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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
June 23, 2022 | 2 min read

Reflections at The End of a Busy Clinical Year

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

Outstanding clinicians are humble, curious, and nonjudgmental. 

January 17, 2024 | 1 min read

“I’m not comfortable”

By Jeffrey Millstein, MD, Penn Medicine

Patients sometimes ask for interventions that conflict with clinical best practice. The most effective responses are ones that focus on patients’ needs and level of understanding rather than on the clinician’s discomfort with their requests. 

October 21, 2025 | 2 min read

Stroke, breath, care

Swimming taught me the importance of rhythm and breath. During difficult conversations with patients and families, I make room for quiet pauses to give them time to process.

November 4, 2021 | 3 min read

Dissection And Reintegration

By Aidan Crowley, Medical Student, University of Pennsylvania

We sometimes “cut” patients apart to assist in the diagnostic process. We must remember to put them back together; we’re charged with caring for their minds and spirits in addition to their bodies.

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!

December 16, 2020 | 2 min read

The Danger of Stereotyping Specialties

By Sarah Temkin, MD, Greater Baltimore Medical Center

Clinicians must critically evaluate the stereotypes that they assign to one another. A diversity of training and backgrounds is beneficial to patient care.

April 14, 2022 | 4 min read

Talking About Climate Change With Patients

By Dean Chien, CLOSLER team, Baltimore, Maryland

Climate change affects the health of everyone. When talking with patients about climate change, meet them where they are and listen nonjudgmentally. 

July 10, 2018 | <1 min read

Better Dementia Care Through Music

By Michele Bellantoni, MD, Johns Hopkins University School of Medicine

Having your older patients listen to music can be an effective way to reduce dementia-related behavioral disturbances.

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. 

June 16, 2021 | 1 min read

Why we Must Talk About E-cigarettes with Teen Patients

By Mike Fingerhood, MD, Johns Hopkins Medicine

Proactively counseling adolescents about the risks of e-cigarette use is essential. The message should acknowledge both the health implications and the pressures that they may feel from their peers.

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.

June 22, 2022 | 1 min read

Explaining The Risks of Vaping

Prioritize discussions about the long-term consequences of smoking. Be aware that just because someone has quit doesn’t mean that they won’t relapse.

January 11, 2024 | 2 min read

Book review of “Changing how we think about ‘difficult’ patients”  

By Jennifer Lycette, MD, rural oncologist in the Pacific Northwest

When caring for a patient whom I found challenging, I reminded myself that my negative reaction had less to do with the patient and more to do with me.  

October 16, 2025 | 4 min read

Prescribing humility 

Standard of care is provisional—reassess therapies as evidence evolves. Be open to changing your thinking and practice as new data emerge. 

November 8, 2021 | 1 min read

Lessons Learned From 30 Years of Night Shifts

By Kimberly Turner, MD, Johns Hopkins Community Physicians

Patience, stamina, and fortitude are important traits to cultivate in medicine at any and all times.

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.

June 25, 2018 | 2 min read

On The Professional Formation of Doctors

By Margaret Chisolm, MD, Johns Hopkins Medicine

By getting out of the business of knowledge and skills and returning to the work of professional formation, not only will medical schools and their patients win, but doctors—and the profession of medicine as a whole—will too.

July 26, 2018 | 1 min read

A Taste of Their Own Medicine

By Scott Wright, MD, Johns Hopkins Medicine

Videos spreading misinformation to patients, promoting unproven therapies, can spread like wildfire on social media. We are sharing another video to fight fire with fire.

"Spending time outdoors helps me cope with the stress and sadness of the job." -Dr. Jared Rubenstein

December 10, 2020 | 3 min read

Coping With Patients’ Heartbreak

By Jared Rubenstein, MD, Baylor College of Medicine

When supporting patients and their loved ones during times of great sadness and loss, cultivating a daily habit of self-care may protect against burnout.

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.

April 14, 2022 | 2 min read

“Explainaholics”

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

Sometimes patients and caregivers feel overwhelmed when clinicians provide too much information. When you sense this to be the case, offering clear recommendations can be helpful.

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.

July 18, 2023 | 1 min read

Can a chatbot be a clinician’s friend?

By Adam Poliak, PhD, Bryn Mawr College, Eric Leas, PhD, Mark Dredze, PhD, Johns Hopkins University

ChatGPT can draft seemingly empathic answers to patient questions on medical portals. This may help clinicians respond more efficiently to their patients’ concerns. 

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. 

June 13, 2022 | 2 min read

3 Tips from the ED For All Healthcare Professionals

By Rodney Omron, MD, MPH, Johns Hopkins Medicine

Sharing appreciations with colleagues and learners is your superpower. Use it. 

