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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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April 14, 2022 | 1 min read

Supporting Young Adults Who Use E-Cigarettes

When talking with young patients about tobacco dependence, first create a judgment-free zone and ask open-ended questions to understand why they use the product. 

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. 

February 24, 2020 | 1 min read

“StoryCorps” Moments

By Sharon Solomon, MD, Johns Hopkins Medicine

Taking the time to listen to patients' stories validates the humanity that is integral in the practice of medicine. It also can create meaning and bring joy within the patient-clinician dyad.

February 15, 2023 | 2 min read

Speaking from my heart

By Leslie Miller, MD, Johns Hopkins Medicine

When deeply worried about the mental health of patients, make sure they feel heard, validated, and empowered.  

September 30, 2019 | 1 min read

Practicing Non-Judgement

By Sophie Lanzkron, MD, MDH, Johns Hopkins University School of Medicine

A key to persuading patients to make healthy choices is a strong therapeutic relationship.

June 10, 2021 | 3 min read

Why Perfectionism May Weaken Your Relationships With Patients

By Maureen Flood, NP, Johns Hopkins Medicine

My perfectionist tendencies weakened my relationship with a patient. Being aware of and working to overcome this habit can be helpful for patients and take pressure off healthcare professionals.

November 27, 2023 | 2 min read

When the truth (literally) hurts

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

When our patients are facing surgery or other procedures, thoughtful questions can help allay their worries.  

February 7, 2019 | 3 min read

8 Tips From a Psychiatric Emergency Nurse

By Andrea Strawther, RN, Johns Hopkins Medicine

We are all patients. The golden rule of treating others as you would like to be treated can help patients and healthcare providers build more trusting relationships.

April 5, 2022 | 1 min read

Playing “Out of Book”

By Jeffrey Millstein, MD, Penn Medicine

Unexpected statements from patients can force clinicians to improvise. As in chess, it helps to view these as challenges with potential rewards.   

March 3, 2025 | 2 min read

The power of small gestures

Actions speak louder than words. Small gestures like listening closely to patients, getting tissues, adjusting the lights, and helping them get comfortable in bed is part of giving holistic care.

February 10, 2020 | 2 min read

Engendering Trust in the Care Team

By Jeffrey Millstein, MD, Penn Medicine

Excellent clinicians help patients expand their circle of trust, beyond their favorite physician, to include more members of the healthcare team.

February 1, 2023 | 1 min read

Patience With Patients

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

Consider the challenges you experience when trying to make changes in your daily habits. Remember to praise your patient’s progress no matter how small. 

October 10, 2018 | <1 min read

Engaging With Patients’ Communities

Making time to engage with my patients' community has made all the difference in giving clinically excellent care. Enjoy my recent TED Talk, where I tell the story of my journey to connect with my patients' community in Baltimore, Maryland.

June 9, 2021 | 2 min read

How to Support Patients When Transitioning Back to “Normal”

As we move through phases of the pandemic, understanding patients’ goals and asking about their worries is paramount.

March 21, 2019 | 3 min read

Sitting with suffering

By Margaret "Molly" Hayes, MD, Harvard Medical School

Sometimes just our presence is all we can do to comfort a grieving family. It never feels like enough and it never will be, but it is something. Silence is powerful and doesn’t need to be filled with empty words. Sit with suffering and silence.

April 8, 2022 | 1 min read

“Better”

By Ben Roberts, CRNP, AGACNP-BC, ACHPN, Johns Hopkins Medicine

Using precise language can help us partner with patients in hoping for the best, without causing confusion. 

February 28, 2018 | 4 min read

Asking patients about adverse childhood experiences (archives, 2018)

By Brent Beasley, MD, University of Oklahoma

Ask. It's scary. But ask anyway.

February 5, 2020 | 2 min read

A Picture’s Worth a Thousand Words

By Rafael Llinas, MD, Johns Hopkins Medicine

The clinically excellent physician knows that sometimes talking isn't enough. When possible, sharing information with patients visually can enhance their understanding.

