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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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August 28, 2023 | 2 min read

Travelers on an Unfamiliar Road

By Daniel Pomerantz, MD, Montefiore New Rochelle Hospital, New York

A rabbi once taught me the distinction between curing and caring. As I accompany patients on the rough road of illness, I consider ways to make their journey a little smoother. 

June 28, 2019 | 1 min read

How to Improve Outpatient Handoffs

Consider performing outpatient handoffs and preparing patients when you will be away. This will make your time away easier for your covering colleagues and for your patients.

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.

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.

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.

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 15, 2019 | 1 min read

7 Things I’ve Learned About Mentoring in 51 Years

By David Levine, MD, MPH, Johns Hopkins University School of Medicine

Helping others to achieve their full potential is the most incredible, wonderful, and exhilarating role one can undertake.

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.

"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.

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.  

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.

September 26, 2024 | 3 min read

Under the influencers 

By Adam Schiavi, MD, PhD, Johns Hopkins Medicine

The social media "Black out challenge" promotes asphyxia that can result in irreversible brain damage or death. Healthcare professionals should warn patients and caregivers to be cautious about social media trends and provocations. 

December 2, 2019 | 2 min read

Improving Communication Between Inpatient Teams and PCPs

By Stephen Berry, MD, Johns Hopkins Medicine

While it's not always easy, hospital-based providers need to find a way to connect with the healthcare professionals who will continue their patient's care.

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. 

August 17, 2023 | 3 min read

The Hospital Playlist 

By Kerry Devlin, MMT, LPMT, MT-BC (she/her), Johns Hopkins Medicine

Consider the hospital soundscape and how it may impact patients’ well-being. To create a more soothing stay, silence or turn down monitors if possible. 

November 29, 2018 | 2 min read

Management Reasoning: Diagnostic Reasoning’s Underappreciated Sibling

By David Cook, MD, MHPE

Management reasoning is primarily a task of shared decision-making and monitoring, and is inherently more complex than diagnostic reasoning. A better understanding of management reasoning will offer insights into the causes and avoidance of medical error, clinical practice quality improvement, and training and assessment of health professionals.

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?"

July 18, 2022 | 2 min read

How to have effective discussions about alcohol 

By Beth McGinty, PhD, Johns Hopkins Medicine, Mike Fingerhood, MD, Johns Hopkins Medicine

Talking with patients about the risks of heavy alcohol consumption and the benefits of change can have a positive impact on their health. 

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. 

March 4, 2024 | 2 min read

Getting the diagnosis right 

By Colleen Christmas, MD, Johns Hopkins Medicine

After arriving at what you think is the diagnosis, pause and consider alternative explanations. For patient populations at high risk for misdiagnosis (women and historically marginalized groups), examine how biases might be influencing your conclusions. 

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.

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.

January 9, 2023 | 2 min read

Questions Raised by “There, There” 

By Mike Fingerhood, MD, Johns Hopkins Medicine

Reflecting on our own “there” (the place where we grew up) can trigger conversation that helps us to understand our patients’ “there.” This can strengthen the patient-clinician relationship.

January 27, 2026 | 3 min read

Mindset matters 

Adopt a growth mindset—treat setbacks and mistakes as data for learning. Ask “What can we learn?” rather than “Who failed?” to help build psychological safety within your healthcare team.

October 28, 2020 | 1 min read

Preventing Dry Eye in the Zoom Era

By Sharon Solomon, MD, Johns Hopkins Medicine

Increased online activities during the pandemic has caused higher rates of dry eye for many. All clinicians should encourage their patients to take regular short breaks from screens.

August 21, 2018 | 1 min read

Talking With Young Adult Patients About Alcohol

By Mike Fingerhood, MD, Johns Hopkins Medicine

Clinicians need to be vigilant to discuss alcohol use with patients and remember that the legal drug, alcohol, causes more morbidity and mortality than opioids.

This is from "The Spirit Catches You and You Fall Down," written by Anne Fadiman. The art copyright is believed to belong to the publisher, Farrar, Straus and Giroux, or the artist. Public domain from wikipedia.org.

November 20, 2019 | 2 min read

“The Spirit Catches You and You Fall Down”

By Laura Pugh, Medical Student, Johns Hopkins Medicine

The gap between cultural systems can be wide. Openness, curiosity, and humility will improve cross-cultural care.

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. 

