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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, 2018 | 4 min read

6 things you need to know about geriatric psychiatry

By Susan Lehmann, MD, Johns Hopkins Medicine

In older adults, as in younger people, poor mental health undermines general health, quality of life, and overall functioning. Given the dearth of specialty-trained geriatric psychiatrists and geriatricians, it is crucial for all clinicians to have skills in the diagnosis and management of common mental health conditions affecting older adults.

December 4, 2024 | 2 min read

The complexities of middle age 

By Alicia Arbaje, MD, MPH, PhD, Johns Hopkins Medicine

Mid-life is a period marked by multifaceted challenges, including physical, emotional, and social stressors. By adopting a holistic approach that addresses the whole patient healthcare professionals can provide more comprehensive and effective care. 

March 6, 2018 | 2 min read

With Respect to Clinical Excellence, Age is Only a Number

By Roy Ziegelstein, MD, Johns Hopkins Medicine

With respect to clinical excellence, compassion, knowledge, diagnostic reasoning, and clinical skill are far more important than age—age is only a number.

June 10, 2024 | 2 min read

Let’s talk about sex and aging 

By Mariah Robertson, MD, Johns Hopkins Medicine

Open and inclusive questions during routine visits with older patients can improve their sexual health outcomes. 

August 3, 2020 | 1 min read

Book Review of “Elderhood”

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

Ageism is a form of discrimination that contributes to poor health outcomes. To mitigate its effects, we must enact policies that address biases in ourselves, our workplaces, and our communities.

August 9, 2018 | 4 min read

Becoming a better ally

By Mariah Robertson, MD, Johns Hopkins Medicine

LGBTQ seniors are at a significantly higher risk for health disparities and frequently withhold their gender identity or sexual orientation from their physician due to fear of being turned away or discriminated against. It is up to each of us to educate ourselves so we can be empowered to routinely ask about the sexual health of our aging patients.

November 19, 2019 | 2 min read

Aging Isn’t a Dirty Word

By Sharon Inouye, MD, MPH, Encore Public Voices Fellowship, and Marcus Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School

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

September 26, 2018 | <1 min read

Dr. Susan Lehmann: A CLOSLER Look

By Gretchen Miller, Managing Editor

Enjoy a three-minute video interview with Dr. Susan Lehmann, who shares how playing the piano helped her become adept at listening to patients while maintaining eye contact and writing notes.

March 6, 2024 | 2 min read

Both sides 

By Joanne Shay, MD, Johns Hopkins Medicine

I realized that I didn’t truly understand my patients’ pain until I experienced pain myself. This has allowed me to give even better care. 

"Letter to myself at age 12," copyright with the artisit.

January 22, 2024 | 1 min read

Letter to myself at age 12

By Ashley Minner Jones, PhD, MFA, Baltimore, MD

When I shared a work of my art at an exhibition, I was surprised how deeply people connected with it. This helped me have even more empathy and understanding for others. We all sometimes struggle with being human.

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. 

December 13, 2022 | 3 min read

Mindful Movement

By Ken Koon Wong, MD, Cleveland Clinic

Consider encouraging your patients to practice tai chi to reduce feelings of anxiety and promote relaxation.  

February 22, 2024 | 1 min read

A journey through time 

By Beatriz Rizkallah Alves, MD, Massachusetts General Hospital

As a young doctor, I cared for a centenarian. I realized that I’d never fully appreciated the complexity and challenges of aging—I now take extra time to uncover my older patients’ struggles. 

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.

May 8, 2025 | 2 min read

Lifting the resistance to strength training

Encouraging patients, especially older adults, to engage in strength training is often overlooked. Specific advice about the how and why can significantly improve uptake and may bolster their quality of life. 

June 16, 2021 | 1 min read

Why we Must Talk About E-cigarettes with Teen Patients

By Mike Fingerhood, MD, Johns Hopkins Medicine

Proactively counseling adolescents about the risks of e-cigarette use is essential. The message should acknowledge both the health implications and the pressures that they may feel from their peers.

