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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 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. 

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.    

Vibraphone. Copyright Chris Dingman.

December 5, 2019 | 2 min read

Peace—Music to Live

By Chris Dingman, vibraphonist and composer

Music with intention and sensitivity can be a powerful tool for helping the terminally ill—and others—cope with physical and emotional pain in order to find peace. Recommending this form of therapy to patients can be a valuable gift.

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 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.

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.

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.  

March 14, 2018 | 2 min read

The Power of Acknowledging Feelings

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

Recognizing and acknowledging feelings can diffuse a patient’s anxiety.

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 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. 

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. 

March 13, 2018 | 2 min read

Reading Your Patient and Changing Your Plan

By Mike Fingerhood, MD, Johns Hopkins Medicine

We usually already have an agenda set when we see patients. However, we have to be ready to improvise by reading the patient, and be open to changing our plan.

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. 

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. 

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. 

November 6, 2019 | 3 min read

Songs From Hospice

By J Lind, Dale Fellow and touring songwriter, Nashville, Tennesse

It's the details of the patient's story that transforms them into a person.

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 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 15, 2020 | 3 min read

How to talk with patients about sexual health (archives, 2020)

By Matthew Hamill, MBChB, PhD, Johns Hopkins Medicine

Sexual health can be a sensitive topic to discuss. Asking open-ended questions and allowing time for your patient’s story to unfold can create a safe space for conversations about sexual health.

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.

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. 

October 30, 2019 | 13 min read

Partnering With Parents—An Appraisal of Familial Feelings

By Monique Webber

The clinically excellent clinician understands that each family responds to and copes with chronic illness or disability differently. Being open-minded when partnering with families, and especially parents, is critical for ensuring a trusting relationship and providing support.

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 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. 

September 9, 2020 | 1 min read

We’re All in This Together

By Mike Fingerhood, MD, Johns Hopkins Medicine

With the added stress caused by the pandemic, make an extra effort to screen your patients for anxiety and depression. Empathizing about shared concerns may facilitate patient expression.

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. 

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.  

October 29, 2019 | 4 min read

Curiosity, Connection, and Comfort

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

Curiosity is an essential part of our humanity and a foundation of the doctor-patient relationship. By remaining curious, we remain faithful to the words of Hippocrates: “Cure sometimes, treat often, comfort always.”

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.  

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. 

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.

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. 

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.

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. 

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.

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.

"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 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.  

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.

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.

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. 

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.

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.

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. 

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