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. 

October 1, 2018 | 2 min read

Listening to Build Trust

By Sophie Lanzkron, MD, MDH, Johns Hopkins University School of Medicine

When I'm helping a patient who's angry about an aspect of care, the most important thing I do is listen, just sit quietly and listen. Often patients just want to be heard. Listening and repeating back their concerns lets them know they've been heard.

Many of the anti-vaccine messages aim to bring forth emotion in the public, especially fear. Remain calm when talking with patients, friends, family, and neighbors.

May 26, 2021 | 1 min read

Talking with those opposed to vaccines (archives, 2021)

When speaking with people who respond to scientific information in a challenging manner, the most critical thing to remember is to stay calm. Refrain from simply "talking over" those with whom you're in conversation.

January 9, 2019 | 1 min read

The Disease of Loneliness

By Shannon Scott-Vernaglia, MD, Mass General

In an environment pushing us ever faster, making the time to listen will often lead to better patient outcomes and greater clinician fulfillment.

"When a patient is riding the wave of anger, instead of defensively explaining your kind intention and clinical justification for decisions, validate their experience."

March 3, 2022 | 1 min read

Listening to my Patient’s Anger

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

When encountering an angry patient, validate feelings rather than becoming defensive.  

February 6, 2020 | 2 min read

Navigating Masculinity in Medicine

By Kultaj Kaleka, MD, RN, Central Michigan University

The clinically excellent physician understands that male patients may need support sharing their perspectives.

November 20, 2023 | 2 min read

Honoring indigenous culture amid serious illness

By Katie Nelson, PhD(c), MSN, RN, Johns Hopkins University School of Nursing

We must seek to understand the beliefs, rituals, and ceremonies of all patients and communities. Failing to honor these may erode trust.

February 4, 2026 | 1 min read

Spring at the bedside

A small, concrete gesture—bringing a bouquet of lilies to a patient—prompted her to share her history of trauma, enabling me to provide better care.

May 20, 2021 | 2 min read

Alleviating Your Patients’ Worries

By April Sharp, MD, Johns Hopkins Medicine

During hospitalizations, patients and families have lots of time to worry. Asking about the concerns and empathizing may be especially helpful.

November 6, 2023 | 2 min read

Believing Patients

By Chloe Lee, MD, MPH, University of Rochester

When patients share their traumatic experiences, trust that they are almost always telling the truth. We must be empathic and compassionate to build therapeutic connections.  

December 19, 2018 | <1 min read

Dr. Michael Carducci, A CLOSLER Look

By Gretchen Miller, Managing Editor

Patients with cancer are vulnerable. There are a lot of emotions associated with this diagnosis, and I want to make patients feel that they are not the disease.

March 1, 2022 | 1 min read

What to Expect When You’re Expecting (to See The Doctor)

By Jeffrey Millstein, MD, Penn Medicine

A journey through a doctor’s office visit is all too familiar to clinicians and staff, but patients may not know what to expect. Managing expectations provides reassurance and may improve the patient experience.

February 24, 2025 | 2 min read

Listening to find answers 

By Michael Albert, MD, Johns Hopkins Medicine

To more accurately arrive at the diagnosis, it is generally wise to believe patients’ recounting of their symptoms and experiences. This can result in uncovering medical conditions that are sometimes labeled as being more generalized—like anxiety—and lead to improved patient outcomes.

January 29, 2020 | 2 min read

How to Give Patients Presence

By Aidan Crowley, Medical Student, University of Pennsylvania

Leaving your own worries at the door, sitting at eye level, and listening attentively are three important ways to connect meaningfully with your patients.

June 25, 2018 | 2 min read

Identity Part II: Knowing Your Own Past

I’m not a doctor who engages with the community; rather, I’m a community member who became a doctor. This identity has helped me strengthen and maintain my relationships with my patients.

