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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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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.

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 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.

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.

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 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.

"My patient dreamed of walking with me at the seashore and staying up late chatting. That dream was an escape, a mental vacation, and a balm for her wounds."

April 19, 2021 | 2 min read

Let Your Patient Dream

By Zeina Moukarzel, MD, MPH, Beirut, Lebanon

From my young patient about to have all of her limbs amputated, I learned about compassion and courage.

May 17, 2023 | 2 min read

Art Cart

By Laura Castillo, pre-med, Johns Hopkins University

Arts and crafts in the hospital can provide simple joy to everyone. Sometimes a colored sheet of paper and a few well-placed folds go a long way. 

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.

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.

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 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.

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. 

August 28, 2025 | 3 min read

Listening for faith

Inquiring about patients’ spiritual lives can help us deliver more compassionate, holistic care. Noting the diversity of religiosity can help us to respect the outlook and perspectives of all patients. 

March 29, 2024 | 4 min read

Using affirming language with LGBTQIA+ patients

By Christopher Clayton, MD, New York, New York, Lila Flavin, MD, New York, New York

To show respect for patients, consider asking them about their gender identity, sexual orientation, and preferred pronouns.

May 11, 2023 | 1 min read

Life is a Rollercoaster

By Lucia Ponor, MD, MBA, Johns Hopkins Medicine

When my patient told me about how chemotherapy was affecting his family, I realized that sometimes we need to set aside medical facts and just listen. 

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.

September 30, 2021 | 1 min read

The Cancer is Back

By Anonymous Physician, Johns Hopkins Medicine

I recently lost a young patient to cancer. I was reminded that even when we cannot cure our patient’s illness, we can always show empathy and compassion.

June 5, 2024 | 2 min read

Near death

By Aurora Grutman, medical student, Johns Hopkins Medicine

Overcoming anxiety about the end of life allows one to explore concerns with empathy and openness. A willingness to learn about patients’ spiritual beliefs can help clinicians provide compassionate and holistic care.

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.

August 25, 2022 | 3 min read

Hugs Are Medicine

By Aidan Crowley, Medical Student, University of Pennsylvania

Showing genuine warmth is a compassionate way to comfort our patients. 

August 27, 2025 | 2 min read

“Did you have the baby?” 

Self-disclosure by the clinician had long been discouraged in medical training. Often, it can significantly enhance the patient-doctor relationship. 

February 11, 2021 | 6 min read

Checklists and Connections

By Neda Frayha, MD, University of Maryland

Take five minutes to connect with a patient with no medical agenda. You may be surprised by how much joy it brings both you and them.

May 10, 2023 | 1 min read

Coming Back Later

By Tetsuyuki Kawai, medical student, Texas Tech

I learned from my patient with terminal lung cancer that it’s often helpful to give time to process bad news before making a medical plan together.  

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.

Autumn leaves

October 5, 2021 | 1 min read

The Sound of Silence

By Michelle Warncke, MBBS, MSc, North Carolina

Creating silent moments when talking with patients gives them time to process and the opportunity to share concerns that may not otherwise be spoken.

May 22, 2024 | 1 min read

Why the well visit? 

By Jeffrey Millstein, MD, Penn Medicine

There is often a reason for an office visit beyond just “well-check.” It can be challenging and rewarding to skillfully create space for concerns to come out. 

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.

August 24, 2022 | 2 min read

Conversations with those who are vaccine-hesitant (archives, 2022)

By Joan Park, MD, Johns Hopkins Medicine

Talking about vaccines with patients can sometimes feel challenging. Extending empathy, sharing your own story, and being honest about potential side effects can be helpful. 

August 26, 2025 | 2 min read

A cultural safety-centric approach 

Ask patients, especially those who have been historically marginalized, if they feel safe, heard, and respected.  Take time to learn about their background and healing practices to deepen trust and improve health outcomes. 

January 14, 2021 | 2 min read

3 Strategies For Responding to Your Patient’s Experience of Loss

By Mollie Marr (she/her), MD/PhD student, Oregon Health & Science University

Even if you don’t fully understand your patient’s experience of loss, you can always listen, honor feelings, and show compassion.

May 9, 2023 | 3 min read

Interpreting Patients’ Goals

By Adela Wu, MD, Stanford Medicine

While caring for a patient who spoke a different language than I, the medical interpreter translated more than words. She also explained cultural differences that proved invaluable.