August 14, 2019 | 3 min read

What Physics Taught me About Patient Stories

By Jeffrey Millstein, MD, Penn Medicine

As in physics, the answers are usually in plain sight. Listening to our patients with curiosity and humility will usually lead to understanding.

July 30, 2024 | 3 min read

Unplug to recharge 

By Jennifer Katzenstein, PhD, Johns Hopkins Medicine

When I engaged in a personal digital detox, I noticed my ability to focus on patients improved. Two ideas to try are setting screen-time limits and establishing tech-free zones. 

June 24, 2021 | 2 min read

How to Emotionally Support Patients Through Challenging Moments

By Rebekah Fenton, MD, Northwestern University

When I was a med student, I tried to “fix” how my patient was feeling. I learned that many patients need time to sit with their feelings and that listening empathically can be the best approach.

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. 

December 6, 2023 | 1 min read

Reality bites 

By Carolina Saldanha, MD, Massachusetts General Brigham Salem Hospital 

I constructed what I thought was a great care plan for my patient with diabetes. I later learned that he wasn’t allowed lunch breaks and had nowhere to store his insulin. I now ask the patient about their daily routine to create a realistic plan. 

January 30, 2025 | 3 min read

If bias is unconscious, what can I do about it? 

By Som Saha, MD, MPH, Johns Hopkins Medicine

We all have biases that are mostly unresectable. By practicing mindfulness, being self-aware, and building connections with patients, we can reduce the harm they might otherwise cause. 

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. 

June 13, 2022 | 1 min read

The Crooner And The Waltz

By Frank Cacace, MD, North Shore University Hospital

Music can convey feelings that are otherwise inexpressible. It can benefit the health, wellness, and healing of both patients and clinicians.

July 6, 2020 | 3 min read

Dropping Out, Surviving, or Thriving

By Jina Sinskey, MD, University of California San Francisco

The practice of medicine inherently involves intense emotional experiences. Instead of avoiding these feelings, we must embrace them if we want to grow.

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.  

May 30, 2019 | 9 min read

Confessions of a Female Doctor who Questions Gender Equity Movements Like TIME’S UP Healthcare

By Kali Cyrus, MD, MPH, Johns Hopkins Medicine

We have to embrace humility and first accept that we have biases, prejudices, and privileges in certain contexts. We must then do the hard work of recognizing when our biases show up in interactions, examine our past experiences that contributed to the development of our biases, and acknowledge the hurt that may be caused by our biases to ourselves and others. If we truly want to stop harassment and create equity, we have to do this emotional work every day. And we should do it to stop harassment and create equity for not just women, but for everyone.

September 26, 2019 | 3 min read

The Necessity of Being an Advocate

By Zackary Berger, MD, PhD, Johns Hopkins Medicine

Clinical care and advocacy are intertwined. In every clinical encounter, we should think about ways that we can advocate for our patients.

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.

October 24, 2024 | 2 min read

The heat is on: How to keep patients cool and safe 

Rising temperatures due to climate change affect patients of all ages, particularly those with chronic health conditions. Counsel patients on strategies to prevent heat-related medical complications. 

October 21, 2020 | 3 min read

Show Me

By Jared Rubenstein, MD, Baylor College of Medicine

Asking patients to share photos and videos can give clinicians a deeper understanding of their lives. This may allow us to give better person-centered care.

October 23, 2024 | 2 min read

Educated lucky: Making critical decisions without all the answers 

By Edana Mann, MD, Johns Hopkins Medicine

In critical care, we often make life-saving decisions with incomplete information. Teamwork is essential, and sometimes acting on our best-educated guess is the only option. These moments remind us of life’s fragility and the importance of trusting our instincts and each other. 

June 21, 2023 | 2 min read

Cultivating Healthy Social Media Practices

By Jennifer Katzenstein, PhD, Johns Hopkins Medicine

When discussing safe social media use, help patients to set their own boundaries around time spent online. With young people especially, discuss cyberbullying and online privacy.  

