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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 1, 2025 | 2 min read

“My Own Private Idaho”

Ask patients how they want their housing documented, and use patient‑preferred, nonstigmatizing language. Some patients may prefer, “lives in a tent, self-identifies as housed."

April 11, 2024 | 1 min read

Takeaways from Adam Grant’s “Think Again” 

By Gretchen Miller, Managing Editor

Healthcare professionals can benefit from adopting a growth mindset that emphasizes rethinking existing beliefs and approaches. A key strategy is questioning assumptions and biases, which can lead to better decision-making. 

December 16, 2019 | 4 min read

Top 10 Tips to be a Great Consultant

By Aline Charabaty, MD, Johns Hopkins Medicine

Read these 10 tips so that next time your pager goes off, you can be an outstanding consultant!

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.     

March 30, 2023 | 2 min read

Cultivating a Beginner’s Mind

By Clara Watkins, student, Emory University School of Nursing, Colleen Christmas, MD, Johns Hopkins Medicine

Remember when you were a new learner? Approach situations with that open, creative, and nonjudgmental mind that you may have had when you started training. 

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.

June 2, 2020 | 3 min read

“Flattening the Curve”

By Madeline Rodriguez, MD, Johns Hopkins University School of Medicine

The pandemic is breaking down the traditional hierarchy of medical education. Opportunities are emerging for faculty to learn even more from residents.

March 10, 2025 | 2 min read

The B12 fix

By Selvi Rajagopal, MD, MPH, Johns Hopkins Medicine

Clinicians should remember to watch for fatigue in patients shifting to plant-based diets; a B12 test can reveal a significant, reversible cause of feeling poorly. 

September 18, 2023 | 3 min read

Do you “need” to say it that way? 

By Gina Piscitello, MD, MS, University of Pittsburgh Medical Center

Using the word “need” to describe a treatment option may mislead patients and loved ones into believing it should be pursued. Prioritizing patient values and preferences may help reduce this risk.  

April 15, 2019 | 1 min read

7 Things I’ve Learned About Mentoring in 51 Years

By David Levine, MD, MPH, Johns Hopkins University School of Medicine

Helping others to achieve their full potential is the most incredible, wonderful, and exhilarating role one can undertake.

August 8, 2022 | 1 min read

988

By Patrick Hemming, MD, Duke University

When we identify patients who are experiencing mental illness, we need to let them know about this new resource in the U.S.

November 25, 2025 | 2 min read

Be the other someone in the near-empty room

For patients without family present, pause to say, “I’m here with you.” Offer chaplaincy, social work, and volunteers to accompany dying patients in their final moments. 

April 3, 2024 | 2 min read

Military kids serve too 

By Richard Schaefer, MD, MPH, Johns Hopkins Medicine

April is the Month of the Military Child. Clinicians caring for military family members should understand their history and stressors specific to the armed service to give the best possible care.    

December 2, 2019 | 2 min read

Improving Communication Between Inpatient Teams and PCPs

By Stephen Berry, MD, Johns Hopkins Medicine

While it's not always easy, hospital-based providers need to find a way to connect with the healthcare professionals who will continue their patient's care.

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.

June 26, 2018 | 1 min read

Harnessing Digital Technology for Clinical Excellence

By Margaret Chisolm, MD, Johns Hopkins Medicine

Digital technology can be leveraged for the greater good of clinically excellent patient care. Social media tools like Twitter enable you to connect with healthcare stakeholders from around the world.

June 28, 2019 | 1 min read

How to Improve Outpatient Handoffs

Consider performing outpatient handoffs and preparing patients when you will be away. This will make your time away easier for your covering colleagues and for your patients.

October 28, 2024 | 2 min read

Spark the change

By Sadiqua Sadaf, MBBS, Deccan College of Medical Sciences, Hyderabad, India

To motivate patients toward change, healthcare professionals can focus on building trust and setting achievable goals.

Kau Sai Chau Public Golf Club, Hong Kong.

July 21, 2020 | 1 min read

Medicine is Like Golf

By Barry Bryant, MD, Johns Hopkins Medicine

In both medicine and golf, it's helpful to accept that much is beyond our control. Trusting our ability —grounded in thousands of hours of focused practice—may allow us to have the confidence that our best efforts will usually translate into favorable results.

February 27, 2025 | 2 min read

Behind the mirror: teen eating disorders 

By Jasmine Reese, MD, MPH, Johns Hopkins Medicine

You don't have to be an eating disorder specialist to make a difference; every healthcare professional can play a vital role in early intervention. Knowing local resources and showing compassion can guide patients toward recovery. 

September 13, 2023 | 1 min read

Firearm Suicides on The Rise

By Katherine Hoops, MD, Johns Hopkins Medicine, Paul Nestadt, MD, Johns Hopkins Medicine

To stem the increase in self-inflicted gun deaths, we must work toward early and accurate diagnosis of mental illness, as well as advocate for better firearm laws.

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.

August 1, 2022 | 1 min read

Keeping Children Safe

By Katherine Hoops, MD, Johns Hopkins Medicine, Monique Burke, MD, President, MD Chapter of the AAP

The new Safer Communities Act helps clinicians connect patients to mental healthcare. Hopefully, this will reduce youth gun violence, including suicide. 

November 21, 2025 | 2 min read

The promise and pitfalls of GLP-1s 

This new class of weight loss drugs is not a magic fix. Work with patients to set realistic goals, start low and titrate slowly, and counsel on GI risks. 

