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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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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. 

April 21, 2021 | 2 min read

Opioid Monitoring in Primary Care

By Jeffrey Millstein, MD, Penn Medicine

Discussions about opioid use with patients must be approached with curiosity and concern, rather than suspicion. Implemented with sensitivity, opioid monitoring programs can strengthen the clinician-patient relationship.

June 20, 2019 | 2 min read

Be Brave Enough to Start Conversations That Matter

By Manasa Ayyala, MD, Rutgers New Jersey Medical School

"Between the World and Me" is a must read. At 152 pages, it's a small investment of time that leaves a large impact. I invite you to read this book with the intent to ask curious questions, to be ok feeling uncomfortable, and to continue this important dialogue.

October 19, 2023 | 2 min read

Healthcare for every body

By Stephanie Pham Van, MD, Johns Hopkins Medicine

To make healthcare more welcoming, be sensitive to how patients prefer to be described. Also, find out what tools they might need to access information, for example, voice to text transcriptions. 

September 13, 2021 | 4 min read

Only Connect

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

Missing a diagnosis made me realize the value of a thorough physical exam. It can often illuminate the cause of the illness.

September 7, 2022 | 2 min read

“Hysteria”

By Tina Zhang, MD, Johns Hopkins Medicine

We need to be aware of our own gender biases that could adversely affect women. To combat this, engage in shared decision-making with patients and be a lifelong learner of female health topics.   

March 27, 2018 | 2 min read

12 Things I Wish I’d Known 50 Years Ago

By Randy Barker, MD, Johns Hopkins Medicine, retired

Twelve things I would tell my younger self—all the things I didn’t know then, but wish I had.

May 14, 2024 | 1 min read

ED overcrowding: every clinician can help

By Catherine Washburn, MD, Johns Hopkins Medicine

Collaboration between healthcare professionals across the hospital is crucial to reduce ED overcrowding and improve patient care. One thing clinicians can do is help patients leave the hospital as soon as they are ready. 

October 19, 2020 | 2 min read

Book Review of “One by One by One”

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

Never underestimate the power of teamwork in caring for patients. What can feel impossible for one person may be accomplished with the collaboration and support of others.

January 14, 2019 | 2 min read

We’re Getting CLOSLER to the Super Bowl!

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

Football-inspired clinical pearls from Vermont family physician Dr. Wilma Ferthler teach us how to be better clinicians.

February 28, 2022 | 4 min read

To Our Interpreters: Gracias, Shukriyah, Todah, Danyavad, Merci, Danke

By Cecilia Murach, Medical Interpreter, Johns Hopkins Medicine, Kamna Balhara, MD, Johns Hopkins Medicine, Nathan Irvin, MD, Johns Hopkins Medicine

When working with an interpreter, remember that they’re a person, not a machine. Saying “thank you” makes them feel like a valued member of the healthcare team. 

April 24, 2023 | 1 min read

How CLOSLER Has Improved My Care of Patients: A Five-Year Retrospective

By Jeffrey Millstein, MD, Penn Medicine

Through CLOSLER, I’ve learned about the power of active listening and how better to navigate challenging conversations. It has also provided many ideas for re-energizing myself both personally and professionally. 

August 17, 2020 | 1 min read

Top Tips For Starting a New Phase in Your Career

By Christle Nwora, MD, Johns Hopkins Medicine

Making time to care for yourself, asking questions, and letting go of perfection can help you successfully navigate a new chapter in your life.

December 4, 2024 | 2 min read

The complexities of middle age 

By Alicia Arbaje, MD, MPH, PhD, Johns Hopkins Medicine

Mid-life is a period marked by multifaceted challenges, including physical, emotional, and social stressors. By adopting a holistic approach that addresses the whole patient healthcare professionals can provide more comprehensive and effective care. 

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. 

April 20, 2021 | 3 min read

Listening to Every Patient

By Pringl Miller, MD, San Francisco, California

To give clinically excellent care to the patient in front of you, ask yourself: “Am I carefully listening to what the patient is telling me? Am I incorporating what I’ve heard into the care plan?”

