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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 2, 2022 | 3 min read

The Alarming Rise in Pediatric Suicide

By Elizabeth Reynolds, PhD, Johns Hopkins Medicine

Rates of childhood suicide have been rising steadily and this is now the second leading cause of death for youth. It's critical to screen children for suicidal thoughts and behaviors.   

May 27, 2021 | 2 min read

How to Support Asian American and Pacific Islander (AAPI) Patients

By James Wu, MD, Medical College of Wisconsin, Neurofourier, MD, New York, New York, Yuemei Zhang, MD, University of Washington

Currently, AAPI people are facing a wave of discrimination. Clinicians need to be sensitive to patients’ experience of racism and educate themselves on how to best offer support.

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. 

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.

June 10, 2019 | 4 min read

Lessons learned from my journey through depression

By Shannon Scott-Vernaglia, MD, Mass General

Being a patient has taught me patience, with myself, with those I care about, and with those I care for as physician. 

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.  

October 14, 2021 | 1 min read

Caring During Death

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

It’s a privilege to care for patients and their loved ones, especially at the end of life. Even when we can’t cure, we can always comfort.

Canadian Pacific Railway in Banff National Park,Canada

February 5, 2026 | 2 min read

Stop, look, and listen 

I find the railroad crossing rule helpful when caring for patients. I stop to consider how best to help the patient reach their health goals, truly see the person before me, and listen to their story. 

January 28, 2020 | 3 min read

Racism From Patients—an Ethical Dilemma

By Sonal Gandhi, MBBS, MD, Johns Hopkins Medicine

A cornerstone of clinical excellence is treating all patients with respect and dignity. This is true even when treating those patients who are not respectful to you.

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. 

March 22, 2022 | 1 min read

Navigating my First Patient Death

By Elissa Abou Khalil, MD, University of Pittsburgh Medical Center

Acknowledging feelings and asking for support may help when dealing with loss.  

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. 

January 7, 2019 | 2 min read

Helping Your Patient Get Better Sleep During Hospital Stays

Sleep is important during hospitalization, and we need to maximize quality and quantity the best we can for our patients. Asking about your patient’s sleep and identifying ways to improve it when possible is one way to start.

April 26, 2022 | 1 min read

The Power of Beliefs

By Stephanie Trudeau, PhD, The Thrive Center For Human Development

Explore your patient’s beliefs that invite healing, as well as those that are causing them to suffer. By understanding this, you can guide them to do more of the former and less of the latter. 

May 19, 2021 | 3 min read

Clinical Training Translating to Clinical Excellence

By Jennifer Spicer, MD, MPH, Emory University

Bias awareness achieved in teaching/learning can transfer to the clinic. Thus learners can help clinicians become aware of bias toward patients.

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.

July 17, 2025 | 3 min read

Cricket and the cadence of care  

Like playing cricket, the art of medicine demands patience, teamwork, and a willingness to redefine victory—not every win is a cure. Sometimes success is helping a patient find comfort and dignity. 

August 19, 2020 | 2 min read

6 ways to address Black mistrust in medicine

By Biosha Jones, MD, Loma Linda University

We must work toward establishing trust with all of our patients instead of assuming it already exists.

"The Starry Night," Vincent Van Gogh, 1889, Museum of Modern Art.

May 16, 2019 | 5 min read

Starry, Starry Night

By Juliette Perzhinsky, MD, MSc, Central Michigan University

There are times that as clinicians we become patients ourselves, needing compassionate care for injuries entirely unrelated to our chief complaint.

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.

October 12, 2021 | 2 min read

Unshackle The Mind

By Kittane "Vishnu" Vishnupriya, MBBS, Johns Hopkins Medicine

When caring for a man in handcuffs, I was reminded that every patient must be shown empathy and compassion.

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.

Bronze sculpture of Emmanuel Kant, by sculptor Daniel Rauch, 1857.

