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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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March 8, 2022 | 3 min read

Tips For Assessing The Intensity of Pain

By Brian Lee, MD, PhD, Johns Hopkins Medicine, David Madder, DO, Johns Hopkins Medicine

When assessing pain, we often ask patients to assign it a number between 0 and 10. Asking about the effect of pain on behavior and functional status can often give us a more meaningful understanding. 

November 3, 2021 | 2 min read

Diagnosing And Treating Pain

By Rebekah Fenton, MD, Northwestern University

Always listen to your patients and make sure that they understand that you believe their experience of pain.

January 12, 2023 | 1 min read

Pain Talk

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

Chronic pain is sometimes a challenging topic to discuss with patients. I’ve learned that the most important thing is to validate my patients’ experience of suffering. 

March 29, 2021 | 2 min read

Validating Your Patient’s Experience of Chronic Pain

By Jocelyn Fitzgerald, MD, University of Pittsburgh

We must empathize with our patients who are suffering from chronic pain. Working with them to achieve a better quality of life may be a reasonable shared goal.

September 23, 2019 | 3 min read

How to Manage Chronic Pain and Opioids

By Ryan Graddy, MD, AbsoluteCARE Medical Center, Atlanta, Georgia

Safe opioid stewardship is a key objective when managing chronic pain. Combining evidence-based strategies and compassionate care can help you to realize these goals.

Employers must cultivate a nurturing culture that supports the emotional and physical needs of their employees.

February 9, 2021 | 3 min read

How to Support Patients With Chronic Pain and Substance Use Disorder

By Juliette Perzhinsky, MD, MSc, Central Michigan University

All patients must be treated with empathy. Those suffering with chronic pain and addiction may be especially deserving of compassion.

September 5, 2019 | 2 min read

Book Review of “In Pain”

By Traci Speed, MD, PhD, Johns Hopkins University School of Medicine

Clinicians need to understand that patients' pain is real to build rapport and reassurance, which will help patients be open to the full range of treatment options.

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. 

February 6, 2024 | 2 min read

Co-bearers of suffering

By Mike McCarthy, MD, Johns Hopkins Medicine

Sometimes a patient’s pain can’t be eliminated. However, we can still walk with them as a co-bearer of suffering. 

April 21, 2021 | 2 min read

Opioid Monitoring in Primary Care

By Jeffrey Millstein, MD, Penn Medicine

Discussions about opioid use with patients must be approached with curiosity and concern, rather than suspicion. Implemented with sensitivity, opioid monitoring programs can strengthen the clinician-patient relationship.

September 21, 2023 | 1 min read

Healthcare Professionals And Fatal Overdose

By Hannah Fetting, MSN, CRNP, Johns Hopkins Medicine

Colleagues with a substance use disorder deserve the utmost compassion. We can offer nonjudgmental support, just like we do for all other conditions. 

December 18, 2023 | 1 min read

The healing power of story

By Shwetha Mudalegundi, medical student, Johns Hopkins Medicine

I used a narrative medicine technique when caring for a patient who mistrusted the healthcare system. By writing his story and reading it back to him, he understood that the care team was truly listening. 

March 13, 2025 | 1 min read

Wearing many hats 

By Jessica Park, MD, Johns Hopkins Medicine

Sharing parts of your identity, for example being a parent, may help you to connect with patients on a deeper level. Shared humanity can create a deeper relationship, which is essential for trust and service. 

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. 

"Abstract Painting (726)" 1990, Gerhard Richter, Tate Museum.

December 6, 2018 | 5 min read

Lines Blurred

By Ekene Ojukwu, MD, Johns Hopkins Medicine

Really taking care of a patient means making hard choices, saying things people don’t want to hear, and letting them decide if they will engage in their own care. At the same time, it means learning different ways of listening, looking for opportunities and strategies to trust our patients, believing their stories, and seeing them as full individuals

June 11, 2024 | 2 min read

From pizza pans to pain plans 

By Christle Nwora, MD, Johns Hopkins Medicine

For young adults transitioning to adult care, building trust and rapport is crucial. With permission, it may be helpful to continue involving parents in care plans to improve health outcomes.  

