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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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September 26, 2022 | 3 min read

Concerning Hobbits: On Middle-earth and Medicine

By Tina Zhang, MD, Johns Hopkins Medicine, Zach Lorenz, MD, Johns Hopkins Medicine

J.R.R. Tolkein’s beloved trilogy offers lessons for life and medicine, including journeying with our patients through dark times and effectively engaging in teamwork. 

November 4, 2021 | 3 min read

Dissection And Reintegration

By Aidan Crowley, Medical Student, University of Pennsylvania

We sometimes “cut” patients apart to assist in the diagnostic process. We must remember to put them back together; we’re charged with caring for their minds and spirits in addition to their bodies.

March 21, 2018 | 2 min read

İnsan Olmak—Being Human

By Ezgi Ozalp Akın, MD, Ankara University

Developmental pediatrician Ezgi Ozalp Akın, MD, shares insights gleaned from "İnsan Olmak" on being human.

June 12, 2024 | 3 min read

Getting serious about citrus 

By Maureen Flood, NP, Johns Hopkins Medicine

In patients with chronic conditions and socially determined health risks, remember to consider vitamin C deficiency. 

"Spending time outdoors helps me cope with the stress and sadness of the job." -Dr. Jared Rubenstein

December 10, 2020 | 3 min read

Coping With Patients’ Heartbreak

By Jared Rubenstein, MD, Baylor College of Medicine

When supporting patients and their loved ones during times of great sadness and loss, cultivating a daily habit of self-care may protect against burnout.

"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.

July 5, 2018 | 1 min read

Getting the Most Out of Your Eyes

By Scott Wright, MD, Johns Hopkins Medicine

If you look at your patients as you would a piece of art in a museum, you will notice many details that would otherwise be missed.

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.

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.

June 16, 2021 | 1 min read

Why we Must Talk About E-cigarettes with Teen Patients

By Mike Fingerhood, MD, Johns Hopkins Medicine

Proactively counseling adolescents about the risks of e-cigarette use is essential. The message should acknowledge both the health implications and the pressures that they may feel from their peers.

"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.

November 21, 2023 | 2 min read

“You’ll need someone to drive you home”

By Megan Murphy, MD, Johns Hopkins Medicine

Transportation may be a barrier to healthcare, especially for procedures requiring sedation. Sometimes we need to think creatively and partner with others in order to find solutions.  

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. 

September 21, 2022 | 1 min read

Helping Patients Navigate Risk in The New Normal

By David Hurwitz, MD, MBA, Johns Hopkins Medicine

Using empathic listening to give COVID-related advice will help your patients balance the risks of the pandemic with enjoying the activities in their lives that matter most. 

November 8, 2021 | 1 min read

Lessons Learned From 30 Years of Night Shifts

By Kimberly Turner, MD, Johns Hopkins Community Physicians

Patience, stamina, and fortitude are important traits to cultivate in medicine at any and all times.

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.

May 30, 2024 | 1 min read

Transparency and trust 

By Justin Colleran, patient, Ireland, Miriam Colleran, MD, St. Brigids Hospice & Naas General Hospital, Ireland

The delayed diagnosis of my brother's appendicitis highlighted the importance of honesty and accountability when medical errors occur. By openly acknowledging mistakes, doctors can rebuild trust. 

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.

May 18, 2023 | 2 min read

Ballet And Medicine

By Maria Guinle, medical student, Stanford Medicine

Medicine is similar to dancing. Learning from mistakes and working as part of a team are necessary for success. 

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. 

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.

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.  

"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.

November 20, 2023 | 1 min read

A surgical sojourn in China

By Hanghang Wang, MD, PhD, Johns Hopkins Medicine

Engaging with healthcare professionals in other countries represents an invaluable learning opportunity. My clinician colleagues in Nanjing helped me to appreciate the value of teamwork across cultures. 

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. 

September 20, 2022 | 2 min read

When And How to Self-disclose

By Meher Kalkat, medical student, Johns Hopkins Medicine

Sharing our own mental health experiences is often discouraged. Sometimes, disclosure may help you connect more deeply with others. 

November 9, 2021 | 3 min read

Giving Exceptional Care Without Exception

A one-liner works in comedy but leads to biases in medicine. Listening, getting to know, and learning from each patient will allow you to serve them best.

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.

May 21, 2024 | 1 min read

Time out 

By Haruka Torok, MD, MSc, University of Minnesota

When emotions run high in clinical situations, it can be helpful for everyone to take a break and come back together when feelings have cooled down.

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!

May 2, 2023 | 2 min read

Treating all patients with compassion (archives, 2023)

By Keisha Ray, PhD, McGovern Medical School

Physician bias is one driver of poor health outcomes among Black patients. A commitment to compassion and active listening can combat this trend. 

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.

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.

"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.

October 19, 2023 | 2 min read

Healthcare for every body

By Stephanie Pham Van, MD, Johns Hopkins Medicine

To make healthcare more welcoming, be sensitive to how patients prefer to be described. Also, find out what tools they might need to access information, for example, voice to text transcriptions. 

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. 

September 13, 2022 | 2 min read

Psychedelics and Health

By Mary Yaden, MD, Johns Hopkins Medicine

Psychedelic therapies have long been feared and avoided. We must acknowledge that there are clinical indications where these treatments are profoundly beneficial.   

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. 

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.

May 16, 2024 | 2 min read

Two coats in one small room: caring for another clinician 

Caring for another clinician is complicated and requires special thoughtfulness; false assumptions about what the “clinician-patient” understands may result in suboptimal care.    

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. 

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.

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.

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. 

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. 

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.

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