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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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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. 

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.

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.

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.     

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 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.

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.

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."

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. 

September 3, 2020 | 3 min read

See Something, Say Something

By Kali Cyrus, MD, MPH, Johns Hopkins Medicine

Being an ally for justice to patients and colleagues requires taking action. Doing or saying something, literally anything, when someone is mistreated is better than nothing.

May 27, 2025 | 2 min read

Whose knowledge counts?  

Listening closely builds patient trust, which is fundamental to effective care. Dismissing a patient's self-reported observations, even unintentionally, erodes this trust and can prevent you from truly understanding their concerns. 

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.

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.

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. 

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.

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.

"Girl with a Bamboo Earring," Awol Erizku, 2009. Used under the fair use Copyright Act.

February 18, 2021 | 2 min read

Art is Integral to Healthcare

By Kamna Balhara, MD, Johns Hopkins Medicine, Sarah Clever, MD, Johns Hopkins Medicine

Engaging with art can address some of medicine’s greatest challenges, including recognizing our common humanity.

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.

July 10, 2018 | 1 min read

Pause Before Hospitalizing the Elderly

By Samuel Durso, MD, Johns Hopkins Medicine

Confusion among hospitalized older adults is common and dangerous. The hospital environment should be avoided if at all possible, with a goal of managing acutely ill older adults at home.

April 17, 2018 | 5 min read

Knowing Your Patient

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

Diagnostic excellence begins and ends with knowing your patient.

May 13, 2025 | 2 min read

The unseen front line: lessons from my military deployment  

In a field hospital, one learns quickly about clear communication and thoughtful decision making. These behaviors and working collaboratively with others are just as critical across all clinical settings. 

July 14, 2022 | 2 min read

How to Talk to Children About Gun Violence

By Carol Vidal, MD, PhD, Johns Hopkins Medicine

Give children time and space to talk about their worries and listen closely. Remember, it’s always best for children to first hear the news from a trusted adult.

August 18, 2021 | 2 min read

Helping Students Transition to Wards

By Howard Chang, Medical Student, Johns Hopkins Medicine

I was nervous taking care of my first patient as a student on the medical wards. I felt more comfortable when I realized that even experienced clinicians don’t know everything, and of course they did not expect me to have all the answers.

July 23, 2019 | 3 min read

Engaging Care Partners in Communication

By Antonio Wolff, MD, Johns Hopkins University School of Medicine, Jennifer Aufill, BA, Johns Hopkins Bloomberg School of Public Health, Jennifer Wolff, PhD, Johns Hopkins Bloomberg School of Public Health

Families and friends are valuable resources. These partners in care can help clinicians improve quality of care and patient outcomes.

Colorectal Cancer Awareness

February 19, 2024 | 2 min read

Mitigating colon cancer in young patients

By Ekta Gupta, MBBS, Johns Hopkins Medicine

There's and increasing risk of colon cancer in younger patients. Clinicians need to be diligent in considering the possibility of colon cancer.

February 24, 2018 | 1 min read

Battling The System in Defense of Diagnosis

By Souvik Chatterjee, MD, Johns Hopkins Medicine

Healthcare delivery is at odds with a fundamental aspect of being a physician—strategic curriculum interventions are necessary to preserve the art of diagnosis.

December 22, 2022 | 2 min read

Bittersweet holidays

By Taryn Schuelke, MS, CT, CCLS, Texas Childrens Hospital

Many experience grief during the holidays. Make sure to acknowledge your patients’ feelings and consider encouraging them to heal through ritual. 

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.

Dingle Peninsula, County Kerry, Ireland.

March 9, 2020 | 1 min read

Embrace the Craic!

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

We would all do well to be more like the Irish!

September 4, 2024 | 2 min read

Knowing when to step back 

Patients may need time to process their thoughts and reflect when making major decisions about their care. Having conversations in stages may help them arrive in the best place.  

Ask your patients, "Are you concerned about how expensive the treatment is?" You don't need to know your patients' income or out-of-pocket costs, but you can think about starting with less expensive but effective treatments.

March 16, 2021 | 3 min read

Best Practices in Shared Decision-Making

By Kevin Frick, PhD, Johns Hopkins Carey Business School

Giving exceptional care includes honoring your patient’s goals and addressing any challenges they might have with the care plan. Be mindful of the financial costs that your patients may face and discuss alternatives when possible.

The author's drawing of her heart utilizing the technique of defamiliarization.

