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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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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.

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 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.

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.

October 17, 2023 | 1 min read

Partnering With Pharmacists in Ambulatory Care

By Heather Folz, PharmD, Notre Dame of Maryland University

Clinicians and pharmacists can work together to give holistic and comprehensive patient care. This requires understanding each other’s expertise. 

April 30, 2025 | 2 min read

Aging and autonomy 

Many older patients struggle with losing independence. Healthcare professionals can partner with them and their loved ones to ease challenging transitions. 

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."

September 7, 2022 | 2 min read

“Hysteria”

By Tina Zhang, MD, Johns Hopkins Medicine

We need to be aware of our own gender biases that could adversely affect women. To combat this, engage in shared decision-making with patients and be a lifelong learner of female health topics.   

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.

May 14, 2024 | 1 min read

ED overcrowding: every clinician can help

By Catherine Washburn, MD, Johns Hopkins Medicine

Collaboration between healthcare professionals across the hospital is crucial to reduce ED overcrowding and improve patient care. One thing clinicians can do is help patients leave the hospital as soon as they are ready. 

January 12, 2026 | 3 min read

Optimizing interdisciplinary care 

Healthcare is a team sport. When working through conflict within your care team, integrate perspectives to deliver better care. 

March 27, 2018 | 2 min read

12 Things I Wish I’d Known 50 Years Ago

By Randy Barker, MD, Johns Hopkins Medicine, retired

Twelve things I would tell my younger self—all the things I didn’t know then, but wish I had.

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.

April 24, 2023 | 1 min read

How CLOSLER Has Improved My Care of Patients: A Five-Year Retrospective

By Jeffrey Millstein, MD, Penn Medicine

Through CLOSLER, I’ve learned about the power of active listening and how better to navigate challenging conversations. It has also provided many ideas for re-energizing myself both personally and professionally. 

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. 

December 4, 2024 | 2 min read

The complexities of middle age 

By Alicia Arbaje, MD, MPH, PhD, Johns Hopkins Medicine

Mid-life is a period marked by multifaceted challenges, including physical, emotional, and social stressors. By adopting a holistic approach that addresses the whole patient healthcare professionals can provide more comprehensive and effective care. 

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 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.

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.

October 5, 2023 | 2 min read

When Medication is an Empty Promise (Sudafed) 

By Charles Flexner, MD, Johns Hopkins Medicine

Communicating uncertainty effectively is part of being an excellent physician. This is especially true when it comes to the medications we recommend to patients. 

April 28, 2025 | 3 min read

Spotting victims—human trafficking is not uncommon 

Healthcare professionals have a unique opportunity to identify and help victims of human and labor trafficking. Read on for practical tips for how to recognize and support these patients. 

Ruth and Carl J. Shapiro Gallery (Gallery 232), Museum of Fine Arts, Boston, featuring "Daughters of Edward Darley Boit," by John Singer Sargent (American, 1856–1925). Photograph by Flora Smyth Zahra.

June 6, 2019 | 7 min read

May Art Museum Challenge

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

The art museum is a space that has lessons to teach about clinical excellence, and fosters both the personal development and professional identity formation of clinicians.

August 29, 2022 | 2 min read

Takeaways From “The Making of a Surgeon”

By Richard Schaefer, MD, MPH, Johns Hopkins Medicine

Reading this book while I was in training inspired me to pursue a surgical career. Rereading it years later, I’m reminded of the importance of treating all patients with dignity.  

October 14, 2021 | 1 min read

Caring During Death

By Vivian Altiery De Jesus, MD, MBE, Johns Hopkins Medicine

It’s a privilege to care for patients and their loved ones, especially at the end of life. Even when we can’t cure, we can always comfort.

December 22, 2025 | 2 min read

BREATHE better at home 

To improve indoor air quality, counsel patients to combine source control with filtration. This includes eliminating smoking/vaping and avoiding fragrances like scented candles/incense. Recommend air cleaners with HEPA and carbon filters. 

An example of a trompe l’oeil in a geriatric hospital setting. Copyright by the author.

January 27, 2020 | 3 min read

Ethical Dilemmas in Dementia Care Design

By Diana Anderson, MD, MArch, Clincial Geriatrics Fellow, University of California, San Francisco

Innovative dementia care designs raise moral questions about whether deception of patients is ever ethical. The clinically excellent physician tries to avoid deception at all costs.

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.

April 19, 2023 | 1 min read

A Fall Into Grace

By Emily Rodriguez, medical student, Johns Hopkins Medicine

I felt disappointed when I forgot to keep my patient at the center of care. I reminded myself that I have the chance to do better next time. 

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.

December 2, 2024 | 4 min read

An intriguing paradox 

By Ghida Kassir, MD, University of Toronto, Canada

Because anorexia is not uncommon, it is likely that we will all encounter a patient who is suffering from this life-threatening condition. Although it may be difficult to understand self-starvation, empathy and compassion must be prioritized to establish a trusting patient-clinician relationship. 