September 13, 2018 | 2 min read

The Core of Compassionate Care

By Ayelet Kuper, MD, University of Toronto

When I have trouble bringing my focus back to the patient, I remind myself that this patient was once a baby that someone held as I have held my own babies.

May 17, 2021 | 1 min read

Validating my Patient’s Despair

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

When my young patient was struggling to accept the diagnosis of leukemia, I was reminded how important validating emotions is in the giving excellent care.

February 17, 2022 | <1 min read

Throw The Heart Machine Out The Window

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

In serving patients, it is sometimes best just to listen, show respect, and withhold judgement.     

August 14, 2018 | 3 min read

Seeing Your Patients Through New Perspectives

By Patrick Hemming, MD, Duke University

We can enhance our patient care if we incorporate the perspectives of life story and behavior.

January 13, 2020 | 4 min read

You are my Sunshine

By Lingsheng Li, MD, MHS, University of California, San Franscisco

The clinically excellent clinician understands that what we say and do may matter more than what we know.

December 14, 2022 | 1 min read

Choosing The Right Words

By Jeffrey Millstein, MD, Penn Medicine, Lori Jia, medical student, Penn Medicine

Using connecting language to seek deeper understanding of patients’ concerns may add richness to clinical encounters and help them feel safe. 

May 18, 2021 | 2 min read

A Question That Transformed my Care of Patients

By Rebekah Fenton, MD, Northwestern University

Asking patients, “What are you most worried about?” can bring to light unspoken concerns and allow fears to be addressed.

October 18, 2023 | 2 min read

Have you done this before?

By Scott Lifchez, MD, Johns Hopkins Medicine

Listen for a patient’s anxiety when they ask questions about treatment. Addressing all concerns builds a trusting relationship and helps them better tolerate procedures that may initially be painful. 

December 20, 2018 | 9 min read

You’re not getting my f-ing box cutter: paradoxical ways kids ask for limits

By Hal Kronsberg, MD, Johns Hopkins University School of Medicine

The most important lesson I’ve learned as a child psychiatrist is how badly kids want limits when they’re struggling, even when they keep that wish to themselves. Kids are smart, and when we catch them breaking a rule, we need to be curious about why it happened.

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.”

August 14, 2018 | 2 min read

Have Guitar – Will Travel

By David Shih Wu, MD, Johns Hopkins Medicine

Consider how you might use your creative gifts—and your imagination—to connect more deeply with your patients and bring them joy.

January 14, 2020 | 3 min read

A Relationship Between Equals

By Madeline Rodriguez, MD, Johns Hopkins University School of Medicine

The clinically excellent practice is centered on core humanistic values rather than on efficiency or productivity.

December 7, 2022 | 4 min read

The Road to Aequanimitas

My medical training in the 80s and 90s taught me to be reserved and distant from patients. After many years in practice, I now know that they deserve a personal relationship with their doctor.  

January 6, 2026 | 2 min read

The sacred art of care 

Let compassion guide your words and touch in every encounter. Kindness and empathy earn trust while facilitating patients’ healing. 

"If I die, tell my mother I love her. If I get better, I'm going to visit her in Tennessee. She has ten acres and a farmhouse."

May 11, 2021 | 1 min read

Empathy at The End of Life

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

At the end of life, clinicians who are present and listen compassionately may be entrusted with patients’ final wishes. Attempting to honor these requests is one way to serve.

October 12, 2023 | 1 min read

A Lesson Emphasized in Brazilian Medical Training

By Thiago Mendes, MD, University of Pittsburgh

In my medical training in Brazil, I learned to live by Theodore Roosevelt’s quotation, “Nobody cares how much you know until they know how much you care." 

"I tend to think I'm above average in singing, but my family isn’t shy in telling me that I’m unskilled and unaware."

February 9, 2022 | 2 min read

How to Improve Clinician-Patient Connections, Part 4

By Christine Ko, MD, Yale University

My “fast” thoughts about a patient may not truly represent their experience. “Slow” thinking may give a more accurate picture.  

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