February 14, 2019 | 3 min read

Defamiliarization

By Sarah Walser, , Penn State College of Medicine

Incorporating defamiliarization into practice builds empathy and broadens our worldview. It challenges us to expand and find confluence between different frameworks through which an experience, such as a disease, can be interpreted.

August 15, 2023 | 2 min read

The Importance of Humanities in Medicine

By Mike McCarthy, MD, Johns Hopkins Medicine

Engaging with and studying the humanities can help us give better patient care. Literature, art, and history remind us that patients are whole persons with lives that exist beyond medical problems. 

"You Let Your Magic Tortoise Go," David Kopacz. Copyright with the artist.

August 27, 2020 | 3 min read

Finding Balance During Unbalanced Times

By David Kopacz, MD, University of Washington

Spending time “going into and opening our hearts” is healing and restorative. We can do this for ourselves as healers and guide patients through the practice. It’s as simple as slowing down, putting your hand on your heart, and taking three deep breaths.

May 6, 2025 | 2 min read

Healing from the emotional toll of a medical error  

Mistakes in patient care are not uncommon. Clinicians can lean on their support systems to recover from stressful events at work. Taking care of yourself enables you to continue giving compassionate care. 

July 7, 2022 | 1 min read

Filial Affection

By Corliss Wong, MS4, The University of Hong Kong

We must listen closely to patients with dementia’s thoughts and feelings, even though their sense of reality may be different than our own.

August 23, 2021 | 1 min read

The Boomerang of Disparaging Remarks

By Harisa Spahic, Medical Student, Johns Hopkins University

Negative remarks about other specialities can discourage students from pursuing these fields. Instead, focus on sharing the positive aspects of your discipline.

August 1, 2019 | 3 min read

Mindset and the Power of Yet: A Conversation With Dr. Gurpreet Dhaliwal

Excellent clinicians are also thoughtful mentors. Mentors are like beacons as we navigate our path forward.

July 25, 2018 | 2 min read

The Joy of Realizing You Were Wrong and the Importance of Believing in Recovery for All

By Angela Guarda, MD, Johns Hopkins Medicine

Helping patients change unhealthy behaviors can feel challenging, but what feels like today’s failure can be tomorrow’s story of recovery.

February 22, 2018 | 3 min read

Family History and Addiction Risk

By Margaret Chisolm, MD, Johns Hopkins Medicine

For some patients the risk of becoming addicted to prescription opioids is extraordinarily high and may outweigh any pain control benefit.

December 19, 2022 | 2 min read

Dismantling ableism in medicine

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

What does it mean to co-construct a plan of care with disabled patients? Their desires may not be what you expect.

January 31, 2022 | 2 min read

Lessons in Medicine From Running a Marathon

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

As a trainee who also competes in races, I’ve learned the importance of leaning on others to reach the finish line.  

September 4, 2024 | 1 min read

Validating a patient’s experience of pain

To effectively treat opioid use disorder, clinicians must consider a patient's both physical and psychological experiences.  

March 10, 2021 | 2 min read

Communication PEARLS

By Catherine Washburn, MD, Johns Hopkins Medicine

When speaking with patients and colleagues, use a respectful tone and convey empathy. Clear communication is the basis for effective and trusting relationships with patients and coworkers.

January 30, 2019 | <1 min read

Dr. David Wu, A CLOSLER Look

By Gretchen Miller, Managing Editor

Palliative care is an approach to medicine that focuses on quality of life. My hope is that every clinician learns basic palliative skills to lead family conversations when there is a critically ill patient. It's a precious privilege to be able to enter people's lives at their most vulnerable time, and help them find some kind of peace.

Parting gift for every customer—homemade pistachio granola.

August 7, 2023 | 3 min read

Insights from the book “Unreasonable Hospitality”  

By Scott Wright, MD, Johns Hopkins Medicine

Healthcare delivery is complex, and hospitality may not be prioritized. As individuals and teams, small changes in behavior may improve patient experience. 

August 31, 2020 | 2 min read

4 Tips for Using Neo and Gender-Neutral Pronouns

By Nat Mulkey (they/them), Medical Student, Boston University Medicine

Becoming familiar and fluent with neo and gender-neutral pronouns takes practice. It is essential to providing affirming care for transgender, genderqueer, and non-binary patients.

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. 

July 6, 2022 | 1 min read

Any Side Effects?

By Jeffrey Millstein, MD, Penn Medicine

Teaching my patients to ask questions helps address their worries about medications. 

August 16, 2021 | 3 min read

The Heart of Clinical Reasoning

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

Making a diagnostic error reminded me that connecting with patients on a personal level is necessary for optimal clinical reasoning.

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