June 18, 2019 | 2 min read

Navigating the Uncertain: A Book Review of “The Laws of Medicine”

Siddhartha Mukherjee, MD, provides a framework to reconcile the uncertainties we constantly experience in our practice of medicine in his book, "The Laws of Medicine."

October 17, 2023 | 1 min read

Partnering With Pharmacists in Ambulatory Care

By Heather Folz, PharmD, Notre Dame of Maryland University

Clinicians and pharmacists can work together to give holistic and comprehensive patient care. This requires understanding each other’s expertise. 

January 12, 2026 | 3 min read

Optimizing interdisciplinary care 

Healthcare is a team sport. When working through conflict within your care team, integrate perspectives to deliver better care. 

August 29, 2022 | 2 min read

Takeaways From “The Making of a Surgeon”

By Richard Schaefer, MD, MPH, Johns Hopkins Medicine

Reading this book while I was in training inspired me to pursue a surgical career. Rereading it years later, I’m reminded of the importance of treating all patients with dignity.  

An example of a trompe l’oeil in a geriatric hospital setting. Copyright by the author.

January 27, 2020 | 3 min read

Ethical Dilemmas in Dementia Care Design

By Diana Anderson, MD, MArch, Clincial Geriatrics Fellow, University of California, San Francisco

Innovative dementia care designs raise moral questions about whether deception of patients is ever ethical. The clinically excellent physician tries to avoid deception at all costs.

October 12, 2020 | 2 min read

Advising Parents on a Safe Halloween

By Jade Cobern, MD, Johns Hopkins Bloomberg School of Public Health, Peyton Pike, MS, CCLS, Johns Hopkins Medicine, Rosemary Hawkins, MS, CCLS, Johns Hopkins Medicine

By being creative, everyone can safely celebrate Halloween this year. Beyond your household, consider holding a neighborhood physically distanced costume parade.

March 18, 2019 | 2 min read

The Truth About Sex

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

How you phrase questions when obtaining a sexual history can mitigate the impact of social desirability bias and enhance the accuracy of the information that is obtained.

February 24, 2022 | 3 min read

New dad and healthcare professional

By Ben Roberts, CRNP, AGACNP-BC, ACHPN, Johns Hopkins Medicine

Placing my child’s and my patients’ needs before my own gives me purpose. These responsibilities help mitigate burnout and allow me to give excellent care.

April 19, 2023 | 1 min read

A Fall Into Grace

By Emily Rodriguez, medical student, Johns Hopkins Medicine

I felt disappointed when I forgot to keep my patient at the center of care. I reminded myself that I have the chance to do better next time. 

August 10, 2020 | 2 min read

Debriefing after death (archives, 2020)

By Christopher Bennett, MD, Stanford University

Reflecting on a patient's death as a team provides an opportunity to process emotions and strengthen team dynamics.

December 2, 2024 | 4 min read

An intriguing paradox 

By Ghida Kassir, MD, University of Toronto, Canada

Because anorexia is not uncommon, it is likely that we will all encounter a patient who is suffering from this life-threatening condition. Although it may be difficult to understand self-starvation, empathy and compassion must be prioritized to establish a trusting patient-clinician relationship. 

April 28, 2025 | 3 min read

Spotting victims—human trafficking is not uncommon 

Healthcare professionals have a unique opportunity to identify and help victims of human and labor trafficking. Read on for practical tips for how to recognize and support these patients. 

March 30, 2021 | 2 min read

Leveraging Your Professional Network For Your Growth

By Kevin Frick, PhD, Johns Hopkins Carey Business School

In your professional network, include those who challenge and question you. Peer feedback and coaching can help improve your care of patients.

Ruth and Carl J. Shapiro Gallery (Gallery 232), Museum of Fine Arts, Boston, featuring "Daughters of Edward Darley Boit," by John Singer Sargent (American, 1856–1925). Photograph by Flora Smyth Zahra.

June 6, 2019 | 7 min read

May Art Museum Challenge

By Flora Smyth Zahra, MA Clin Ed, DRestDent RCS, FHEA, Kings College London, Margaret Chisolm, MD, Johns Hopkins Medicine

The art museum is a space that has lessons to teach about clinical excellence, and fosters both the personal development and professional identity formation of clinicians.

