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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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October 10, 2024 | 1 min read

Trust and truth

Nonjudgmental communication can help us understand the true nature of a patient’s condition and motivations. Connecting more deeply with a patient over time allowed us to learn more of the story. 

February 13, 2019 | 2 min read

Disparities in New Treatments

By Utibe Essien, MD, MPH, University of Pittsburgh School of Medicine

When beginning new treatments, it's important to ask patients what they understand about the medication, what their expectations are, what barriers might exist to remaining on this agent, and what they value most out of their treatment plan.

September 11, 2023 | 2 min read

AI And Humanistic Care

By Daniel Brotman, MD, Johns Hopkins Medicine

In a clinical world that is increasingly algorithmic, what AI can NOT do is truly understand human emotions. Computers will never appreciate the joy and privilege of connecting with patients. 

April 17, 2018 | 5 min read

Knowing Your Patient

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

Diagnostic excellence begins and ends with knowing your patient.

December 20, 2021 | 1 min read

What Patients With Serious Illness Want to Know Most

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

After receiving a terminal diagnosis, many patients especially want to know how long they have to live, what symptoms to expect, and how to cope with impending decline.  

June 19, 2018 | 2 min read

Sleep solutions (archives, 2018)

People see sleep as a luxury, but it's a basic human need. As clinicians, we should ask patients how they're sleeping. Here are nine things you can recommend to help them feel more rested.

August 1, 2019 | 3 min read

Mindset and the Power of Yet: A Conversation With Dr. Gurpreet Dhaliwal

Excellent clinicians are also thoughtful mentors. Mentors are like beacons as we navigate our path forward.

May 2, 2018 | 1 min read

Top Tips To Improve Your Webside Manner

By Joshua Wadlin, MD, Johns Hopkins University School of Medicine

You might think your bedside manner is excellent, but how’s your webside manner?

March 21, 2024 | 2 min read

Young LGBTQ+ patients deserve more 

By Brady Hanshaw, medical student, Harvard Medical School, Thara Nagarajan, MD, UCSF

36% of LGBTQ+ youth are unsure they’ll live until the age of 35. These mental health outcomes are even more severe for LGBTQ+ youth of color. It’s critical that clinicians create a safe space to talk about anxiety, depression, self-harm, and suicidal ideation. 

February 22, 2018 | 3 min read

Family History and Addiction Risk

By Margaret Chisolm, MD, Johns Hopkins Medicine

For some patients the risk of becoming addicted to prescription opioids is extraordinarily high and may outweigh any pain control benefit.

July 15, 2021 | 1 min read

Honoring Patients’ and Families’ Goals of Care

By Shireen Heidari, MD, Stanford University

When supporting critically ill or dying patients, keep their care goals at the forefront of conversations and planning.

October 3, 2024 | 2 min read

Patient time 

By Katherine Majzoub Morgan, MD, Brigham and Womens Hospital

Ask patients if they are concerned about the amount of time it takes to engage with health care systems. For those who are, include time as a factor in shared decision-making conversations. 

The author's drawing of her heart utilizing the technique of defamiliarization.

February 14, 2019 | 3 min read

Defamiliarization

By Sarah Walser, , Penn State College of Medicine

Incorporating defamiliarization into practice builds empathy and broadens our worldview. It challenges us to expand and find confluence between different frameworks through which an experience, such as a disease, can be interpreted.

September 7, 2023 | 2 min read

“Wild Problems” Book Review

By Margaret Chisolm, MD, Johns Hopkins Medicine

When it comes to the big decisions in life, abandoning a rational, algorithmic approach—and going back to guiding principles—may be the secret to happiness. 

"You Let Your Magic Tortoise Go," David Kopacz. Copyright with the artist.

August 27, 2020 | 3 min read

Finding Balance During Unbalanced Times

By David Kopacz, MD, University of Washington

Spending time “going into and opening our hearts” is healing and restorative. We can do this for ourselves as healers and guide patients through the practice. It’s as simple as slowing down, putting your hand on your heart, and taking three deep breaths.

December 7, 2021 | 3 min read

A Window Into a Patient’s World

By Deirdre Johnston, MBBCh, MD, Johns Hopkins Medicine

Visiting a patient’s home environment, either virtually or in person, may shed light on the source of their distress.

July 26, 2022 | 2 min read

Sharing One More Pint

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

When caring for a cancer patient who lived days longer than expected, I learned to be humble in my prognostications and to help patients receive “extra” moments of life as gift. 

February 25, 2021 | 2 min read

How You Can Help With Intimate Partner Violence

By Lisa Geller, MPH, Educational Fund to Stop Gun Violence

Intimate partner violence (IPV) is a public health crisis and most deadly when a gun is involved. Clinicians should screen patients for IPV, ask about firearm possession, and refer those at risk of IPV to appropriate services.