April 2, 2024 | 3 min read

A dose of reality (TV)  

By Maria Fazal, MD, Baltimore, Maryland

A patient who had severe anxiety and depression told me that watching “The Great British Bake Off” was a helpful relaxation technique. She taught me that shows like this may provide a therapeutic escape.  

This is from "The Spirit Catches You and You Fall Down," written by Anne Fadiman. The art copyright is believed to belong to the publisher, Farrar, Straus and Giroux, or the artist. Public domain from wikipedia.org.

November 20, 2019 | 2 min read

“The Spirit Catches You and You Fall Down”

By Laura Pugh, Medical Student, Johns Hopkins Medicine

The gap between cultural systems can be wide. Openness, curiosity, and humility will improve cross-cultural care.

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.

March 6, 2023 | 1 min read

Supporting Menopausal Patients

By Talia Sobel, MD, Mayo Clinic

Women often receive misinformation about menopause and even experience medical gaslighting from healthcare professionals. Clinicians should validate patients’ symptoms, and work with them to improve quality of life. 

November 29, 2018 | 2 min read

Management Reasoning: Diagnostic Reasoning’s Underappreciated Sibling

By David Cook, MD, MHPE

Management reasoning is primarily a task of shared decision-making and monitoring, and is inherently more complex than diagnostic reasoning. A better understanding of management reasoning will offer insights into the causes and avoidance of medical error, clinical practice quality improvement, and training and assessment of health professionals.

October 17, 2024 | 2 min read

Gaming for mental health 

By Barry Bryant, MD, Johns Hopkins Medicine

Understanding the therapeutic potential of video games is important. Clinicians may elect to recommend them for certain young patients struggling with mental health challenges.

"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 12, 2025 | 1 min read

Insights from the book “Decoding Greatness”

By Scott Wright, MD, Johns Hopkins Medicine

Achieving greatness in any field is not only about talent or practice; it’s also about studying the successes of those who are exemplary. In medicine, observing and analyzing the approaches of admirable colleagues can allow us to grow and evolve toward being more clinically excellent. 

September 11, 2023 | 2 min read

AI And Humanistic Care

By Daniel Brotman, MD, Johns Hopkins Medicine

In a clinical world that is increasingly algorithmic, what AI can NOT do is truly understand human emotions. Computers will never appreciate the joy and privilege of connecting with patients. 

April 1, 2019 | 3 min read

Practicing Medicine and Having a Ball

By Wilma Ferthler, MD, Rural Country Doctor, Northeast Kingdom, Vermont

Hope our 2019 April Fool's piece makes you chuckle!

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.

"My book knowledge will allow me to recognize the pattern leading to a medical diagnosis, but I must also move beyond the mnemonic and to make time for the person seated in front of me."

July 28, 2022 | 2 min read

Passing Tests And Failing my Family

By Emily Rodriguez, medical student, Johns Hopkins Medicine

Book knowledge about addiction offered me little to support my family members and others affected by this illness. To holistically serve, we need to take the time to connect and genuinely understand each person.

November 13, 2025 | 2 min read

Cognitive shuffle 

For patients with insomnia, coach them to visualize vivid, unrelated images to disrupt rumination and promote sleep onset. You can try it yourself, too! 

March 25, 2024 | 1 min read

Graphic medicine: a picture is worth a thousand words 

By Benjamin Vipler, MD, MEd, University of Colorado

Pictures can often be a more effective way to explain complex medical concepts to trainees and patients than words alone. 

November 19, 2019 | 2 min read

Aging isn’t a dirty word

To many, "aging" and "old" are considered dirty words. Clinicians should fight ageism.

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.  

November 12, 2018 | 3 min read

Insights From “A Whole New Mind”

Daniel Pink's "A Whole New Mind" highlights the importance of cultivating empathy, humor, and the ability to create meaning.

October 10, 2024 | 1 min read

Trust and truth

Nonjudgmental communication can help us understand the true nature of a patient’s condition and motivations. Connecting more deeply with a patient over time allowed us to learn more of the story. 

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 Bluebird Cafe, Nashville, Tennessee. Copyright by the author.

May 11, 2020 | 3 min read

Redefining Rounds—Will The Circle be Unbroken?

By Chase Webber, DO, Vanderbilt University Medical Center

A patient care team performs best when all voices harmonize and creative approaches are applauded.

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.

September 7, 2023 | 2 min read

“Wild Problems” Book Review

By Margaret Chisolm, MD, Johns Hopkins Medicine

When it comes to the big decisions in life, abandoning a rational, algorithmic approach—and going back to guiding principles—may be the secret to happiness. 

March 13, 2019 | <1 min read

Dr. Elliot Fishman, A CLOSLER Look

By Gretchen Miller, Managing Editor

Artificial intelligence (AI) will drastically alter all of medicine, with the potential to enhance patient care through improved diagnoses.

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.

June 19, 2018 | 2 min read

Sleep solutions (archives, 2018)

People see sleep as a luxury, but it's a basic human need. As clinicians, we should ask patients how they're sleeping. Here are nine things you can recommend to help them feel more rested.

November 10, 2025 | 1 min read

Takeaways from the book “Bankroll your mind”  

Attention invested in small moments—like a few screen‑free minutes at the start of a patient encounter—can compound into a trusting patient-clinician relationship. 

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