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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
March 1, 2018 | 2 min read

Most Physicians Sit Down at the Bedside When Entering a Patient’s Room

By Scott Wright, MD, Johns Hopkins Medicine

Choice architecture, framing, herd behavior, and feedback—how to nudge your patient towards healthier choices.

September 3, 2024 | 1 min read

More than hot flashes

By Wen Shen, MD, Johns Hopkins Medicine

When thinking about menopause, hot flashes are frequently the first thing that come to mind. But clinically excellent care requires recognizing the full spectrum of symptoms.  

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 6, 2020 | 1 min read

Addiction Recovery During the Pandemic

By Mike Fingerhood, MD, Johns Hopkins Medicine

We are all stressed by the great uncertainty related to COVID-19, but for our patients with addiction, it is much greater. Check in with your patients and support them in finding healthy ways to cope.

Parting gift for every customer—homemade pistachio granola.

August 7, 2023 | 3 min read

Insights from the book “Unreasonable Hospitality”  

By Scott Wright, MD, Johns Hopkins Medicine

Healthcare delivery is complex, and hospitality may not be prioritized. As individuals and teams, small changes in behavior may improve patient experience. 

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?”

February 18, 2019 | 1 min read

A Tense Moment in the ER

By Danielle Ofri, MD, PhD, New York University School of Medicine

There are no easy solutions for conflicts of race, class, gender, societal roles, and economics. It’s only our individual work chipping away that will get us to a new place. It’s up to each of us to bring change.

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. 

July 6, 2022 | 1 min read

Any Side Effects?

By Jeffrey Millstein, MD, Penn Medicine

Teaching my patients to ask questions helps address their worries about medications. 

February 5, 2024 | 1 min read

When patients emphatically question the diagnosis

By Will Frye, PhD, Johns Hopkins All Childrens, St. Petersburg, Florida

Sometimes patients and families struggle when processing a new diagnosis. Embracing open communication, education, and collaboration may transform disagreements into understanding. 

August 12, 2019 | 3 min read

Mental Illness and Mass Shootings

By Cassandra Crifasi, PhD, MPH, Emma Beth McGinty, PhD, Johns Hopkins Bloomberg School of Public Health

Most people with serious mental illness are never violent toward others. Due to the media’s misleading focus on the role of mental illness in gun violence generally and mass shootings specifically, many people are afraid that a diagnosis of a serious mental health condition like schizophrenia means they or their loved one are at high risk of hurting other people, which is not supported by the research evidence.

December 1, 2022 | 1 min read

World Cup Fever

By Scott Wright, MD, Johns Hopkins Medicine

As you watch lots of “The Beautiful Game” this month, there are lessons for healthcare professionals. All members of our teams are important and diversity drives success.  

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.

February 28, 2018 | 3 min read

Sacred or Stigma? A New Realm of Expression

By David Efron, MD, Johns Hopkins University School of Medicine

In 2018, do not resuscitate options are broad—distillation of the letters DNR do not provide enough guidance, and tattoos have yet to be validated as a definitive expression of this wish.

August 26, 2024 | 1 min read

The medical Tower of Babel  

Immigrant patients often face challenges when accessing healthcare because of language and cultural barriers. Certified medical interpreters can help reduce the likelihood of inequities in care. 

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.

Martin Luther King Jr. Memorial, Washington, D.C.

March 25, 2020 | 1 min read

Standing With Courage During Challenging Times

By Juliette Perzhinsky, MD, MSc, Central Michigan University

"The ultimate measure of a [person] is not where [s/he] stands in moments of comfort and convenience, but where [s/he] stands at times of challenge and controversy." -Martin Luther King Jr.

August 1, 2023 | 2 min read

Psychological First Aid

By Albert Wu, MD, MPH, Johns Hopkins Medicine, Matt Norvell, DMin, Johns Hopkins Medicine

Healthcare professionals experience traumatic events that may exceed their ability to cope. Timely emotional support can help maintain their well-being. 

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.

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. 

June 14, 2018 | 1 min read

AI and the Art of Medicine

By Souvik Chatterjee, MD, Johns Hopkins Medicine

Exploring the new challenge of combining the art of healing with the new science of machine learning.

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. 

"When the hospital is suspiciously quick to sweep everything about the error and suicide under the rug, Noah turns for guidance to the journal of his late father, a respected surgeon."

January 31, 2024 | 1 min read

Book review of “The committee will kill you now” 

By Joan Naidorf, DO

This novel reminded me that even in a complex healthcare system, individual clinicians can make a substantial contribution to the ethical treatment of their patients.  

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.

"Sun Rise," by David Kopacz.

