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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
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. 

July 23, 2019 | 3 min read

Engaging Care Partners in Communication

By Antonio Wolff, MD, Johns Hopkins University School of Medicine, Jennifer Aufill, BA, Johns Hopkins Bloomberg School of Public Health, Jennifer Wolff, PhD, Johns Hopkins Bloomberg School of Public Health

Families and friends are valuable resources. These partners in care can help clinicians improve quality of care and patient outcomes.

June 4, 2018 | 2 min read

Half Baked

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

Your monthly dose of comic relief from William Osler's long lost cousin Wilma Ferthler.

February 24, 2018 | 1 min read

Battling The System in Defense of Diagnosis

By Souvik Chatterjee, MD, Johns Hopkins Medicine

Healthcare delivery is at odds with a fundamental aspect of being a physician—strategic curriculum interventions are necessary to preserve the art of diagnosis.

Dingle Peninsula, County Kerry, Ireland.

March 9, 2020 | 1 min read

Embrace the Craic!

By Michelle Gyenes, MS, Columbia Mailman School of Public Health

We would all do well to be more like the Irish!

February 17, 2021 | 1 min read

How to Talk to Patients About Unnecessary Antibiotics

By Benjamin Miller, Johns Hopkins University, Sara Keller, MD, MPH, MSPH, Johns Hopkins Medicine

When talking with patients about antibiotics that are not indicated, emphasize personal potential side effects such as yeast infections and diarrhea.

July 10, 2018 | <1 min read

Better Dementia Care Through Music

By Michele Bellantoni, MD, Johns Hopkins University School of Medicine

Having your older patients listen to music can be an effective way to reduce dementia-related behavioral disturbances.

May 24, 2022 | 2 min read

The Reflexive Practitioner

By Corliss Wong, MS4, The University of Hong Kong

Our own biases and judgements inevitably affect our care of patients. Deep introspection can help us overcome our prejudices and improve clinical practice. 

March 10, 2025 | 2 min read

The B12 fix

By Selvi Rajagopal, MD, MPH, Johns Hopkins Medicine

Clinicians should remember to watch for fatigue in patients shifting to plant-based diets; a B12 test can reveal a significant, reversible cause of feeling poorly. 

"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.

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.

July 21, 2021 | 2 min read

Talking With Patients About Safe Summer Swimming

By Jade Cobern, MD, Johns Hopkins Bloomberg School of Public Health

Swimming is a summertime joy, but it is not without risk. Before patients take the plunge, they should be reminded to always swim with a buddy (never alone) and to apply sunscreen.

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. 

January 11, 2024 | 2 min read

Book review of “Changing how we think about ‘difficult’ patients”  

By Jennifer Lycette, MD, rural oncologist in the Pacific Northwest

When caring for a patient whom I found challenging, I reminded myself that my negative reaction had less to do with the patient and more to do with me.  

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.

June 25, 2018 | 2 min read

On The Professional Formation of Doctors

By Margaret Chisolm, MD, Johns Hopkins Medicine

By getting out of the business of knowledge and skills and returning to the work of professional formation, not only will medical schools and their patients win, but doctors—and the profession of medicine as a whole—will too.

January 5, 2022 | 1 min read

Bringing my nursing pearls to my doctoring (archives, 2022)

By Nina Wagner-Johnston, MD, Johns Hopkins Medicine

From my experience as a nurse, I always remember the importance of engaging the whole team. Each team member provides unique insights that can optimize the care of the patient. 

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 26, 2018 | 1 min read

A Taste of Their Own Medicine

By Scott Wright, MD, Johns Hopkins Medicine

Videos spreading misinformation to patients, promoting unproven therapies, can spread like wildfire on social media. We are sharing another video to fight fire with fire.

February 3, 2021 | 3 min read

How to Cultivate a “Friendtorship”

By Jared Rubenstein, MD, Baylor College of Medicine, Liz Salmi, OpenNotes Communications, Beth Israel Deaconess Medical Center

A “friendtorship” is an informal peer-mentor relationship between two people with shared interests but different careers. “Friendtorships” can help you develop new perspectives and ideas about your own field.

July 18, 2023 | 1 min read

Can a chatbot be a clinician’s friend?

By Adam Poliak, PhD, Bryn Mawr College, Eric Leas, PhD, Mark Dredze, PhD, Johns Hopkins University

ChatGPT can draft seemingly empathic answers to patient questions on medical portals. This may help clinicians respond more efficiently to their patients’ concerns. 

May 17, 2022 | 1 min read

Word Choice Related to Substance Use Disorders

By Beth McGinty, PhD, Johns Hopkins Medicine

Words matter; calling patients with a substance use disorder an “addict” defines them by their addiction. We need to ensure that our patients feel comfortable and supported so that they will engage in treatment.  

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.

February 27, 2025 | 2 min read

Behind the mirror: teen eating disorders 

By Jasmine Reese, MD, MPH, Johns Hopkins Medicine

You don't have to be an eating disorder specialist to make a difference; every healthcare professional can play a vital role in early intervention. Knowing local resources and showing compassion can guide patients toward recovery. 

