying despite repeated efforts, ask how they learn best. Perhaps draw a diagram and/or use an analogy.

March 20, 2025 | 3 min read

Falling up 

By Emily Ma, medical student, Johns Hopkins Medicine

The transition from pediatric to adult care poses significant challenges for patients with disabilities. Healthcare professionals can help by seeking to improve access and continuity of care. 

"Blue Rider," Franz Marc, 1911.

May 14, 2019 | 4 min read

Review of “Critical Crash”

By Andre Lijoi, MD, York, Pennsylvania

We all have our woundedness, and our own story is important in the context of caring for our patients. These stories and wounds operate in the background of our consciousness and we must recognize and manage them.

July 21, 2021 | 2 min read

Talking With Patients About Safe Summer Swimming

By Jade Cobern, MD, Johns Hopkins Bloomberg School of Public Health

Swimming is a summertime joy, but it is not without risk. Before patients take the plunge, they should be reminded to always swim with a buddy (never alone) and to apply sunscreen.

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.  

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. 

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 12, 2020 | 1 min read

Agents of Change—Learning From Gen Z Healthcare Students

By Kevin Pan, Medical Student, Ohio University School of Medicine

Excellent clinicians are committed to reducing health inequity.

January 5, 2022 | 1 min read

Bringing my nursing pearls to my doctoring (archives, 2022)

By Nina Wagner-Johnston, MD, Johns Hopkins Medicine

From my experience as a nurse, I always remember the importance of engaging the whole team. Each team member provides unique insights that can optimize the care of the patient. 

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.

"Nighthawks," Edward Hopper, 1942.

January 2, 2019 | 3 min read

The Human Experience of Illness

By Tina Zhang, MD, Johns Hopkins Medicine

Paintings, photographs, and poems can foster dialogue about the human experience of illness and allow learners to approach challenging topics in a more comfortable way.

February 3, 2021 | 3 min read

How to Cultivate a “Friendtorship”

By Jared Rubenstein, MD, Baylor College of Medicine, Liz Salmi, OpenNotes Communications, Beth Israel Deaconess Medical Center

A “friendtorship” is an informal peer-mentor relationship between two people with shared interests but different careers. “Friendtorships” can help you develop new perspectives and ideas about your own field.

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. 

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.

May 17, 2022 | 1 min read

Word Choice Related to Substance Use Disorders

By Beth McGinty, PhD, Johns Hopkins Medicine

Words matter; calling patients with a substance use disorder an “addict” defines them by their addiction. We need to ensure that our patients feel comfortable and supported so that they will engage in treatment.  

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. 

"Wheat Field with Cypresses," Vincent van Gogh, 1889. Metropolitan Museum of Art.

May 7, 2019 | 2 min read

Finding Balance

By Danielle Johnson, MD, Lindner Center of HOPE, University of Cincinnati

Small gestures while supporting patients through trauma and grief can make a big difference.

July 20, 2021 | 2 min read

3 lessons on clinical excellence from the oncology clinic

By Sajya Singh, Medical Student, Johns Hopkins Medicine

While shadowing clinicians in cancer care, I learned the importance of spending time to gather the family history, building trusting relationships, and balancing treatment plans with quality-of-life considerations.

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. 

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 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. 

March 20, 2018 | 2 min read

7 Things Clinicians Can Learn From Therapy Dogs

By Stephanie Cooper Greenberg, Johns Hopkins Pet Therapy Program

Dogs see the person in front of them only as people and not as patients.

December 21, 2021 | 4 min read

How to Make New Habits Stick, Part 2 

By Howard Chang, Medical Student, Johns Hopkins Medicine

We can build good habits in our own lives and help patients do the same by implementing the four laws of behavior change: make it obvious, make it attractive, make it easy, and make it satisfying. 

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. 

December 27, 2018 | 2 min read

“Charm City” Movie Review

The upcoming film "Charm City" emphasizes that the struggles of each patient who comes to clinic extend far beyond a medical diagnosis. We must be conscious of our patients' many challenges and mindful to address them. Making time to ask about your patient's day-to-day concerns, worries, and fears about their homes, neighborhoods, and communities can help you to get a fuller perspective of their medical and social determinants of health. This will allow you to reach relevant goals of care together.

February 1, 2021 | 2 min read

The Emperor’s New Curtains

By Charlotte Squires, MBChB, Borders General Hospital, Scotland

Clinically excellent physicians consider the setting of private conversations with patients and families. Quiet rooms with a door that closes are ideal for sensitive discussions.

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. 

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.

May 9, 2022 | 2 min read

Talking With Patients About Their Online Research

By Rebekah Fenton, MD, Northwestern University

Patients’ online research may leave them wondering if they have a particular disease. Listen to their concerns, normalize their fears, and provide reputable resources. And remember, sometimes they’re right.  

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. 

July 22, 2021 | <1 min read

Responding Instead of Reacting

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

When confronted publicly by a colleague, I learned that it is helpful to respond calmly instead of reacting defensively. This strategy will allow us to move forward.

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. 

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. 

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.  

The Rolling Stones in concert at the British Summer Time Festival in Hyde Park, July 6, 2013. Wikimedia, Public Domain.

January 2, 2020 | 1 min read

A Commonly Uncommon Patient

By Jeffrey Trost, MD, Johns Hopkins Medicine

Asking colleagues for help and re-reviewing data are essential in identifying clues to an accurate diagnosis.

December 20, 2021 | 1 min read

What Patients With Serious Illness Want to Know Most

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

After receiving a terminal diagnosis, many patients especially want to know how long they have to live, what symptoms to expect, and how to cope with impending decline.  

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. 

November 28, 2018 | <1 min read

Dr. Jim Black, A CLOSLER Look

By Gretchen Miller, Managing Editor

A favorite part of my job is telling patients when they, in fact, do NOT need surgery!

January 27, 2021 | 2 min read

Gin And Tonic—Cultural Footprints of Disease

By Kittane "Vishnu" Vishnupriya, MBBS, Johns Hopkins Medicine

To mitigate incorrect assumptions about patients who have been infected with COVID-19, we must work to spread truths and to minimize inaccuracies—particularly those that may be shameful or demeaning.

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.  

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.

May 5, 2022 | 1 min read

Lessons From Choosing a Specialty

By Howard Chang, Medical Student, Johns Hopkins Medicine

Deciding on an area of practice during medical school reminded me to ask for help when needed and to be comfortable with uncertainty. These skills will help me when I care for patients in the future.    

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. 

April 16, 2019 | 2 min read

4 Lessons From 12 Years as a Patient-Doctor

By Julia Michie Bruckner, MD, MPH, Children\'s Hospital Colorado, University of Colorado School of Medicine

Our white coats are not shields; they could be traded in for a flimsy hospital gown at any moment. Keeping this in mind, we can think of how we want to be cared for when our time comes, and then give this level of care to others. We can honor our shared humanity and vulnerability in our practice.

July 15, 2021 | 1 min read

Honoring Patients’ and Families’ Goals of Care

By Shireen Heidari, MD, Stanford University

When supporting critically ill or dying patients, keep their care goals at the forefront of conversations and planning.

January 4, 2024 | 1 min read

Searching for the solution

By Scott Wright, MD, Johns Hopkins Medicine

Improving clinical reasoning skills is a career-long journey where we feel like an expert one day and a novice the next. Commitment to growth and learning from mistakes are absolutely required.  

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