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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
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.  

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 13, 2021 | 4 min read

Only Connect

By Susrutha “Sus” Kotwal, MBBS, MD, Johns Hopkins Medicine

Missing a diagnosis made me realize the value of a thorough physical exam. It can often illuminate the cause of the illness.

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 12, 2022 | 1 min read

Equity and Inclusion: Beyond The Recognition Phase

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

Increasing the diversity of minority clinicians is a first step in combatting racism in medicine. We must also ensure that curricula are free of stereotypes and bias. 

July 9, 2024 | 3 min read

Takeaways from the book “Progress Notes” 

By Abraham Nussbaum, MD, Denver Health

Excellent clinicians understand patients not just as bodies, but also as individuals within a community. Healthcare professionals should be trained in both for a more holistic approach to patient care. 

October 19, 2020 | 2 min read

Book Review of “One by One by One”

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

Never underestimate the power of teamwork in caring for patients. What can feel impossible for one person may be accomplished with the collaboration and support of others.

"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.

February 28, 2022 | 4 min read

To Our Interpreters: Gracias, Shukriyah, Todah, Danyavad, Merci, Danke

By Cecilia Murach, Medical Interpreter, Johns Hopkins Medicine, Kamna Balhara, MD, Johns Hopkins Medicine, Nathan Irvin, MD, Johns Hopkins Medicine

When working with an interpreter, remember that they’re a person, not a machine. Saying “thank you” makes them feel like a valued member of the healthcare team. 

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.

White Mountains, New Hampshire.

July 6, 2023 | 3 min read

Peaks And Patients

By Rishab Ramapriyan, medical student, Harvard Medical School

In medicine, as in hiking, learning to be comfortable with uncertainty is one of the most important lessons I’ve learned in my medical training. 

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.

April 20, 2021 | 3 min read

Listening to Every Patient

By Pringl Miller, MD, San Francisco, California

To give clinically excellent care to the patient in front of you, ask yourself: “Am I carefully listening to what the patient is telling me? Am I incorporating what I’ve heard into the care plan?”

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.  

June 7, 2022 | 2 min read

“What’s Your Name Again?”

By Simone Lescott, MD, Johns Hopkins Medicine

Those who are underrepresented in medicine experience increased discrimination. It’s important to speak up against micro and macro aggressions.   

December 12, 2023 | 2 min read

“CARE”

By Kelly Buckholdt, PhD, Veterans Health Administration, William Laurento II, MEdL

There’s no more dramatic way to understand patient-centered care than being a patient. 

September 18, 2025 | 3 min read

Continuity in ADHD care

Life transitions, such as starting college, can be especially challenging for patients with ADHD. Ensuring continuity of care during these times is essential.

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!

July 2, 2024 | 4 min read

Seeing

By Kamna Balhara, MD, Johns Hopkins Medicine

When patients present frequently to the ED, clinicians must make an effort to validate them as individuals. It's also important to be aware of and work to change the underlying social determinants that may drive their visits.

October 12, 2020 | 2 min read

Advising Parents on a Safe Halloween

By Jade Cobern, MD, Johns Hopkins Bloomberg School of Public Health, Peyton Pike, MS, CCLS, Johns Hopkins Medicine, Rosemary Hawkins, MS, CCLS, Johns Hopkins Medicine

By being creative, everyone can safely celebrate Halloween this year. Beyond your household, consider holding a neighborhood physically distanced costume parade.

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.

February 24, 2022 | 3 min read

New dad and healthcare professional

By Ben Roberts, CRNP, AGACNP-BC, ACHPN, Johns Hopkins Medicine

Placing my child’s and my patients’ needs before my own gives me purpose. These responsibilities help mitigate burnout and allow me to give excellent care.

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.

July 3, 2023 | 1 min read

Pronouns Matter

By Kevin Frick, PhD, Johns Hopkins Carey Business School

A reminder to try to use a person’s preferred pronouns. This can help people feel more welcome and comfortable.

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. 

March 30, 2021 | 2 min read

Leveraging Your Professional Network For Your Growth

By Kevin Frick, PhD, Johns Hopkins Carey Business School

In your professional network, include those who challenge and question you. Peer feedback and coaching can help improve your care of patients.

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 1, 2022 | 2 min read

“The Pause”

By Eileen Barrett, MD, MPH

Healthcare professionals give their best patient care when they are emotionally well. Making time to grieve the loss of a patient can help clinicians heal. 

December 7, 2023 | 2 min read

“I need this test.” 

By Pavitri Dwivedi, DO, MPH, Johns Hopkins Medicine

When patients request a test that you think is unnecessary, be curious and elicit why they feel this way. Then address their concerns about the condition being screened. 

September 15, 2025 | 6 min read

How to support LGBTQ+ patients

Amid increasing anti-LGBTQ+ legislation, clinicians have an ethical duty to provide inclusive care. Read on for how to create welcoming environments in clinic and connect LGBTQ+ patients with appropriate resources. 