"Dreamscape." Painting by the author.

September 30, 2024 | <1 min read

Approaching the horizon 

By Jessica Berry, PhD, clinical psychologist

My painting, “Dreamscape,” represents the importance of acknowledging and addressing patients' feelings about aging and mortality.  

February 27, 2020 | 3 min read

How to Survive Medical Litigation

By Kimberly Turner, MD, Johns Hopkins Community Physicians

Even excellent clinicians can be sued for malpractice. This stressful event can be managed and overcome.

December 4, 2019 | 1 min read

The Power of Petite

By Kimberly Turner, MD, Johns Hopkins Community Physicians

Your  unique qualities and attributes allow you to interact with each of your patients in a way that only you can. Embrace what sets you apart.

March 29, 2023 | 1 min read

Remarkable Human Spirit

By Jeffrey Millstein, MD, Penn Medicine

In the aftermath of my patient’s devastating consequences of illness, his reaction was anything but what I expected.

November 9, 2021 | 3 min read

Giving Exceptional Care Without Exception

A one-liner works in comedy but leads to biases in medicine. Listening, getting to know, and learning from each patient will allow you to serve them best.

March 15, 2023 | 1 min read

Einstein’s Relativity And Patient Care

By Steve Kravet, MD, MBA, Johns Hopkins Community Physicians

Conversations about the passing of time can stimulate meaningful reflections during patient visits.  

June 12, 2024 | 3 min read

Getting serious about citrus 

By Maureen Flood, NP, Johns Hopkins Medicine

In patients with chronic conditions and socially determined health risks, remember to consider vitamin C deficiency. 

October 9, 2018 | 2 min read

Five Authors to Follow

By Sam Kant, MD, Johns Hopkins University School of Medicine

Reading for a few minutes before bedtime is a calming habit, and a great way to fit in a few words from inspiring authors to fuel your practice.

November 6, 2019 | 3 min read

Songs From Hospice

By J Lind, Dale Fellow and touring songwriter, Nashville, Tennesse

It's the details of the patient's story that transforms them into a person.

August 31, 2021 | 1 min read

Finding Common Ground

By Faisal Nawaz, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE

Connecting with patients through shared interests or hobbies can help to strengthen and deepen relationships. For many, this adds to the joy of medicine.

December 23, 2024 | 1 min read

Beyond the Grinch’s grump 

By Heather Agee, MD, Johns Hopkins Medicine

Patients exhibiting "Grinch-like" behaviors may be masking underlying trauma and vulnerability. Try an empathetic "Cindy Lou" approach to foster trust and facilitate healing. 

February 8, 2023 | 2 min read

Taking Time For Pizza

By Heather Agee, MD, Johns Hopkins Medicine

When possible, take time to share dinner with colleagues and friends. This is a gift we can give ourselves to help decrease work stress.

"I've learned that keeping a vegetable garden is worth a medicine cabinet full of pills."-Lucy Beneventi

May 24, 2023 | 3 min read

An Email Chain That Made me Smile 

By Scott Wright, MD, Johns Hopkins Medicine

Each year of life has lessons to teach us. The insights in this piece may serve as a reminder to seek out advice from those who are older, and to make time for reflection. 

January 29, 2025 | 2 min read

Addiction in older adults 

By Bethea (Annie) Kleykamp, PhD, MA, University of Maryland

Deaths in the U.S. due to tobacco and opioid-related overdose are more common among older adults from historically marginalized groups. Treatments tailored to their unique needs can help reverse this trend.

Black piece of paper with word Ageism concept.

November 16, 2023 | 3 min read

How to be anti-ageist

By Timothy Farrell, MD, University of Utah Health

Ageism can impede clinicians from eliciting what matters most to older adults. Practical strategies to oppose such sentiment can be implemented across clinical, research, and policy realms. 

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.

August 27, 2019 | 3 min read

Letting the Laughter In

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

Excellent clinicians know that laughter can be a powerful tool in enhancing communication and building trust, particularly when working with older patients.

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