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.

"Planting The Seed of The Heart," by David Kopacz.

September 21, 2021 | 7 min read

How are you . . . really?

By David Kopacz, MD, University of Washington

A helpful practice to connect and understand your patient is to ask, "How are you doing . . . really?” If they’re hesitant to respond, consider sharing something you’ve found stressful lately to open the conversation.

April 29, 2024 | 3 min read

A patient’s reflection on connecting with clinicians—what matters most 

By Jennifer Ball, BSJ, MA, Chicago, IL

Empathy and cultural competence are cornerstones of excellent patient care. Prioritizing these values can help each patient feel respected, empowered, and supported. 

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.

August 23, 2022 | 1 min read

Supporting Patients When Their Previous Physician Has Left The Practice 

By Carol Bernstein, MD, Montefiore Medical Center, Jeffrey Millstein, MD, Penn Medicine

Thoughtful communication with new patients whose longtime clinicians have recently left positions can reduce stress and help develop rapport. 

August 6, 2025 | 1 min read

A better way to care 

A patient’s anger showed me I needed to recognize his suffering and not simply offer a diagnosis. True care means moving beyond technical skill to connect with the whole person. 

December 21, 2020 | 3 min read

Lessons From a Kitten

By Shara Nauth, MD, Western University, Ontario, Canada

Pets can prompt reflection about what it means to be human. This may strengthen our connections with patients and improve care.

"A return to 'normalcy' may be a return to challenging situations–school or workplace bullying, for example."

May 8, 2023 | 1 min read

“How are you?”

By Rheanna Platt, MD, MPH, Johns Hopkins Medicine

When asking patients and others how they are doing post-pandemic, consider opening with, “I know the transition back to ‘normal’ hasn’t been easy for everyone.” Then leave time for responses other than “fine.”  

Infectious disease physician Amash Adalja, MD, often uses car analogies to concretize abstract concepts for his patients.

December 17, 2018 | 1 min read

How to Make Abstract Concepts Concrete

By Amesh Adalja, MD, Johns Hopkins Bloomberg School of Public Health

To explain complex subjects to patients, you take an abstract concept and concretize it. This is important for patient counseling, and as a method to check your own knowledge.

"Chrysantheme und Biene." Hokusai, K. (ca. 1832). Public domain, Wikimedia.

September 22, 2021 | 8 min read

The Role of Visual Thinking Strategies Coaching in Clinical Excellence

By Margaret Chisolm, MD, Johns Hopkins Medicine

Take an appreciative approach when giving feedback to learners. It will not only build clinical skills, but will also foster a healthy community of learning and practice.

April 18, 2024 | 1 min read

Anger: a sign of trauma

By Lucia Ponor, MD, MBA, Johns Hopkins Medicine

Healthcare professionals can move beyond simply treating the physical condition by creating a safe space for patients to share traumatic experiences. 

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.

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.   

July 14, 2025 | 2 min read

Patient-directed discharge  

When a patient decides to leave the hospital earlier than advocated for by the medical team, many factors may drive their decision. Understanding their perspective and partnering on care plans can help them feel safe to stay and complete treatment. 

December 14, 2020 | 2 min read

Lessons From a Zoom Thanksgiving Applied to Patient Care

By Ambereen Mehta, MD, Johns Hopkins Medicine

Zoom made it possible for me to connect with many friends and family for Thanksgiving. Patient video visits that include family members from far away may enhance goals of care discussions.

May 4, 2023 | 2 min read

The Power of Stories

By Flora Kisuule, MD, Johns Hopkins Medicine, Scott Wright, MD, Johns Hopkins Medicine

A recent grand rounds by Dr. Kimberly Manning illuminated how stories give meaning to why we do what we do.

September 14, 2021 | 3 min read

The Healing Power of Music

By Brian Garibaldi, MD, Johns Hopkins Medicine

Connecting with a patient around a shared interest can be mutually fulfilling. For me, my guitar helps me to be present and give excellent care to patients.

April 10, 2024 | 1 min read

Toxic positivity

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

A stage 4 cancer patient taught me how constant encouragement can be emotionally draining for someone facing their mortality. Presence, love, and understanding may be better received. 

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