October 5, 2023 | 2 min read

When Medication is an Empty Promise (Sudafed) 

By Charles Flexner, MD, Johns Hopkins Medicine

Communicating uncertainty effectively is part of being an excellent physician. This is especially true when it comes to the medications we recommend to patients. 

December 22, 2025 | 2 min read

BREATHE better at home 

To improve indoor air quality, counsel patients to combine source control with filtration. This includes eliminating smoking/vaping and avoiding fragrances like scented candles/incense. Recommend air cleaners with HEPA and carbon filters. 

August 17, 2022 | 1 min read

Lessons From “A Field Guide to Getting Lost”

By David Kopacz, MD, University of Washington

Many clinicians feel burned out at some point in their careers. While this may feel disorienting, it’s possible to learn and grow from this experience.

January 15, 2020 | 1 min read

Extra Minutes

By Scott Newsome, DO, Johns Hopkins University School of Medicine

Every extra minute a clinician spends with a patient is worth it.

April 16, 2024 | 1 min read

Changing gears (archives, 2024)

By Chris Tiplady, MD, Northumbria Healthcare, England

At the start of the pandemic, I permanently switched my commute from car to bike. I'm now passionate about motivating patients to be more active.

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.

April 11, 2023 | 2 min read

“Can I hold my newborn baby?”

By Carolyn Sufrin, MD, PhD, Johns Hopkins Medicine

Giving birth while imprisoned usually occurs under inhumane conditions, with women remaining shackled and not being permitted to hold newborns. This is a reminder that every patient deserves our compassionate and nonjudgmental care. 

August 3, 2020 | 1 min read

Book Review of “Elderhood”

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

Ageism is a form of discrimination that contributes to poor health outcomes. To mitigate its effects, we must enact policies that address biases in ourselves, our workplaces, and our communities.

November 12, 2024 | 2 min read

DIY drugs: a risky prescription 

Healthcare professionals need to know about the growing trend of do-it-yourself (DIY) medicine. By asking open-ended questions about medication sources, clinicians can prevent adverse health outcomes. 

April 23, 2025 | 3 min read

Teamwork Rx

Medical team huddles are a powerful practice to foster unity. This routine promotes teamwork, collaboration, and respect. 

September 27, 2023 | 1 min read

Guardrails And Ambulances 

By Mike Fingerhood, MD, Johns Hopkins Medicine

Over 100,000 Americans die every year from overdoses, and most are preventable. Discuss with patients and loved ones the dangers of having old prescription or counterfeit pills, as well as the importance of keeping naloxone on hand.

December 15, 2025 | 2 min read

Pause, pattern, plan 

Turn gut feelings into patient-centered next steps. Instincts may guide you, but confirm each step with the patient’s goals, evidence, and team input. 

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.

August 15, 2022 | 2 min read

Role Modeling Vulnerability

By Daniel Saddawi-Konefka, MD, MBA, Massachusetts General Hospital

When a patient dies, sharing your emotions with trainees normalizes this response and highlights our shared humanity.  

January 23, 2020 | <1 min read

Close Listening

By Scott Newsome, DO, Johns Hopkins University School of Medicine

An excellent clinician always listens closely to their patients. This enhances their perspective on the patient's point of view.

July 30, 2018 | 1 min read

What’s a book club doing at a medical conference?

By Scott Wright, MD, Johns Hopkins Medicine

Join a book club or start a book club - in either your professional or personal context. You'll be glad you did!

January 31, 2019 | 1 min read

How to be Mindful About Infection Prevention

By Clare Rock, MBBCh, Johns Hopkins University School of Medicine

To be mindful of preventing the spread of infection, embrace change in procedures with an open mind when it is for the greater good.

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.”

April 10, 2023 | 1 min read

Sips And Gulps

By Judy Ashley, patient

Patients may need a clinician’s help with things that seem easy or obvious, like how to swallow pills.

April 11, 2018 | 3 min read

Five Tips to Support Your Grieving Patient

By Jane Schindler, LCSW-C ACHP-SW, Johns Hopkins University School of Medicine

A licensed clinical social worker offers her top tips for supporting grieving patients.

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