January 9, 2024 | 3 min read

Dust and distrust

By Matthew Kelly, PhD, MPH, Johns Hopkins Medicine

Infection-related epidemics, like AIDS and COVID, teach us much about caring. To provide humanistic care, clinicians must continuously endeavor to assess and build trust with patients. 

October 13, 2025 | 2 min read

The word “want” may leave patients wanting 

When prior notes document that a patient doesn’t “want” a specific intervention, elicit the patient’s desired outcome and acceptable trade-offs. Then determine whether “I don’t want X” is absolute or conditional and align the care plan accordingly. 

November 9, 2021 | 3 min read

Giving Exceptional Care Without Exception

A one-liner works in comedy but leads to biases in medicine. Listening, getting to know, and learning from each patient will allow you to serve them best.

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.

November 2, 2022 | 2 min read

Psychedelics to Quit Smoking?

By Matthew Johnson, PhD, Johns Hopkins Medicine

Patients may ask about using psilocybin to stop smoking. While being actively studied, please remind them that it’s still illegal and not necessarily risk-free. 

July 11, 2024 | 2 min read

Protecting the most vulnerable from heat-related illnesses (archives, 2024)

By Joanna Cohen, MD, Johns Hopkins Medicine

When caring for patients during heat waves, healthcare professionals should be aware of social determinants of health—like no air conditioning at home. Clinicians should know the available resources to recommend, such as cooling centers within the communities they serve. 

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.

April 12, 2022 | 2 min read

Describing the Scribe: How We Help Clinicians

By Dean Chien, CLOSLER team, Baltimore, Maryland

Medical scribes allow clinicians to focus more fully on the patient in front of them. 

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.

July 17, 2023 | 3 min read

Choreographing Clinical Care

By Hanghang Wang, MD, PhD, Johns Hopkins Medicine

Exceptional patient care is akin to a ballet performance. Synergistic team interactions, thoughtful decisions, and deliberate actions are all critical steps in the dance of patient care. 

"The Doctor's Visit," Jan Steen. Philadelphia Museum of Art. Publicly shared via the Fair Use Act.

June 15, 2021 | 4 min read

How Art History Can Improve Your Care of Patients

By Siobhan Conaty, Art History Professor, La Salle University

Focusing on visual cues from our patients can help us to better understand them. Closely looking at art is one way that a clinician can improve their observation skills.

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!

June 13, 2022 | 3 min read

On Wondering

By Crystal Favorito, pre-med, Johns Hopkins Medicine

To wonder is to acknowledge possibility and open the door for progress. As a pre-med, it will help me become a lifelong learner on my professional journey. 

Treponema pallidum Syphilis bacterium, the bacterium responsible for the dangerous sexually transmitted infection, syphilis.

January 8, 2024 | 3 min read

Combatting the syphilis epidemic 

By Zach Lorenz, MD, Johns Hopkins Medicine

Rates of syphilis and other sexually transmitted infections are skyrocketing. It’s imperative that we have candid conversations with patients about their sexual behaviors. 

October 7, 2025 | 2 min read

The compass of care 

When the path is grey, reach out to your ethics committee for perspective. They help clarify options and provide guidance, which can improve communication with patients, families, and colleagues. 

October 27, 2021 | 4 min read

Digital Media Addiction: It’s Complicated

By Natalie Gukasyan, MD, Johns Hopkins Medicine

It’s tempting to resort to simple explanations for complex behaviors like digital media use. Deep relationships with patients can help you understand what’s behind the behavior. 

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.

October 17, 2022 | 2 min read

Working With The Media For The Public Good

By Maria Simbra, MD

Clinicians can communicate health messages effectively by using memorable stories to share the main message and understanding the reporter’s constraints.  

July 10, 2024 | 2 min read

Lessons from earlier in life: bagging groceries 

The service industry principles I learned while working in a grocery store apply to medicine. These include prioritizing customer needs, actively listening, and appreciating colleagues. 

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.

July 13, 2023 | 2 min read

5 More Ways Social Workers Can Help Patients

By Abbey Becker, LMSW, Johns Hopkins Medicine

Hospital social workers can gather missing information essential to patient care. They can also assist patients in completing advance directives.  

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. 

June 7, 2021 | 2 min read

It’s Not About Weight

By Nicole Cifra, MD, MPH, University of Rochester

Approaches employed by eating disorder specialists can be applied to support all patients. This includes emphasizing healthy behaviors and acknowledging your own assumptions about weight.

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.

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.   

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