March 19, 2024 | 2 min read

Caring for transgender and gender-expansive patients, Part 2

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

Transgender and gender-expansive patients often feel uncomfortable in healthcare settings and avoid care. Be sure to use every patient’s chosen name/pronoun and take care not to misgender.

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.   

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.

February 2, 2023 | 2 min read

We Just Disagree

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

When colleagues offer a conflicting opinion, remember to always put the patient first, check your facts, and be open to learning.  

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.

August 23, 2018 | 4 min read

How To Incorporate Students Effectively Into Clinic

Making the time and effort to integrate students into clinic cohesively can be associated with both improved clinical productivity and educational value.

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 30, 2023 | 2 min read

Containing Chaos Through Dance

By Shreya Srivastava, medical student, Albany Medical College

The strength, stamina, emotional understanding, and situational awareness that dancers develop over time can also benefit healthcare professionals.  

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.

November 23, 2021 | 3 min read

Preventive Care And COVID

By Aline Charabaty, MD, Johns Hopkins Medicine

As a gastroenterologist, I’ve been encouraging people to continue with colon cancer screening through the pandemic. A delay may have serious health consequences.

July 20, 2022 | 2 min read

“I’ll do your abortion.”

By Jill Edwardson, MD, MPH, Johns Hopkins Medicine

We enter every patient encounter with our own unique experiences, judgements, and values, as do our patients. Only when we acknowledge this can we truly connect with compassion.

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.

March 18, 2024 | 2 min read

Caring for transgender and gender-expansive patients, Part 1 

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

Clinicians must be aware that transgender and gender-expansive patients face widespread discrimination in healthcare settings, including harassment and denial of care, and work to mitigate this disturbing trend. 

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. 

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. 

January 31, 2023 | 1 min read

Brain Candy

By Carol Vidal, MD, PhD, Johns Hopkins Medicine

Because we don't know yet how social media affects our brain, it needs to be consumed in moderation. Scheduling times to spend time with friends and family may make it easier to get offline. 

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.

July 6, 2021 | 2 min read

CARE: Connect, Assess, Respond, Evaluate

By Cheryl Barnes-Neff, PhD, MDiv, RN, President, Laurel Oak Group, Online Education & Training

To understand and better care for your patients, be curious about their life stories. Reflect on what you hear and consider the extent to which you are truly connecting.

October 2, 2024 | 1 min read

Pain management: a perspective from a doctor in Kuwait 

Pain and suffering are ubiquitous. Observing approaches and practices in the U.S. highlighted for me the importance of open dialogue, patient empowerment, and multimodal approaches.   

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 29, 2023 | 1 min read

Music and Medicine: The Same Melody 

By Tara Rajendran, MBBS, MFA, Annamalai University, Annamalai Nagar, Chidambaram, Tamil Nadu, India 

My training in classical Indian music helped me to become better at focused listening and recognizing the importance of teamwork in medicine. 

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.

November 22, 2021 | 4 min read

Noticing What We’ve Seen Without Seeing

By Ekene Ojukwu, MD, Johns Hopkins Medicine

Carefully observing our patients can lead to clinically relevant insights. Sometimes what seems inconsequential at first glance may be surprisingly significant.

The author discusses patient sleep with a colleague.

June 18, 2018 | 2 min read

How To Help Your Patients Get Better Sleep, Part I

A sleep specialist reminds us of the importance of asking patients about their sleep.

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.

December 17, 2020 | 4 min read

Racial Discrimination And Larger Bodies

By Kristal Brown, PhD, MSPH, Johns Hopkins Medicine

We must be aware of our own biases and prejudices in order to give excellent care to every patient.

March 14, 2024 | 3 min read

Why sexual orientation and gender identity in the EMR matters 

By Tyler Cornell, MSN/MPH, CRNP (she/her), Johns Hopkins Medicine  

Always ask patients about their gender identity, preferred name, pronouns, and how they define their sexual orientation. This builds trust and helps your patients feel safe to return for follow-up. 

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. 

December 4, 2025 | 3 min read

Winter humbles the leaves 

Balance diagnostic exhilaration with goals-of-care conversations centered on the values of the patient and family. 

January 25, 2023 | 2 min read

All in The Family

In my general internal medicine practice, I’ve learned that getting to know a patient’s family gives a unique window into their lives.  

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.

July 7, 2021 | 1 min read

Lessons Learned During my Palliative Care Rotation

By Rayah Sawaya, MD, American University of Beirut

In the wake of disaster, I witnessed the value of palliative care firsthand. This service prioritizes patient comfort and end-of-life preferences.

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