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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
February 2, 2023 | 2 min read

We Just Disagree

By Eric Last, DO, Northwell Health, Wantagh, New York

When colleagues offer a conflicting opinion, remember to always put the patient first, check your facts, and be open to learning.  

August 23, 2018 | 4 min read

How To Incorporate Students Effectively Into Clinic

Making the time and effort to integrate students into clinic cohesively can be associated with both improved clinical productivity and educational value.

February 28, 2018 | 3 min read

Sacred or Stigma? A New Realm of Expression

By David Efron, MD, Johns Hopkins University School of Medicine

In 2018, do not resuscitate options are broad—distillation of the letters DNR do not provide enough guidance, and tattoos have yet to be validated as a definitive expression of this wish.

Martin Luther King Jr. Memorial, Washington, D.C.

March 25, 2020 | 1 min read

Standing With Courage During Challenging Times

By Juliette Perzhinsky, MD, MSc, Central Michigan University

"The ultimate measure of a [person] is not where [s/he] stands in moments of comfort and convenience, but where [s/he] stands at times of challenge and controversy." -Martin Luther King Jr.

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.

February 19, 2019 | 4 min read

On Feeling Helpless: A Psychiatrist Reflects on the Aftermath of a Patient Suicide

By Dinah Miller, MD, Johns Hopkins University School of Medicine

If you've been distressed by the loss of a patient to suicide, I hope my story will provide a moment of relief as you begin the process of healing; I hope that you may feel less alone.

July 20, 2022 | 2 min read

“I’ll do your abortion.”

By Jill Edwardson, MD, MPH, Johns Hopkins Medicine

We enter every patient encounter with our own unique experiences, judgements, and values, as do our patients. Only when we acknowledge this can we truly connect with compassion.

March 18, 2024 | 2 min read

Caring for transgender and gender-expansive patients, Part 1 

By Paula Neira, JD, MSN, RN, CEN, FAAN, Johns Hopkins Medicine

Clinicians must be aware that transgender and gender-expansive patients face widespread discrimination in healthcare settings, including harassment and denial of care, and work to mitigate this disturbing trend. 

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. 

"Sun Rise," by David Kopacz.

August 8, 2019 | 2 min read

The Circle of Re-Humanizing Medicine

By David Kopacz, MD, University of Washington

We need human-based medicine in conjunction with evidence-based medicine. If we only identify as scientists and not as healers, we risk dehumanizing our patients and ourselves.

January 31, 2023 | 1 min read

Brain Candy

By Carol Vidal, MD, PhD, Johns Hopkins Medicine

Because we don't know yet how social media affects our brain, it needs to be consumed in moderation. Scheduling times to spend time with friends and family may make it easier to get offline. 

October 2, 2024 | 1 min read

Pain management: a perspective from a doctor in Kuwait 

Pain and suffering are ubiquitous. Observing approaches and practices in the U.S. highlighted for me the importance of open dialogue, patient empowerment, and multimodal approaches.   

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.

September 27, 2018 | <1 min read

Knowing the Patient as a Person in Precision Medicine

By Roy Ziegelstein, MD, Johns Hopkins Medicine

We must consider each person’s life experiences – so-called Personomics – alongside the many “-omics” that are essential components of Precision Medicine. Personomonics contributes to how illness is expressed, and ideally how it should be diagnosed and treated.

Alfred Nobel, The Nobel Peace Center, Oslo, Norway.

March 18, 2020 | 2 min read

A nobel cause: an interview with Dr. Gregg Semenza

Mentors are invaluable. Whether pursuing excellence in research or clinical medicine, reach out to mentors so that you can grow efficiently.

August 29, 2023 | 1 min read

Music and Medicine: The Same Melody 

By Tara Rajendran, MBBS, MFA, Annamalai University, Annamalai Nagar, Chidambaram, Tamil Nadu, India 

My training in classical Indian music helped me to become better at focused listening and recognizing the importance of teamwork in medicine. 

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.”

March 19, 2019 | 3 min read

Reversing the Backslide: Sexually Transmitted Infections in the US

By Matthew Hamill, MBChB, PhD, Johns Hopkins Medicine

Open, non-judgmental, respectful, medically-relevant conversations need to be the cornerstone of all therapeutic relationships. As long as patients feel valued and at the center of their care, patients are willing to engage in discussions about sexually transmitted infections.

The author discusses patient sleep with a colleague.

June 18, 2018 | 2 min read

How To Help Your Patients Get Better Sleep, Part I

A sleep specialist reminds us of the importance of asking patients about their sleep.

March 14, 2024 | 3 min read

Why sexual orientation and gender identity in the EMR matters 

By Tyler Cornell, MSN/MPH, CRNP (she/her), Johns Hopkins Medicine  

Always ask patients about their gender identity, preferred name, pronouns, and how they define their sexual orientation. This builds trust and helps your patients feel safe to return for follow-up. 

May 10, 2018 | 3 min read

Truly Listen: Clinical Excellence in Nephrology

By Edward Kraus, MD, Johns Hopkins University School of Medicine

Listen to your patient, try to understand what they're saying, and think beyond policies and protocols to be the best advocate possible.

August 5, 2019 | 2 min read

Training and Identity

What parts of yourself do you want to bring back into your life that you may have lost during residency?

January 25, 2023 | 2 min read

All in The Family

In my general internal medicine practice, I’ve learned that getting to know a patient’s family gives a unique window into their lives.  

