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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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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.  

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.

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 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.

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.

"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.

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.  

February 18, 2026 | 1 min read

How’s Spot doing?

Patients’ lives are often closely tied to their pets. Ask about them in clinic and during follow-ups to build connection.

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.

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.

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.   

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.

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.

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.

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. 

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.

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.

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. 

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.

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.

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. 

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.  

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.

"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 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.

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.

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.

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.

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.

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. 

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?"

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.

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.

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.

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.

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.

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 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." 

April 26, 2019 | 2 min read

Building Authentic Rapport

By Leslie Ordal, MSc, CGC

Building rapport is about meeting patients where they are and showing that you’re putting their concerns first. Strong rapport transforms a clinical interaction into a human interaction, which is the heart of patient-partnered 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 | 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.

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.

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.

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. 

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. 

October 2, 2023 | 4 min read

Exclamation Points And Exhalations

By Ajibike Lapite, MD, MPHTM, Texas Childrens Hospital

Even when lab results are normal, some patients may still have concerns. Take time to address their fears and worries.

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