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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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January 10, 2022 | 2 min read

Being Present During The Dying Process

By Shireen Heidari, MD, Stanford University

It’s the job of all clinicians to guide patients and their loved ones through the experience of death. Offering support and being present can help them navigate the end of life. 

September 12, 2024 | 2 min read

Validating feelings 

I cared for a patient who had been rejected from a rehab facility because of her weight. I was reminded of the importance of acknowledging the patient’s emotions as part of the care plan. 

March 29, 2018 | 1 min read

Top Five Tips For Successful Community Engagement

Part II of II: Five specific strategies to gain the trust of your patient’s community, agree on health goals, and together define what success looks like.

October 24, 2022 | 1 min read

Wayfinding

By Jeffrey Millstein, MD, Penn Medicine, William Cohen, medical student, Penn Medicine

When a clinical visit begins to feel like being lost at sea, a simple inquiry about what a patient would most like to accomplish during their visit may help guide the encounter. 

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.

September 6, 2023 | 3 min read

Getting Older in Medicine

By Joanne Shay, MD, Johns Hopkins Medicine

Both of my knees need to be replaced—I already can’t wait to get back to playing pickleball. I now have renewed empathy in the OR and remind patients: “Recovery will take time. Try to be patient.” 

May 28, 2019 | 3 min read

Supporting my Patients who Smoke

It's important to make sure that the responsibility for addressing tobacco dependence is placed on the shoulders of clinicians, and off of the shoulders of the afflicted.

January 6, 2022 | 1 min read

Celebrating The Wonderful Throughout The Year

By Susan Lehmann, MD, Johns Hopkins Medicine

Reinforcing our ties with family and friends (including coworkers) is more important than ever. These connections can be an antidote to despair and anxiety. 

September 11, 2024 | 1 min read

Would you like to share a photo?  

By Jeffrey Millstein, MD, Penn Medicine

Asking patients to show photos of family, pets, or other meaningful things can help them feel more thoroughly known and cared for. This can sometimes make a visit more productive and meaningful for everyone. 

April 15, 2020 | 2 min read

Keeping Older Adults Connected

By Susan Lehmann, MD, Johns Hopkins Medicine

Social distancing can increase loneliness, especially among older adults. Finding ways to stay connected through phone and virtual visits can combat social isolation.

October 20, 2022 | 2 min read

How I Comfort Patients

By Joanne Shay, MD, Johns Hopkins Medicine

We are sometimes unable to cure our patients. We can still make them feel heard and understood, and consider what it might be like to walk in their shoes.

September 4, 2018 | 1 min read

7 Tips for Working With an Interpreter

By Stephanie Nothelle, MD, Johns Hopkins University School of Medicine

Pause often, ask one question at a time, and avoid idioms when speaking through an interpreter.

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.

August 21, 2023 | 2 min read

DO you see me? CAN you see me? 

By Mandy Hill, DrPH, MPH, UTHealth Houston, McGovern Medical School

As a part of every patient encounter, I ask myself how I can ensure that they have a positive experience. This begins with recognizing the patient as a person. 

May 21, 2019 | 3 min read

Telling People Terrible Things

By Amy Caruso Brown, MD, SUNY Upstate Medical University

Learning to break bad news gently takes time and practice, with the goal of telling the most terrible things to our patients a little bit less terrible.

December 15, 2021 | 1 min read

The Power of Humor

By Jennifer Eitingon, MD, Johns Hopkins Medicine

My dying patient taught me that laughter can sometimes normalize difficult situations. Finding humor in the problem lightened the mood and allowed us to devise a care plan that preserved her dignity.  

August 8, 2024 | 2 min read

Unspoken  

From my experience working on an inpatient psychiatry unit, I learned to look for hidden messages in the patient’s story and explore these with curiosity. Sometimes a patient’s cry for help is cloaked in other behaviors.  

March 28, 2018 | 2 min read

The Physician-Citizen—Making Health Accessible to All

Part I of II: Why being “bedside” in our patients’ communities matters.

October 13, 2022 | 1 min read

Asking Hard Questions

By Thuy Ngo, DO, MEd, Johns Hopkins Medicine

In the ED, my adolescent patient shared that she was being sexually abused. It reminded me of the importance of creating a safe space for courageous conversations. 

October 31, 2025 | 2 min read

Starting over 

Approach each patient encounter with humility and curiosity. If you misstep, apologize and invite a reset to restore trust. 

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.

July 10, 2023 | 3 min read

Dying With Peace And Joy 

By Lillie Shockney, RN, MS, Johns Hopkins Medicine

Empowering your patient to be the ultimate decision maker about all things related to the end of their life is fulfilling and meaningful for both of you. 

The author enjoying time with her beautiful family. Photo credit to the author, and used with permission.

April 18, 2019 | 1 min read

Patients Are Partners, Not Consumers

By Hala Durrah, MTA, Patient Family Engagement Advocate & Consultant, Washington, DC

My hope is that physicians, patients, and families, consider each other as partners, with mutual respect, trust, compassion, understanding, and empathy guiding and facilitating interactions and relationships.

December 1, 2021 | 1 min read

Building Bridges Between Visits

By Jeffrey Millstein, MD, Penn Medicine

Telling patients how to contact me with questions or concerns between visits improves communication and can positively impact health outcomes. 

August 7, 2024 | 2 min read

Listen, understand, empower 

Soliciting diverse perspectives and considering unexpected etiologies can improve diagnostic accuracy. Answers to clinical puzzles may be rooted in cultural and geographic specificities.

