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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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December 16, 2025 | 1 min read

Check box vs. check-in  

Medical visits today often involve care gap inquiries. The way we ask patients about them can help transform a rote task into a curious and satisfying conversation. 

October 8, 2019 | 4 min read

Can you hear me now?

By Mariah Robertson, MD, Johns Hopkins Medicine

The onus may be on the clinically excellent doctor to overcome a the patient's disability that interferes with care. A pocket talker can make a big difference for patients with hearing impairment.

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.

"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.  

November 5, 2020 | 3 min read

Cultivating Compassion

By Aidan Crowley, Medical Student, University of Pennsylvania

Compassion—acting on the desire to relieve suffering—is central to giving clinically excellent care to those in need.

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. 

December 5, 2022 | 2 min read

The “List”

By Jeffrey Millstein, MD, Penn Medicine

Reviewing patients’ lists of concerns is an opportunity to build trust and partnership. It may also make visits more productive and satisfying for both patients and clinicians. 

"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.

December 10, 2025 | 2 min read

Beyond the signature 

Informed consent includes a patient-centered conversation grounded in their goals, not just a list of risks. Ask what matters most and address any concerns that arise. 

October 7, 2019 | 2 min read

5 Tips for Effective Shared Decision-Making

By Mary Catherine Beach, MD, MPH, Johns Hopkins Berman Institute of Bioethics

The clinically excellent physician practices effective shared decision-making with patients routinely. Select recommendations outlined include using decision aids, and establishing a relationship that is egalitarian and respectful.

September 28, 2023 | 1 min read

Out of Body 

By Jeffrey Millstein, MD, Penn Medicine

Even when clear and without excessive jargon, explanations of body processes can be confusing for some patients. Real world, non-medical analogies may be enlightening. 

February 8, 2022 | 2 min read

How to Improve Patient-Clinician Connections, Part 3

By Christine Ko, MD, Yale University

Starting each visit with a centering exercise focused on the patient may allow one to be fully present.    

August 20, 2020 | 2 min read

2 Minutes of Presence

By Zara Latif, MD, Beth Israel Deaconess Medical Center

When talking with your patient, dedicate at least two minutes to pure listening. During that time, try to not think about the next question you want to ask and just hear your patient’s perspective.

November 21, 2024 | 2 min read

Building bridges with patients through writing

By Roshni Beeharry, MBBS, University College London

Reflective journaling can be used to help us step into our patient’s shoes to understand their unique challenges. Consider experimenting with this and other forms of writing.

November 15, 2022 | 1 min read

Will I lose my hair? (from the 2022 archives)

By Lauren Rissman, MD, Advocate Childrens Hospital

Talking with my young patient about his cancer, he shared being most afraid of going bald. I learned that it’s important to acknowledge and validate all worries, including those that are not life-threatening.

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.

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.

October 1, 2019 | 4 min read

Developing a Complete Culture of Interpretation

By April Lugo, Program Coordinator, Johns Hopkins Medicine Office of Diversity and Inclusion

The clinically excellent clinician prioritizes training for themselves and their staff on the proper role of an interpreter. They work to empower interpreters to translate not only the patient's words, but also the patient's tone, cadence, and meaning.

September 26, 2023 | 2 min read

Talk Less, Listen More

By Aurora Grutman, medical student, Johns Hopkins Medicine

A conversation with a fentanyl overdose survivor taught me to listen with humble curiosity, and talk to patients thoughtfully with respect and sensitivity.

February 7, 2022 | 2 min read

How to Improve Clinician-Patient Connections, Part 2

By Christine Ko, MD, Yale University

I almost always run late in clinic. By having a growth mindset, I’ve reframed this as an opportunity to improve.  

August 5, 2020 | 2 min read

Discomfort as Your Internal Compass

By Preetha Hebbar, MPH, medical student, Medical University of South Carolina

There are situations that can make us feel uncomfortable when caring for patients. Acknowledging these feelings may result in deeper and more meaningful relationships with patients.

October 22, 2024 | 4 min read

Note to self: “Sit down and shut up” 

By William Ravekes, MD, Johns Hopkins Medicine

Sitting down demonstrates presence and creates a sense of equality in the interaction. Together with active listening and avoiding interruptions, this fosters trust and rapport. 

November 9, 2022 | 2 min read

Trust

By Joanne Shay, MD, Johns Hopkins Medicine

While caring for a four-year-old girl diagnosed with lymphoma, I learned that acknowledging and validating patient and family fears strengthens relationships.

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.

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.

September 7, 2023 | 2 min read

“That Guy”

By Maureen Flood, NP, Johns Hopkins Medicine

When caring for a patient that pushes my buttons, I remind myself that they were once an innocent baby who was loved by someone. 

"Deliberate practice is needed."

January 19, 2022 | 2 min read

Cognitive Psychology And Patient-Clinician Connections

By Christine Ko, MD, Yale University

To foster warmth toward patients, first be aware of how you’re feeling. If you're feeling burned out, you can intentionally practice cultivating a more caring attitude. 

July 17, 2020 | 1 min read

Person-Centered LGBTQ Care in the Pandemic Era

By Justin Fontenot, MSN, RN

Patient-centered care requires considering your patients’ wants and needs in their management. ALL patients deserve person-centered care.

October 9, 2024 | 2 min read

Softening the “SPIKES” 

When delivering challenging news, it is crucial to tailor the communication to the patient's preferences. Break down the message into small, spaced-out segments to allow for gradual processing. 

November 2, 2022 | 2 min read

The Last Choice

By Ivy Akid, MD, Johns Hopkins Medicine

Caring for a man dying of cancer reminded me to always guide patients toward decisions that best align with their goals of care. 

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.

September 19, 2019 | 2 min read

The Importance of Partnering With Patients

By Michael Crocetti, MD, MPH, Johns Hopkins Community Physicians

What patients and families need is a clinician advocate who is available to listen, translate complex medical language, and support both the physical and mental health of the patient.

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.” 

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. 

June 11, 2020 | 2 min read

The Power of Accompaniment

By Aidan Crowley, Medical Student, University of Pennsylvania

When there are no further treatment options available, healthcare professionals can still compassionately accompany their patients until the very end.

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. 

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. 

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.

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.

hearts

September 10, 2019 | 1 min read

3 Reasons why Shared Decision-making Matters

By Minas Chrysopoulo, MD, PMRA Plastic Surgery

When patients and clinicians arrive at a treatment plan together, patients feel more involved, confident, and satisfied with their 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. 

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. 

"Facilitate finding new ways of having fun and staying busy. Recovery is not punishment."

April 3, 2018 | 1 min read

10 tips to support patients with a substance use disorder

By Mike Fingerhood, MD, Johns Hopkins Medicine

I’ve devoted my entire career to supporting patients with substance use disorders (SUD). Here are the top 10 tips that I’ve learned over the past few decades.

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. 

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.

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.

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. 

September 3, 2019 | 2 min read

“Hand-holding”

By Colleen Leavitt, MD, Johns Hopkins Community Physicians

Personalized care softens the edges of a one-size-fits-all medical system that perpetuates inequities. For some, clinicians and the healthcare system need to be able to step-up and take actions that support their patients' health.

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. 

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.  

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