February 21, 2019 | 1 min read

Substance Use Disorders in Later Life

By Mike Fingerhood, MD, Johns Hopkins Medicine

Substance use disorders in older adults often go undiagnosed because screening is frequently overlooked. Key to supporting patients to make a change is developing rapport and trust.

April 17, 2024 | 2 min read

Kratom—the opioid-like herbal drug your patients may be using  

By Megan Buresh, MD, Johns Hopkins Medicine

Kratom use is on the rise. It is important to ask patients about use in a nonjudgmental manner. 

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.

October 19, 2021 | 2 min read

Asking About Your Patient’s Pet

By Elizabeth Steuber, MD, Johns Hopkins Medicine, Todd Brenner, MD, Johns Hopkins Medicine

Ask patients about their pets. This can build a bridge to talking about topics like functional status, home life, and family dynamics.

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. 

February 10, 2022 | 1 min read

How to Express Empathy With Humility

By Rebekah Fenton, MD, Northwestern University

To show we care, we can simply say something like, “I can’t imagine how hard this must be.”

October 19, 2023 | 2 min read

Healthcare for every body

By Stephanie Pham Van, MD, Johns Hopkins Medicine

To make healthcare more welcoming, be sensitive to how patients prefer to be described. Also, find out what tools they might need to access information, for example, voice to text transcriptions. 

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.

"Primary Colors Ascending," by Janice Greenberg.

December 17, 2024 | 5 min read

The portal paradox   

By Megan Gerber, MD, MPH, Albany Medical College

Communicating with patients electronically presents both benefits and challenges. I’ve cherished when patients have shared creative works with me—both in person and via the portal—although I recognize this may add to my message count. 

November 21, 2022 | 3 min read

The Angry Daughter

By Bill Bachman, MD, Albany Medical College

When working with patients or loved ones who are confrontational, recognize your own feelings, try to understand theirs, and know when to ask for help from colleagues. 

March 1, 2018 | 2 min read

Individualized Medicine Calls Me Back to Patient Stories

By Tom Laskow, MD, Johns Hopkins University School of Medicine

New thinking mirrors old wisdom: to understand this manifestation of disease, understand this patient.

February 4, 2021 | 2 min read

The Clinician as Patient

By Neha Pidatala, MD, New York, New York

When you’re a patient, use your medical knowledge to clearly communicate your goals of care. When treating a patient who works in healthcare, consider their unique perspective to facilitate meaningful discussions.

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. 

January 5, 2021 | 5 min read

Seeing and Healing Social Isolation

By Katherine Otto Chebly, MD, New York University

Social isolation and loneliness are established risk factors for disease and early death. Routinely asking about patients about their social support system (or lack thereof) allows us to give more effective care.

July 2, 2024 | 4 min read

Seeing

By Kamna Balhara, MD, Johns Hopkins Medicine

When patients present frequently to the ED, clinicians must make an effort to validate them as individuals. It's also important to be aware of and work to change the underlying social determinants that may drive their visits.

Clinician self-disclosure must be done thoughtfully if it is to strengthen the root of the patient-doctor relationship.

January 18, 2021 | 5 min read

The Pros and Cons of Clinician Self-disclosure

By Howard Chang, Medical Student, Johns Hopkins Medicine

Clinician self-disclosure, if done thoughtfully, may help some patients feel better understood and strengthen the patient-doctor relationship.

October 23, 2019 | 4 min read

A Tale of Two Stents

By Frank Cacace, MD, North Shore University Hospital

We are all vulnerable to cognitive biases. The clinically excellent clinician takes time to slow down and steps back when working toward the definitive diagnosis.

