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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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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 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. 

April 24, 2018 | 2 min read

Equality v. Equity

Working towards giving equitable care, not equal care, should be our focus, especially if we’re aiming to shrink the health disparities gap.

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.

March 23, 2022 | <1 min read

Keeping The Readers in Mind

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

When documenting in the medical record, we must use respectful language. Both our patients and colleagues will appreciate and benefit from our thoughtfulness. 

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.

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.

January 16, 2025 | 2 min read

Talk to her 

By Uma Balachandran, medical student, Ichan School of Medicine at Mount Sinai

My blind aunt's encounter with a clinician highlighted the problem of ableism in medicine. Her experience is a reminder to always communicate directly with disabled patients and ask about their preference for identity-first or person-first language. 

May 13, 2021 | 2 min read

Talking with patients who are vaccine-hesitant (archives, 2021)

By Jade Cobern, MD, Johns Hopkins Bloomberg School of Public Health

We must listen without judgment to patients who are vaccine-hesitant. We need to hear their worries and concerns to address them appropriately.

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. 

October 11, 2021 | 2 min read

Helping Patients Share Disappointing Diagnoses With Loved Ones

By Ambereen Mehta, MD, Johns Hopkins Medicine, Michelle McWhirter, LCSW-C, Johns Hopkins Medicine

Patients often want to share significant health news with loved ones. You can help them choose when and how to disclose this information.

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.

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 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. 

October 28, 2020 | 1 min read

Preventing Dry Eye in the Zoom Era

By Sharon Solomon, MD, Johns Hopkins Medicine

Increased online activities during the pandemic has caused higher rates of dry eye for many. All clinicians should encourage their patients to take regular short breaks from screens.

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.

March 16, 2022 | 1 min read

How to Support Patients With Autism Post-Pandemic

By Ayman Mukerji Houseman, MS, MSW, New York City

When caring for patients with autism who are moving back to in-person interactions, suggest changes that are gradual with input from patients and their caregivers. 

May 25, 2023 | 2 min read

Fighting The Feed

By Colleen Schreyer, PhD, Johns Hopkins Medicine

Limiting social media use and being selective about what you view can help cultivate a positive body image. 

January 15, 2025 | 2 min read

A spray away from the answer 

This clinical conundrum, related to hypoxia, underscores the importance of meticulous history-taking and the potential for unexpected complications with seemingly benign medications. 

May 6, 2021 | 3 min read

Plus ça Change: The Rise And Rise of Syphilis

By Matthew Hamill, MBChB, PhD, Johns Hopkins Medicine

Syphilis cases have reached an all-time high. To turn the tide, the first thing we need to do is ask patients an open-ended question about sexual activity, like "When was the last time you had sex?"

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!

July 31, 2018 | 3 min read

Waste Not, Want Not!

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

Keeping meat properly refrigerated is critical. Don’t forget to specifically ask patients if they have eaten roadkill if they present with diarrhea (especially in summer) & no other obvious source of infection is apparent.

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. 

October 4, 2021 | 1 min read

Words Matter

By Leslie Miller, MD, Johns Hopkins Medicine

When serving as an advocate for a family member, I noted judgmental language in the EHR. This reminds me as a clinician to consider how patients (and their families) will feel when they read my notes.

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.

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. 

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. 

March 10, 2022 | 2 min read

Balanced conversations about weight

By Colleen Schreyer, PhD, Johns Hopkins Medicine

Clinicians can treat weight as simply one more piece of health information that they incorporate into a holistic care plans. This can mitigate stigma and foster empathy. 

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.

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.

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.

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.  

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. 

September 27, 2021 | 2 min read

How to Communicate Clearly About Medication Directions

By Jeffrey Millstein, MD, Penn Medicine

Always use simple language with patients when giving directions about how to take medication, and check for understanding.   

November 12, 2019 | 2 min read

The Early Bird Special

By Rebecca Hamburger, Medical Student, Central Michgan University College of Medicine

Timing is everything. Doing our best to optimize access to healthcare is a first step to serving our patients.

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. 

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.

If weather permits, advise patients to plan their feast outside this Thanksgiving,

November 12, 2020 | 1 min read

How to Have Healthy Holidays

Helping patients plan safe get-togethers can slow the spread of COVID-19. Following guidelines may allow patients to connect with their family.

"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.

March 8, 2022 | 3 min read

Tips For Assessing The Intensity of Pain

By Brian Lee, MD, PhD, Johns Hopkins Medicine, David Madder, DO, Johns Hopkins Medicine

When assessing pain, we often ask patients to assign it a number between 0 and 10. Asking about the effect of pain on behavior and functional status can often give us a more meaningful understanding. 

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.

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. 

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.  

April 27, 2021 | 2 min read

Lessons Learned From Cancer During COVID

By Catherine Ling, PhD, Johns Hopkins Medicine

Encourage and support patients to schedule preventative screenings delayed during the pandemic. These are critical to ensure your patients’ health.

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.  

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. 

August 14, 2025 | 2 min read

Rose, bud, and thorn 

Try starting your next team meeting with an icebreaker activity. Rituals like this can jumpstart connections with colleagues and build healthier care teams. 

September 16, 2021 | 1 min read

Recognize, Synthesize, Execute

By Harisa Spahic, Medical Student, Johns Hopkins University

Reflecting about the inspiring clinicians that I’ve shadowed, I noticed that they have a gift for synthesizing information in a way that’s clear and appropriate for the patient.

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.

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. 

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