September 9, 2021 | 2 min read

Advising Patients About Heat-Related Illness

By Shaista Ahmed, MBBS, MPH, Johns Hopkins Medicine

Many heat-related illnesses are preventable. Advise patients to avoid going outdoors in peak heat hours, drink plenty of fluids, and know where cooling centers are in their community.

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.

Dr. William Greenough teaches about best practice in homecare.

June 20, 2018 | 1 min read

Home Care: A Better Way To Care For Ventilator Patients

By William Greenough, MD, Johns Hopkins University School of Medicine

Using portable ventilator technologies in the patient’s home can provide a higher quality of life.

June 24, 2024 | 2 min read

Partnering with patients with intellectual and developmental disabilities in medical decision-making 

By Sara Mixter, MD, MPH, Johns Hopkins Medicine

When caring for patients with intellectual and developmental disabilities, explore supported decision-making options and prioritize communication needs. These steps should offer them more control over medical choices. 

Encourage parents to support their teens in connecting with friends safely.

October 7, 2020 | 1 min read

CLOSLER Together

By Scott Wright, MD, Johns Hopkins Medicine

Discussing CLOSLER pieces in groups may yield more insights than simply reading on your own. Consider adding a discussion of a piece to your next staff, practice, or division meeting.

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.

June 20, 2023 | 1 min read

The Road Not Taken 

By Antonio Forte, LMSW, Johns Hopkins Medicine, Larkin Corrigan, MSW, Portland, Oregon

If patients can’t manage on their own, clinicians and staff can help them use social support networks and other resources to find transportation to their appointments. Virtual visits can also be considered. 

January 22, 2025 | 2 min read

The ulcer: a window into a patient’s emotional distress 

By Margret Nassuuna, DCP, Innerspark Recovery, Naalya, Uganda

The body, a masterful storyteller, often reveals insights into a patient’s mental state. By deciphering its narratives, clinicians may also be able to better address both the mental and emotional aspects of care.

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."

May 26, 2022 | 3 min read

Who Was Trayvon Martin?!

By Victor Ekuta, visiting medical student, Penn Medicine

We must pay attention to current events that may be significant to our patients. Staying curious may help us to connect and build rapport with those we serve.   

December 4, 2023 | 2 min read

More than a “picture” 

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

When explaining medical procedures to patients, use straightforward terms. Also, be mindful to maintain accuracy and clearly outline any risks. 

“Imagine your baby’s lungs are a tree,” she said. “A pleural effusion would be a puddle around the tree while pulmonary edema is water on the leaves.” The mother seemed to follow along, nodding her head. I was grateful to hear this metaphor that inspired me to utilize pictorial representations more.

August 19, 2021 | 2 min read

The Power of Pictures

By Rebekah Fenton, MD, Northwestern University

When educating patients about their illness, it’s often helpful to include pictures and visual descriptions to improve understanding.

September 24, 2019 | 1 min read

Counseling Patients on the Dangers of E-cigarettes

E-cigarettes pose unique health risks. Screening and informing our patients of these concerns is imperative.

September 27, 2022 | 2 min read

When?

By Shreya Srivastava, medical student, Albany Medical College

When my friend was struggling with her mother’s new diagnosis, she listened to the popular French song about cancer entitled, “Quand c’est?” It gave her a sense of support, empathy, and solidarity with others.

June 13, 2024 | 2 min read

Lightening the load 

By Susan Lehmann, MD, Johns Hopkins Medicine

Clinicians can prioritize patient well-being by discussing the burden of engaging in care. Collaborate with patients to ensure recommendations are feasible and consider alternative approaches if necessary. 

October 11, 2018 | 1 min read

Book Review of “Beartown”

By Tina Zhang, MD, Johns Hopkins Medicine

Medicine, much like hockey, is a team sport, where it takes the effort of many to realize success. The sacrifices required and pressures of being a hockey coach or player are similar to those that providers face. I highly recommend this book to everyone.

Reverse Waterfall, Nasik, Maharashtra, India.

February 16, 2022 | 1 min read

Mentorship in Reverse

By Rayah Sawaya, MD, American University of Beirut

If you find a mentor who’s helpful and generous, consider reciprocating with “reverse mentoring.”

April 21, 2020 | 2 min read

“Jiro Dreams of Sushi”

By Scott Wright, MD, Johns Hopkins Medicine

Role models can be found on Netflix. Jiro, the master sushi chef, is aiming for perfection, and we must also continuously try to get better in our work with patients.

June 6, 2023 | 3 min read

Plant Straight Rows

By Kyle Glienke, MD, Buena Vista Regional Medical Center, Iowa

In farming, as in medicine, focusing only on daily tasks may keep us from seeing the impact we have.

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