March 10, 2020 | 1 min read

Observing and Acknowledging Family Dynamics

By Kimberly Zeren, NP, Johns Hopkins Community Physicians

During your next patient encounter, take the time to observe the family dynamics. Don't be afraid to ask the difficult questions.

October 11, 2022 | 6 min read

Learning About Your Patients And Their Communities

By Hailey Haffey, PhD, University of Utah

Receiving patient and community stories with thoughtful attention can help serve the aims of equity in healthcare. 

October 29, 2025 | 2 min read

The long way home 

As my patient’s symptoms eased, our conversations evolved from medical check-ins to life planning. Including patient-defined milestones—like “safe to fly”—in the treatment plan makes healthcare more meaningful for both patients and clinicians. 

"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.

July 9, 2018 | <1 min read

On Clipping Nails

By William Greenough, MD, Johns Hopkins University School of Medicine

Making a moment for foot care creates an opportunity to bond with my patient and strengthen our relationship.

May 6, 2019 | 3 min read

When I Could not Hear my Patient

By Erin Snyder, MD, University of Alabama School of Medicine

Listening and understanding is what leads to true patient partnership, which is what is going to lead to true health.

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.

July 22, 2024 | 1 min read

The third guest—ambiguity

By Javier Rascon, MD, Mallorca, Spain

Before a specific diagnosis has been established, clear communication is paramount. Use of metaphors, reviewing what is known so far, and encouraging questions builds trust and reduces patient fear. 

March 11, 2020 | 3 min read

Saturdays With Mr. Hargett

By Yolonda Wilson, PhD, 2019-2020 Fellow at the National Humanities Center and 2019-2020 Encore Public Voices Fellow

Loneliness is an epidemic. Being aware of this, asking about it, and empathizing can make a world of difference.

October 6, 2022 | 2 min read

Repairing Trust

By Fiona Miller, medical student, UCSF, Pringl Miller, MD, San Francisco, California

Establishing rapport with each patient includes asking about previous experiences with the healthcare system. If there was a negative experience, understand that rebuilding trust may take time and commitment.  

September 29, 2025 | 1 min read

The healing pause

To connect with patients, sit at eye level, offer calm reassurance, and listen. Patients feel your steadiness before any test—presence is often the strongest initial intervention.

May 10, 2021 | 2 min read

Bearing Witness

By Jennifer Caputo-Seidler, MD, University of South Florida

During the pandemic healthcare professionals have often been the only ones present with patients at the end of life. It’s ok if you struggle to find the right words—sitting with a patient so they're not alone is enough.

June 5, 2023 | 1 min read

Saying No With Compassion And Curiosity

By Jeffrey Millstein, MD, Penn Medicine

When patients request something that is unsafe, be curious and explore their perspective before declining. This approach is collaborative and less stressful for both clinician and patient. 

April 3, 2019 | <1 min read

Dr. Lee Akst: A CLOSLER Look

By Gretchen Miller, Managing Editor

When meeting a new patient, Dr. Akst asks himself, "How can I educate and empower my patient to work with me as a team?"

November 1, 2021 | 1 min read

“Routine Visits”

By Eliana Perrin, MD, MPH, Johns Hopkins Medicine

Taking the time to explicitly welcome new patients to your clinic may help them feel comfortable. This can dramatically influence their experience.

July 17, 2024 | 1 min read

Building bridges

Some patients have strong preferences that may not align with best practices of care. Empathy, active listening, and kindness can build trust and guide patients toward making informed medical decisions.

Encourage parents to support their teens in connecting with friends in physically-distanced ways.

March 3, 2020 | 3 min read

The Power of the “Ordinary”

By Gaye Cunnane, MD, PhD, Trinity College Dublin

Excellent clinicians recognize that sometimes the opportunity to make a difference in the lives of patients comes in the most unexpected moments.

September 28, 2022 | 1 min read

The Fist Bump

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

My patient and her family showed me how to celebrate and enjoy each moment, even in the face of a terminal diagnosis. 

September 22, 2025 | 1 min read

Touchdowns, “trash talk,” and treatment 

Conversing about sports with patients and colleagues, even if you cheer for rival teams, can be a light and fun way to build connections. 

May 5, 2021 | 2 min read

Empathy Instead of Judgment

By Isaiah Crum, MD, University of Pittsburgh

Through the death of an infant patient, I was reminded of how integral being compassionate and non-judgmental is to clinical care.

May 23, 2023 | 3 min read

“Both And”

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

As the only oncologist in a small rural town, I must often care for patients who are also my friends.

June 17, 2024 | 2 min read

Beyond superficiality

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

A few minutes genuinely listening to a patient's story can make a world of difference. It can foster authentic connections and translate into enhanced trust. 

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.

September 19, 2022 | 1 min read

What I’ve Learned as an ESL Physician

By Ming-Hsien Wang, MD, Johns Hopkins Medicine

Growing up with non-English speaking parents, I know first-hand the challenges that these patients face. Being able to communicate is imperative for connecting and creating effective treatment plans. 

September 16, 2025 | 2 min read

Lessons from quiet care

True bedside presence isn’t about answers or interventions; it’s about recognizing when silence, observation, and steadfast company are the most meaningful forms of patient care.

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Stimulating healthcare professionals and trainees to reflect on giving exceptional care to every patient.

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