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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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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.

June 27, 2022 | 3 min read

Caring for people and their gender stories

By Hailey Haffey, PhD, University of Utah

To care for people is to care for the stories that shape them. Clinicians can enhance patients’ confidence in the healthcare system by skillfully engaging with their stories of gender and sexual orientation.

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.  

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!

“Imagine your baby’s lungs are a tree,” she said. “A pleural effusion would be a puddle around the tree while pulmonary edema is water on the leaves.” The mother seemed to follow along, nodding her head. I was grateful to hear this metaphor that inspired me to utilize pictorial representations more.

August 19, 2021 | 2 min read

The Power of Pictures

By Rebekah Fenton, MD, Northwestern University

When educating patients about their illness, it’s often helpful to include pictures and visual descriptions to improve understanding.

February 25, 2018 | 1 min read

Diagnostic Excellence Starts With an Incessant Watch

By Reza Manesh, MD, Johns Hopkins University School of Medicine

Feedback is the key to improvement of any craft. No one is born an expert. It is earned through deliberate practice and an incessant thirst for progress.

Hobbit holes, Hobbiton, Matamata, New Zealand. Photo by Jackie Ick, flickr.com, public domain, wikimedia.org.

February 21, 2020 | 2 min read

Hobbits of Healthcare

By David Shih Wu, MD, Johns Hopkins Medicine

The excellent clinician demonstrates hobbit-like bravery by leaning into hard conversations.

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.

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.

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.”

January 30, 2019 | <1 min read

Dr. David Wu, A CLOSLER Look

By Gretchen Miller, Managing Editor

Palliative care is an approach to medicine that focuses on quality of life. My hope is that every clinician learns basic palliative skills to lead family conversations when there is a critically ill patient. It's a precious privilege to be able to enter people's lives at their most vulnerable time, and help them find some kind of peace.

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.

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.

May 10, 2018 | 3 min read

Truly Listen: Clinical Excellence in Nephrology

By Edward Kraus, MD, Johns Hopkins University School of Medicine

Listen to your patient, try to understand what they're saying, and think beyond policies and protocols to be the best advocate possible.

July 1, 2019 | 1 min read

Looking Under the Hood

By Daniel Minter, MD, University of California, San Francisco

Promoting a culture of thinking out loud can demystify the process of clinical reasoning and make it accessible to all learners.

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. 

August 26, 2021 | 1 min read

Destigmatizing Addiction: The Power of Words

By Namrata Walia, MD, Baylor College of Medicine

Please use the term 'person with substance use disorder’ instead of ‘addict’!

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."

February 25, 2020 | 2 min read

5 Things Clinicians can do to Reduce Drug Prices

By Justin McArthur, MBBS, MPH, Johns Hopkins Medicine

Excellent clinicians prescribe thoughtfully—pruning medication lists, advising patients on how to save money, and advocating for change.

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. 

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.     

January 28, 2019 | 3 min read

Reflections on “Healing Alone”

By Helen Bradshaw, MD, Johns Hopkins University School of Medicine

In defense of the practice of pimping, though the term is a regrettable word choice, I learned from having questions directed at me. And my frequently incorrect responses were usually met with thoughtful explanations.

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.

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.

May 9, 2018 | 2 min read

Applying the Coaching Model to Medical Education

By Ryan Graddy, MD, AbsoluteCARE Medical Center, Atlanta, Georgia

Coaching—direct observation of learners with feedback geared toward skills development—is an important way to teach individualized medical education. Outstanding coaches across disciplines share characteristics that can be applied in clinical coaching encounters.

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. 

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.

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.

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.    

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. 

March 22, 2018 | 7 min read

Fundamentals for Caring for Transgender Patients

By Paula Neira, JD, MSN, RN, CEN, FAAN, Johns Hopkins Medicine

Improve your skills as you work to support your transgender patients and interact with your transgender colleagues.

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.

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.

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.

A shire in Shropshire. Author's photo.

January 29, 2019 | 7 min read

“Good Doctoring”

By Taylor Purvis, MD, St. Vincent Medical Center, Bridgeport, CT

Reflections from a medical student on the practice of medicine as captured in the novels "The Bad Doctor," by Ian Williams, and "A Fortunate Man," by John Berger & Jean Mohr.

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.

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.  

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 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.

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."

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. 

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.  

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.

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. 

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.

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. 

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.

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.

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.

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.

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