March 18, 2019 | 2 min read

The Truth About Sex

By Khalil Ghanem, MD, PhD, Johns Hopkins University School of Medicine

How you phrase questions when obtaining a sexual history can mitigate the impact of social desirability bias and enhance the accuracy of the information that is obtained.

August 3, 2020 | 1 min read

Book Review of “Elderhood”

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

Ageism is a form of discrimination that contributes to poor health outcomes. To mitigate its effects, we must enact policies that address biases in ourselves, our workplaces, and our communities.

May 19, 2021 | 3 min read

Clinical Training Translating to Clinical Excellence

By Jennifer Spicer, MD, MPH, Emory University

Bias awareness achieved in teaching/learning can transfer to the clinic. Thus learners can help clinicians become aware of bias toward patients.

September 27, 2023 | 1 min read

Guardrails And Ambulances 

By Mike Fingerhood, MD, Johns Hopkins Medicine

Over 100,000 Americans die every year from overdoses, and most are preventable. Discuss with patients and loved ones the dangers of having old prescription or counterfeit pills, as well as the importance of keeping naloxone on hand.

April 23, 2025 | 3 min read

Teamwork Rx

Medical team huddles are a powerful practice to foster unity. This routine promotes teamwork, collaboration, and respect. 

August 17, 2022 | 1 min read

Lessons From “A Field Guide to Getting Lost”

By David Kopacz, MD, University of Washington

Many clinicians feel burned out at some point in their careers. While this may feel disorienting, it’s possible to learn and grow from this experience.

October 12, 2021 | 2 min read

Unshackle The Mind

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

When caring for a man in handcuffs, I was reminded that every patient must be shown empathy and compassion.

April 16, 2024 | 1 min read

Changing gears (archives, 2024)

By Chris Tiplady, MD, Northumbria Healthcare, England

At the start of the pandemic, I permanently switched my commute from car to bike. I'm now passionate about motivating patients to be more active.

December 15, 2025 | 2 min read

Pause, pattern, plan 

Turn gut feelings into patient-centered next steps. Instincts may guide you, but confirm each step with the patient’s goals, evidence, and team input. 

January 15, 2020 | 1 min read

Extra Minutes

By Scott Newsome, DO, Johns Hopkins University School of Medicine

Every extra minute a clinician spends with a patient is worth it.

November 17, 2020 | 4 min read

Allyship and Upstanding

By Geoff Stetson, MD, UCSF

It’s critical to promote a culture of emotional safety in your clinical setting. Offer support and speak up when you witness hurtful incidents.

April 11, 2023 | 2 min read

“Can I hold my newborn baby?”

By Carolyn Sufrin, MD, PhD, Johns Hopkins Medicine

Giving birth while imprisoned usually occurs under inhumane conditions, with women remaining shackled and not being permitted to hold newborns. This is a reminder that every patient deserves our compassionate and nonjudgmental care. 

March 22, 2022 | 1 min read

Navigating my First Patient Death

By Elissa Abou Khalil, MD, University of Pittsburgh Medical Center

Acknowledging feelings and asking for support may help when dealing with loss.  

November 12, 2024 | 2 min read

DIY drugs: a risky prescription 

Healthcare professionals need to know about the growing trend of do-it-yourself (DIY) medicine. By asking open-ended questions about medication sources, clinicians can prevent adverse health outcomes. 

April 11, 2018 | 3 min read

Five Tips to Support Your Grieving Patient

By Jane Schindler, LCSW-C ACHP-SW, Johns Hopkins University School of Medicine

A licensed clinical social worker offers her top tips for supporting grieving patients.

May 13, 2021 | 2 min read

Talking with patients who are vaccine-hesitant (archives, 2021)

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

We must listen without judgment to patients who are vaccine-hesitant. We need to hear their worries and concerns to address them appropriately.

July 18, 2018 | 2 min read

The Bell Curve

By Lee Akst, MD, Johns Hopkins University School of Medicine

The difference between a 99.5% and 99.95% success rate isn't necessarily in knowledge or training, but in physician attitudes towards adapting and changing to evolving information.

April 8, 2025 | 3 min read

“Can you help me die?” 

By Carolyn Rennels, MD, University of San Francisco

When a patient asks about medical assistance in dying, prioritize deep listening and exploration of fears and hopes over immediate procedural responses. This can help reassure them that you’ll accompany them to the end. 

June 3, 2019 | 1 min read

Every Piece of Data Matters

By Rabih Geha, MD, University of California San Francisco

Bolded, flagged, or typed in a different color, an abnormal result demands the mind’s eye in many modern EMRs, but it is equally important to direct our gaze to the quietly normal labs; not uncommonly, they may be screaming a powerful clue.

August 15, 2022 | 2 min read

Role Modeling Vulnerability

By Daniel Saddawi-Konefka, MD, MBA, Massachusetts General Hospital

When a patient dies, sharing your emotions with trainees normalizes this response and highlights our shared humanity.  

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