September 26, 2024 | 3 min read

Under the influencers 

By Adam Schiavi, MD, PhD, Johns Hopkins Medicine

The social media "Black out challenge" promotes asphyxia that can result in irreversible brain damage or death. Healthcare professionals should warn patients and caregivers to be cautious about social media trends and provocations. 

“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.

August 28, 2023 | 2 min read

Travelers on an Unfamiliar Road

By Daniel Pomerantz, MD, Montefiore New Rochelle Hospital, New York

A rabbi once taught me the distinction between curing and caring. As I accompany patients on the rough road of illness, I consider ways to make their journey a little smoother. 

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.     

MERIT Health Leadership Academy students, Baltimore, Maryland, author's photo.

February 27, 2019 | 2 min read

The Need for Diversity

By Tyler Mains, MD, University of California, San Francisco

Our future healthcare workforce must be as diverse as the communities it serves.

July 18, 2022 | 2 min read

How to have effective discussions about alcohol 

By Beth McGinty, PhD, Johns Hopkins Medicine, Mike Fingerhood, MD, Johns Hopkins Medicine

Talking with patients about the risks of heavy alcohol consumption and the benefits of change can have a positive impact on their health. 

March 4, 2024 | 2 min read

Getting the diagnosis right 

By Colleen Christmas, MD, Johns Hopkins Medicine

After arriving at what you think is the diagnosis, pause and consider alternative explanations. For patient populations at high risk for misdiagnosis (women and historically marginalized groups), examine how biases might be influencing your conclusions. 

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.

September 2, 2025 | 3 min read

Gambling with health 

Gambling disorder frequently goes unrecognized in clinical settings despite its significant impact on mental and physical health. Clinicians can routinely screen for it using validated tools and refer at-risk patients to resources. 

July 30, 2019 | 3 min read

Searching for Bicarb in July

By Camille Petri, MD, Mass General

To succeed in clinical practice, be humble and open to learning from all members of your team.

January 9, 2023 | 2 min read

Questions Raised by “There, There” 

By Mike Fingerhood, MD, Johns Hopkins Medicine

Reflecting on our own “there” (the place where we grew up) can trigger conversation that helps us to understand our patients’ “there.” This can strengthen the patient-clinician relationship.

August 21, 2018 | 1 min read

Talking With Young Adult Patients About Alcohol

By Mike Fingerhood, MD, Johns Hopkins Medicine

Clinicians need to be vigilant to discuss alcohol use with patients and remember that the legal drug, alcohol, causes more morbidity and mortality than opioids.

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’!

September 18, 2018 | 3 min read

No Blushing! How to Talk About Sex With All Patients

By Helene Hedian, MD, Johns Hopkins University School of Medicine

Engaging in open, nonjudgmental discussions about patients’ sexual health provides an opportunity to assess risk, screen for sexual dysfunction, provide counseling, and offer appropriate vaccinations.

WWI Battle of Verdun Cemetery, Verdun, France.

March 23, 2020 | 4 min read

Finding the Right Words—Lessons From Nurse Mary Borden

By Iro Filippaki, PhD, Johns Hopkins University School of Medicine

WWI Nurse Mary Borden's autobiography provides inspiration to search for the right words to describe our experience, and perhaps, find solace as we face the challenges of medicine.

August 17, 2023 | 3 min read

The Hospital Playlist 

By Kerry Devlin, MMT, LPMT, MT-BC (she/her), Johns Hopkins Medicine

Consider the hospital soundscape and how it may impact patients’ well-being. To create a more soothing stay, silence or turn down monitors if possible. 

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.

February 11, 2019 | 5 min read

The Dots We Connect – An Interview with Dan Pink

Dan Pink distills pearls of wisdom for health professionals from his bestselling books "A Whole New Mind" and "When."

June 13, 2018 | 1 min read

Behavioral Change Bolstered By Human Touch

By Souvik Chatterjee, MD, Johns Hopkins Medicine

A human doctor is a critical component of creating change in patient behavior and health.

February 29, 2024 | 1 min read

“It could happen to you”

By Hayley Sparks, MD, Johns Hopkins Medicine

When talking with vaccine-hesitant patients, I bring up the recent measles outbreaks. It can be effective to use current events to motivate better compliance with immunization guidelines. 

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.

August 21, 2025 | 2 min read

Academic medical departments can learn much from Department Q

Warning, if you begin the “Dept Q” series, you won’t be able to stop! By the time you finish reading these books, you’ll be a more compassionate person and a better healthcare professional. 

July 31, 2019 | 3 min read

The Healing Circle as a Holistic Framework

By David Kopacz, MD, University of Washington

As can be learned from a Native American healer, to heal profoundly, one must holistically integrate mental, emotional, physical, and spiritual aspects of being human.

September 17, 2024 | 1 min read

Navigating drug shortages

By Carmen Lopez-Arvizu, MD, Johns Hopkins Medicine

In the face of drug shortages, clinicians must become proactive resource navigators. By staying informed, collaborating with patients, and exploring alternative solutions, clinicians can help mitigate the negative impact of shortages.

August 16, 2023 | 1 min read

The Other Medical History

By Jeffrey Millstein, MD, Penn Medicine

Learning about the history of medicine can help put current health system challenges in perspective. I was especially struck by the enduring primacy of the patient-doctor relationship. 

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.

February 13, 2019 | 2 min read

Disparities in New Treatments

By Utibe Essien, MD, MPH, University of Pittsburgh School of Medicine

When beginning new treatments, it's important to ask patients what they understand about the medication, what their expectations are, what barriers might exist to remaining on this agent, and what they value most out of their treatment plan.

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