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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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"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.  

November 4, 2020 | 3 min read

It’s All Relative

By Elisabeth Marsh, MD, Johns Hopkins Medicine

It's essential that we approach each patient with a fresh outlook. Bringing emotions, positive or negative, from a previous clinical interaction can adversely affect the next patient.

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.

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.

June 29, 2021 | 2 min read

Making Jewelry With my Patients

By Deirdre Johnston, MBBCh, MD, Johns Hopkins Medicine

Some clinicians are lucky enough to interact with patients outside of medical encounters. In such settings, recognition of additional facets of their personalities may become evident, which will strengthen the patient-clinician relationship.

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.  

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.

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.

September 15, 2020 | 3 min read

How to talk with patients about sexual health

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 30, 2020 | 2 min read

Perspective-taking Through Poetry

By Howard Chang, Medical Student, Johns Hopkins Medicine

Creative writing may enhance our ability to recognize and understand conflicting perspectives in order to better empathize with our patients.

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 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.

June 25, 2021 | 3 min read

“Tell me About Yourself”

By Aidan Crowley, Medical Student, University of Pennsylvania

During my recent experiences interviewing for med school, I learned that the best interviewers, like the best clinicians, focused on my comfort and let our conversation flow naturally. Such prioritizations promote deeper human connections

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. 

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.

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 | 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.

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.

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. 

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?"

June 24, 2021 | 2 min read

How to Emotionally Support Patients Through Challenging Moments

By Rebekah Fenton, MD, Northwestern University

When I was a med student, I tried to “fix” how my patient was feeling. I learned that many patients need time to sit with their feelings and that listening empathically can be the best approach.

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." 

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.

February 10, 2022 | 1 min read

How to Express Empathy With Humility

By Rebekah Fenton, MD, Northwestern University

To show we care, we can simply say something like, “I can’t imagine how hard this must be.”

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.

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 7, 2022 | 4 min read

The Road to Aequanimitas

My medical training in the 80s and 90s taught me to be reserved and distant from patients. After many years in practice, I now know that they deserve a personal relationship with their doctor.  

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.

June 21, 2021 | 2 min read

Seen But Not Heard

By Nick Sawyer, MD, MBA, University of California, Davis

Some patients sense that their stories aren’t appreciated. Taking the time to sit and listen to patients can build trust and begin to restore their faith in the healthcare system.

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.

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.

"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.  

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. 

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.

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. 

January 22, 2020 | 2 min read

How to Help Patients who Feel Angry

By Leslie Miller, MD, Johns Hopkins Medicine

Asking your patient open-ended questions about how they're doing can lead to a much deeper conversation that not only illuminates the origin of their anger and suggests treatment strategies, but can also be therapeutic in itself.

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.

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 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.

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.    

November 21, 2024 | 2 min read

Building bridges with patients through writing

By Roshni Beeharry, MBBS, Kings 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.

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.

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.

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.

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 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.

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.  

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. 

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.

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.

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