August 8, 2019 | 2 min read

The Circle of Re-Humanizing Medicine

By David Kopacz, MD, University of Washington

We need human-based medicine in conjunction with evidence-based medicine. If we only identify as scientists and not as healers, we risk dehumanizing our patients and ourselves.

Aiden Crowley said that “a hug can be medicine” and that simple “presence and accompaniment” provides more for the patient and family than we might think.

November 23, 2022 | 1 min read

Using CLOSLER For Grand Rounds

By Richard Schaefer, MD, MPH, Johns Hopkins Medicine

CLOSLER has a wealth of material that can be leveraged to enhance teaching in a variety of settings, including lectures, bedside, and small group discussions. 

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.

September 27, 2018 | <1 min read

Knowing the Patient as a Person in Precision Medicine

By Roy Ziegelstein, MD, Johns Hopkins Medicine

We must consider each person’s life experiences – so-called Personomics – alongside the many “-omics” that are essential components of Precision Medicine. Personomonics contributes to how illness is expressed, and ideally how it should be diagnosed and treated.

August 21, 2024 | 2 min read

Confessions of a non-flosser 

By Kyra Reu, medical student, University of Pennsylvania

When I told my dentist I didn’t floss regularly, it reminded me of a patient who shared she was not taking her medication as directed. Careful questioning of how the patient is actually taking their medication should be done before modifying the treatment. 

Alfred Nobel, The Nobel Peace Center, Oslo, Norway.

March 18, 2020 | 2 min read

A nobel cause: an interview with Dr. Gregg Semenza

Mentors are invaluable. Whether pursuing excellence in research or clinical medicine, reach out to mentors so that you can grow efficiently.

Role playing "Dungeons and Dragons."

July 31, 2023 | 3 min read

Dungeons and Dragons and Medicine

By Lillian Houston, MD, Southern Illinois University

D&D teaches us that the team is our most important asset. Interdisciplinary and diverse teams that communicate openly are most successful. 

February 19, 2019 | 4 min read

On Feeling Helpless: A Psychiatrist Reflects on the Aftermath of a Patient Suicide

By Dinah Miller, MD, Johns Hopkins University School of Medicine

If you've been distressed by the loss of a patient to suicide, I hope my story will provide a moment of relief as you begin the process of healing; I hope that you may feel less alone.

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 19, 2019 | 2 min read

The Importance of Partnering With Patients

By Michael Crocetti, MD, MPH, Johns Hopkins Community Physicians

What patients and families need is a clinician advocate who is available to listen, translate complex medical language, and support both the physical and mental health of the patient.

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.

January 23, 2024 | 1 min read

Book review of “The algorithm will see you now”

By Joan Naidorf, DO

In this medical thriller set in the not-too-distant future, diagnosis and treatment are performed entirely by AI. The novel serves as a reminder that AI must be used thoughtfully and responsibly.  

“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.

August 5, 2019 | 2 min read

Training and Identity

What parts of yourself do you want to bring back into your life that you may have lost during residency?

November 17, 2022 | 2 min read

Personalized Clinical Quality Improvement

By Jeffrey Krimmel-Morrison, MD, University of Washington

Use evidence-informed practices in your self-directed learning—build a case tracking system, work simulated cases, use quizzing, and seek new evidence efficiently. 

August 7, 2024 | 2 min read

Wait! Is that a zebra?

Common things are common, but occasionally unusual conditions are seen. To improve diagnostic accuracy, clinicians should consider alternative explanations and challenge their own assumptions.

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.”

July 24, 2023 | 2 min read

Prince of Yonkers

By Carey Roesler, PA-C, Johns Hopkins Medicine

When my car broke down, a mechanic went above and beyond to make sure I made it to my aunt’s funeral. This reminded me of how lucky I am to be able to help my patients through challenging times. 

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.

March 19, 2019 | 3 min read

Reversing the Backslide: Sexually Transmitted Infections in the US

By Matthew Hamill, MBChB, PhD, Johns Hopkins Medicine

Open, non-judgmental, respectful, medically-relevant conversations need to be the cornerstone of all therapeutic relationships. As long as patients feel valued and at the center of their care, patients are willing to engage in discussions about sexually transmitted infections.

April 8, 2025 | 3 min read

“Can you help me die?” 

By Carolyn Rennels, MD, University of San Francisco

When a patient asks about medical assistance in dying, prioritize deep listening and exploration of fears and hopes over immediate procedural responses. This can help reassure them that you’ll accompany them to the end. 

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.

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. 

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. 

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’!

July 30, 2019 | 3 min read

Searching for Bicarb in July

By Camille Petri, MD, Mass General

To succeed in clinical practice, be humble and open to learning from all members of your team.

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