June 13, 2019 | 6 min read

How to Talk With a Vaccine Skeptic

By Dharushana Muthulingam, MD, Yale School of Medicine

You cannot treat those who challenge you with contempt. Conversations must be navigated with respect and compassion.

"The Starry Night," Vincent Van Gogh, 1889, Museum of Modern Art.

May 16, 2019 | 5 min read

Starry, Starry Night

By Juliette Perzhinsky, MD, MSc, Central Michigan University

There are times that as clinicians we become patients ourselves, needing compassionate care for injuries entirely unrelated to our chief complaint.

January 30, 2023 | 2 min read

What to Know About Cryotherapy

By Alexis Coslick, DO, MS, Johns Hopkins Medicine

Cryotherapy is being touted as a “cure-all” to enhance health and well-being. It may be helpful in treating some acute injuries, but will not “fix” all health concerns. 

January 16, 2019 | 8 min read

An Ode to the Herculean Heart

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

"Heart: A History," elevates our appreciation of how our predecessors worked to better patient lives, as well as the psychosocial aspects of heart disease.

July 30, 2018 | 2 min read

Stepping Forward

By Dorianne Feldman, MD, MS, Johns Hopkins University School of Medicine

There is no greater reward than the gratitude of a patient you've helped to heal.

July 27, 2023 | 2 min read

Book Review of “The Pastoral Clinic” 

By Juliana Fan, medical student, Johns Hopkins Medicine

Garcia’s ethnography highlights the need for healthcare professionals to foster hope, particularly when working with patients with opioid use disorder. Remember to be kind, patient, and positive with those who are suffering. 

April 13, 2020 | 3 min read

Social Distancing, Not Emotional Distancing

By Loveleena Virk, MD, Kaiser Permanente, Oakland Medical Center, California.

Creating space to recognize and manage feelings of helplessness is critical to prevent burnout and maintain wellness during the pandemic. We share strategies in this piece to help you cope during these challenging times.

August 17, 2022 | 2 min read

Listening to The How Can Reveal The Why

By Jeffrey Millstein, MD, Penn Medicine, Meshulam Twerski, medical student, Penn Medicine

The way patients express their reluctance to pursue screening can help uncover truths that guide meaningful conversations and build trust.   

June 13, 2022 | 3 min read

Pause, Relax, Open

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

In these politically polarizing times, we must continue to practice loving kindness toward our patients. This includes patients who share prejudiced and/or judgmental opinions with us. 

June 1, 2022 | 2 min read

“The Pause”

By Eileen Barrett, MD, MPH

Healthcare professionals give their best patient care when they are emotionally well. Making time to grieve the loss of a patient can help clinicians heal. 

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. 

April 16, 2019 | 2 min read

4 Lessons From 12 Years as a Patient-Doctor

By Julia Michie Bruckner, MD, MPH, Children\'s Hospital Colorado, University of Colorado School of Medicine

Our white coats are not shields; they could be traded in for a flimsy hospital gown at any moment. Keeping this in mind, we can think of how we want to be cared for when our time comes, and then give this level of care to others. We can honor our shared humanity and vulnerability in our practice.

March 20, 2019 | 4 min read

Social History as Story

By Colleen Farrell, MD, New York University

We cannot understand our patients’ bodies if we do not understand something about who they are as human beings,

August 31, 2018 | 1 min read

A Walk in the Woods Keeps the Doctor Away

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

The benefits of a walk outside include improved mood, self-awareness, emotional processing and regulation, attentiveness, and sense of well-being, as well as decreased feelings of stress and anxiety. 

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. 

January 22, 2025 | 2 min read

The ulcer: a window into a patient’s emotional distress 

By Margret Nassuuna, DCP, Innerspark Recovery, Naalya, Uganda

The body, a masterful storyteller, often reveals insights into a patient’s mental state. By deciphering its narratives, clinicians may also be able to better address both the mental and emotional aspects of care.

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. 

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