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 13, 2022 | 2 min read

3 Tips from the ED For All Healthcare Professionals

By Rodney Omron, MD, MPH, Johns Hopkins Medicine

Sharing appreciations with colleagues and learners is your superpower. Use it. 

July 20, 2021 | 2 min read

3 lessons on clinical excellence from the oncology clinic

By Sajya Singh, Medical Student, Johns Hopkins Medicine

While shadowing clinicians in cancer care, I learned the importance of spending time to gather the family history, building trusting relationships, and balancing treatment plans with quality-of-life considerations.

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. 

January 9, 2024 | 3 min read

Dust and distrust

By Matthew Kelly, PhD, MPH, Johns Hopkins Medicine

Infection-related epidemics, like AIDS and COVID, teach us much about caring. To provide humanistic care, clinicians must continuously endeavor to assess and build trust with patients. 

November 2, 2022 | 2 min read

Psychedelics to Quit Smoking?

By Matthew Johnson, PhD, Johns Hopkins Medicine

Patients may ask about using psilocybin to stop smoking. While being actively studied, please remind them that it’s still illegal and not necessarily risk-free. 

December 21, 2021 | 4 min read

How to Make New Habits Stick, Part 2 

By Howard Chang, Medical Student, Johns Hopkins Medicine

We can build good habits in our own lives and help patients do the same by implementing the four laws of behavior change: make it obvious, make it attractive, make it easy, and make it satisfying. 

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.

July 11, 2024 | 2 min read

Protecting the most vulnerable from heat-related illnesses (archives, 2024)

By Joanna Cohen, MD, Johns Hopkins Medicine

When caring for patients during heat waves, healthcare professionals should be aware of social determinants of health—like no air conditioning at home. Clinicians should know the available resources to recommend, such as cooling centers within the communities they serve. 

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.

February 1, 2021 | 2 min read

The Emperor’s New Curtains

By Charlotte Squires, MBChB, Borders General Hospital, Scotland

Clinically excellent physicians consider the setting of private conversations with patients and families. Quiet rooms with a door that closes are ideal for sensitive discussions.

July 17, 2023 | 3 min read

Choreographing Clinical Care

By Hanghang Wang, MD, PhD, Johns Hopkins Medicine

Exceptional patient care is akin to a ballet performance. Synergistic team interactions, thoughtful decisions, and deliberate actions are all critical steps in the dance of patient care. 

May 9, 2022 | 2 min read

Talking With Patients About Their Online Research

By Rebekah Fenton, MD, Northwestern University

Patients’ online research may leave them wondering if they have a particular disease. Listen to their concerns, normalize their fears, and provide reputable resources. And remember, sometimes they’re right.  

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.

February 12, 2025 | 1 min read

Insights from the book “Decoding Greatness”

By Scott Wright, MD, Johns Hopkins Medicine

Achieving greatness in any field is not only about talent or practice; it’s also about studying the successes of those who are exemplary. In medicine, observing and analyzing the approaches of admirable colleagues can allow us to grow and evolve toward being more clinically excellent. 

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.

June 13, 2022 | 3 min read

On Wondering

By Crystal Favorito, pre-med, Johns Hopkins Medicine

To wonder is to acknowledge possibility and open the door for progress. As a pre-med, it will help me become a lifelong learner on my professional journey. 

July 22, 2021 | <1 min read

Responding Instead of Reacting

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

When confronted publicly by a colleague, I learned that it is helpful to respond calmly instead of reacting defensively. This strategy will allow us to move forward.

May 6, 2025 | 2 min read

Healing from the emotional toll of a medical error  

Mistakes in patient care are not uncommon. Clinicians can lean on their support systems to recover from stressful events at work. Taking care of yourself enables you to continue giving compassionate care. 

Treponema pallidum Syphilis bacterium, the bacterium responsible for the dangerous sexually transmitted infection, syphilis.

January 8, 2024 | 3 min read

Combatting the syphilis epidemic 

By Zach Lorenz, MD, Johns Hopkins Medicine

Rates of syphilis and other sexually transmitted infections are skyrocketing. It’s imperative that we have candid conversations with patients about their sexual behaviors. 

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.

October 17, 2022 | 2 min read

Working With The Media For The Public Good

By Maria Simbra, MD

Clinicians can communicate health messages effectively by using memorable stories to share the main message and understanding the reporter’s constraints.  

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.  

"“Hanging in there” with patients in the face of uncertainty, adversity, and conditions that are difficult to diagnose or treat is challenging for us but so appreciated by patients."

January 13, 2026 | 2 min read

Reflections on 40 years of clinical practice 

Patients notice and appreciate when we’re thorough, go the extra mile, and stick with them through the twists and turns of their medical journey. These behaviors build trust.

July 10, 2024 | 2 min read

Lessons from earlier in life: bagging groceries 

The service industry principles I learned while working in a grocery store apply to medicine. These include prioritizing customer needs, actively listening, and appreciating colleagues. 

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.

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