January 28, 2026 | 3 min read

Lessons from philosophy on facing uncertainty  

Giving exceptional care requires us to be open to other perspectives, recognize the limits of medical knowledge, and respect the patient’s lived experience. 

November 17, 2020 | 4 min read

Allyship and Upstanding

By Geoff Stetson, MD, UCSF

It’s critical to promote a culture of emotional safety in your clinical setting. Offer support and speak up when you witness hurtful incidents.

March 21, 2018 | 2 min read

İnsan Olmak—Being Human

By Ezgi Ozalp Akın, MD, Ankara University

Developmental pediatrician Ezgi Ozalp Akın, MD, shares insights gleaned from "İnsan Olmak" on being human.

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.

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. 

November 7, 2024 | 2 min read

Following my own rules  

By Julie Caffrey, DO, MS, Johns Hopkins Medicine

Having my own set of guidelines has helped me to continuously improve. One of my favorites is consciously learning something new every day.

April 14, 2022 | 3 min read

Afraid to Tell The Truth

By Kirsten Elin Smith, PhD, National Institute on Drug Abuse

When I shared with my clinician that I had previously been a heroin user, she made me feel ashamed. This taught me the importance of listening to patients with nonjudgmental curiosity. 

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.

July 18, 2018 | 2 min read

The Bell Curve

By Lee Akst, MD, Johns Hopkins University School of Medicine

The difference between a 99.5% and 99.95% success rate isn't necessarily in knowledge or training, but in physician attitudes towards adapting and changing to evolving information.

The autism ribbon.

June 12, 2025 | 2 min read

The strengths of neurodiverse healthcare professionals 

Neurodivergent healthcare professionals bring unique attributes to a medical team that can enhance patient care. We can foster inclusive environments that actively support these diverse ways of thinking and working.

Three common zebras (Equus quagga), Kruger National Park, South Africa.

August 18, 2020 | 2 min read

Zebras Are Out There

By Eric Last, DO, Northwell Health, Wantagh, New York

Looking at the big picture and verifying details will help you consider diagnoses that may be unlikely, but still possible.

"L'Atelier au mimosa," Pierre Bonnard.

May 13, 2019 | 7 min read

April Art Museum Challenge

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

Slow looking can enable clinicians to see more deeply, think more critically, and engage more meaningfully in patient care. Time spent in a museum supports clinician wellness and nurtures student professional identity formation.

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.  

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.

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 28, 2026 | 4 min read

A model mentor 

Effective clinical teaching pairs rigor with kindness. Building psychological safety can accelerate learning, reduce burnout, and improve patient care. 

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.

February 12, 2020 | 1 min read

Agents of Change—Learning From Gen Z Healthcare Students

By Kevin Pan, Medical Student, Ohio University School of Medicine

Excellent clinicians are committed to reducing health inequity.

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. 

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. 

"Nighthawks," Edward Hopper, 1942.

January 2, 2019 | 3 min read

The Human Experience of Illness

By Tina Zhang, MD, Johns Hopkins Medicine

Paintings, photographs, and poems can foster dialogue about the human experience of illness and allow learners to approach challenging topics in a more comfortable way.

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. 

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?"

September 20, 2023 | 2 min read

Sharing Our Stories

By Hailey Haffey, PhD, University of Utah

Stories we’ve internalized about healing may direct our approach to patient care. Find the one that resonates most with you.

June 9, 2025 | 3 min read

When care hurts 

Patients’ past healthcare experiences influence their ability to engage in care. Taking time to learn about their life stories builds trust and empowers them to participate in their healing. 

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.

"Blue Rider," Franz Marc, 1911.

May 14, 2019 | 4 min read

Review of “Critical Crash”

By Andre Lijoi, MD, York, Pennsylvania

We all have our woundedness, and our own story is important in the context of caring for our patients. These stories and wounds operate in the background of our consciousness and we must recognize and manage them.

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.

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