August 16, 2023 | 1 min read

The Other Medical History

By Jeffrey Millstein, MD, Penn Medicine

Learning about the history of medicine can help put current health system challenges in perspective. I was especially struck by the enduring primacy of the patient-doctor relationship. 

November 12, 2018 | 3 min read

Insights From “A Whole New Mind”

Daniel Pink's "A Whole New Mind" highlights the importance of cultivating empathy, humor, and the ability to create meaning.

June 13, 2018 | 1 min read

Behavioral Change Bolstered By Human Touch

By Souvik Chatterjee, MD, Johns Hopkins Medicine

A human doctor is a critical component of creating change in patient behavior and health.

May 27, 2025 | 2 min read

Whose knowledge counts?  

Listening closely builds patient trust, which is fundamental to effective care. Dismissing a patient's self-reported observations, even unintentionally, erodes this trust and can prevent you from truly understanding their concerns. 

February 29, 2024 | 1 min read

“It could happen to you”

By Hayley Sparks, MD, Johns Hopkins Medicine

When talking with vaccine-hesitant patients, I bring up the recent measles outbreaks. It can be effective to use current events to motivate better compliance with immunization guidelines. 

April 1, 2019 | 3 min read

Practicing Medicine and Having a Ball

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

Hope our 2019 April Fool's piece makes you chuckle!

September 27, 2021 | 2 min read

How to Communicate Clearly About Medication Directions

By Jeffrey Millstein, MD, Penn Medicine

Always use simple language with patients when giving directions about how to take medication, and check for understanding.   

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.

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.

September 17, 2024 | 1 min read

Navigating drug shortages

By Carmen Lopez-Arvizu, MD, Johns Hopkins Medicine

In the face of drug shortages, clinicians must become proactive resource navigators. By staying informed, collaborating with patients, and exploring alternative solutions, clinicians can help mitigate the negative impact of shortages.

November 19, 2019 | 2 min read

Aging isn’t a dirty word

To many, "aging" and "old" are considered dirty words. Clinicians should fight ageism.

March 10, 2022 | 2 min read

Balanced conversations about weight

By Colleen Schreyer, PhD, Johns Hopkins Medicine

Clinicians can treat weight as simply one more piece of health information that they incorporate into a holistic care plans. This can mitigate stigma and foster empathy. 

July 10, 2018 | 1 min read

Pause Before Hospitalizing the Elderly

By Samuel Durso, MD, Johns Hopkins Medicine

Confusion among hospitalized older adults is common and dangerous. The hospital environment should be avoided if at all possible, with a goal of managing acutely ill older adults at home.

April 27, 2021 | 2 min read

Lessons Learned From Cancer During COVID

By Catherine Ling, PhD, Johns Hopkins Medicine

Encourage and support patients to schedule preventative screenings delayed during the pandemic. These are critical to ensure your patients’ health.

July 14, 2022 | 2 min read

How to Talk to Children About Gun Violence

By Carol Vidal, MD, PhD, Johns Hopkins Medicine

Give children time and space to talk about their worries and listen closely. Remember, it’s always best for children to first hear the news from a trusted adult.

May 13, 2025 | 2 min read

The unseen front line: lessons from my military deployment  

In a field hospital, one learns quickly about clear communication and thoughtful decision making. These behaviors and working collaboratively with others are just as critical across all clinical settings. 

Colorectal Cancer Awareness

February 19, 2024 | 2 min read

Mitigating colon cancer in young patients

By Ekta Gupta, MBBS, Johns Hopkins Medicine

There's and increasing risk of colon cancer in younger patients. Clinicians need to be diligent in considering the possibility of colon cancer.

March 13, 2019 | <1 min read

Dr. Elliot Fishman, A CLOSLER Look

By Gretchen Miller, Managing Editor

Artificial intelligence (AI) will drastically alter all of medicine, with the potential to enhance patient care through improved diagnoses.

September 16, 2021 | 1 min read

Recognize, Synthesize, Execute

By Harisa Spahic, Medical Student, Johns Hopkins University

Reflecting about the inspiring clinicians that I’ve shadowed, I noticed that they have a gift for synthesizing information in a way that’s clear and appropriate for the patient.

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.

December 22, 2022 | 2 min read

Bittersweet holidays

By Taryn Schuelke, MS, CT, CCLS, Texas Childrens Hospital

Many experience grief during the holidays. Make sure to acknowledge your patients’ feelings and consider encouraging them to heal through ritual. 

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