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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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September 25, 2025 | 2 min read

Healing words

By using respectful, person-first language and recognizing the complex realities behind type 2 diabetes, clinicians can avoid stigma. This may also foster trust, empower patients, and improve outcomes. 

October 2, 2019 | 2 min read

Partnering With Patients to Prevent Diabetes

By Eva Tseng, MD, MPH, Johns Hopkins Medicine

Clinically excellent clinicians effectively counsel and motivate patients to prevent diabetes. Setting specific goals for lifestyle changes, referring to evidence-based Diabetes Prevention Programs, and scheduling timely follow-up visits are among the tips outlined.

Can I have some?

March 28, 2023 | 2 min read

A Prevention Partnership

By Eliana Perrin, MD, MPH, Johns Hopkins Medicine

Obesity is a complex disease that can be hard to treat. Promoting healthy lifestyles while preserving and honoring cultural and family traditions can start with newborns.    

December 6, 2023 | 1 min read

Reality bites 

By Carolina Saldanha, MD, Massachusetts General Brigham Salem Hospital 

I constructed what I thought was a great care plan for my patient with diabetes. I later learned that he wasn’t allowed lunch breaks and had nowhere to store his insulin. I now ask the patient about their daily routine to create a realistic plan. 

September 6, 2018 | 2 min read

The Power of Finding Common Journeys Between You and Your Patients

By Sherita Golden, MD, MHS, Johns Hopkins University School of Medicine

Our patients are deeply impacted by their community experiences outside of the healthcare setting. As physicians it is imperative that we lead by example in understanding our patients’ social challenges so that we can more comprehensively address their medical issues by treating the “whole person” and not just the disease.

March 29, 2023 | 1 min read

Remarkable Human Spirit

By Jeffrey Millstein, MD, Penn Medicine

In the aftermath of my patient’s devastating consequences of illness, his reaction was anything but what I expected.

September 18, 2024 | 2 min read

“My cotton-wool-spotted coat” 

By Victoria Holm, medical student, California University of Science and Medicine

Along with disease-knowledge, effective care for patients always requires empathy and compassion. In patients with diabetes, it’s important to recognize the unique challenges they face and the impact the disease has on their lives. 

December 28, 2018 | 3 min read

How do you measure a year?

By Dawn Harris Sherling, MD, Florida Atlantic University

How do we measure a year in medicine? I’d like to measure mine in patient laughter, hugs, and lives that were made just a little bit better.

April 14, 2022 | 1 min read

“Don’t Worry”

By Jeffrey Millstein, MD, Penn Medicine

General reassurances are often ineffective when they don’t address patients’ true concerns.

January 30, 2025 | 3 min read

If bias is unconscious, what can I do about it? 

By Som Saha, MD, MPH, Johns Hopkins Medicine

We all have biases that are mostly unresectable. By practicing mindfulness, being self-aware, and building connections with patients, we can reduce the harm they might otherwise cause. 

April 4, 2019 | 2 min read

Top tips for talking with patients about food

You are what you eat! Making the time to talk to your patients about food and nutrition can help them achieve lasting health.

The author discusses patient sleep with a colleague.

June 18, 2018 | 2 min read

How To Help Your Patients Get Better Sleep, Part I

A sleep specialist reminds us of the importance of asking patients about their sleep.

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. 

November 11, 2025 | 1 min read

Purpose shapes practice

I found more meaning in my work when I stopped treating “cases” and started seeing people. Compassionate attention became my most effective clinical tool.

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. 

May 10, 2018 | 3 min read

Truly Listen: Clinical Excellence in Nephrology

By Edward Kraus, MD, Johns Hopkins University School of Medicine

Listen to your patient, try to understand what they're saying, and think beyond policies and protocols to be the best advocate possible.

July 2, 2025 | 2 min read

Lead with listening   

When a patient’s fears and misinformation create barriers to care, start with listening and validating concerns rather than beginning with facts. Shifting the conversation to what matters to them builds trust and can open the door to effective treatment. 

May 5, 2025 | 3 min read

Pause. Process. Proceed.

To navigate the emotional aftermath of traumatic patient encounters, clinicians can utilize the ALL-CLEAR framework: Accept the event, Label emotions, Learn from it, take a moment to pause for breath, and CLEAR your mind. This may enable you to bring your whole self to the next patient while honoring your emotions. 

"While Ms. R's body seemed to work fine, her mind just didn’t cooperate. She felt like she was in a fog sitting at her desk staring at the computer screen."

February 10, 2021 | 2 min read

Supporting Patients Through Small Strokes

By Elisabeth Breese Marsh, MD, Johns Hopkins Medicine

Cognitive dysfunction is common after small strokes. Reassure your patient that symptoms will improve over time and that recovery may take several months.

December 10, 2019 | 2 min read

No Patience for Patient Violence

By Che Harris, MD, Johns Hopkins University School of Medicine

The clinically excellent clinician prepares before intervening to de-escalate patients who may be behaving aggressively.

"In the real world of practicing medicine today, we probably need to land somewhere between Occam’s razor and Hickam’s dictum."

November 19, 2025 | 4 min read

Occam’s razor and Hickam’s dictum 

When the working diagnosis doesn’t fit, think again—recheck the facts, consult a colleague, and consider concurrent disease processes. 

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.

"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.

March 20, 2019 | 4 min read

Social History as Story

By Colleen Farrell, MD, New York University

We cannot understand our patients’ bodies if we do not understand something about who they are as human beings,

November 21, 2025 | 2 min read

The promise and pitfalls of GLP-1s 

This new class of weight loss drugs is not a magic fix. Work with patients to set realistic goals, start low and titrate slowly, and counsel on GI risks. 

If a patient doesn’t appear to understand what you’re saying despite repeated efforts, ask how they learn best. Perhaps draw a diagram and/or use an analogy.

March 20, 2025 | 3 min read

Falling up 

By Emily Ma, medical student, Johns Hopkins Medicine

The transition from pediatric to adult care poses significant challenges for patients with disabilities. Healthcare professionals can help by seeking to improve access and continuity of care. 

December 18, 2019 | 3 min read

Top 5 Coffee-Drinking Tips

By Aidan Crowley, Medical Student, University of Pennsylvania

Many clinicians have a love affair with coffee. Moderation is the way to go.

June 12, 2024 | 3 min read

Getting serious about citrus 

By Maureen Flood, NP, Johns Hopkins Medicine

In patients with chronic conditions and socially determined health risks, remember to consider vitamin C deficiency. 

White Mountains, New Hampshire.

July 6, 2023 | 3 min read

Peaks And Patients

By Rishab Ramapriyan, medical student, Harvard Medical School

In medicine, as in hiking, learning to be comfortable with uncertainty is one of the most important lessons I’ve learned in my medical training. 

The author's drawing of her heart utilizing the technique of defamiliarization.

February 14, 2019 | 3 min read

Defamiliarization

By Sarah Walser, , Penn State College of Medicine

Incorporating defamiliarization into practice builds empathy and broadens our worldview. It challenges us to expand and find confluence between different frameworks through which an experience, such as a disease, can be interpreted.

June 19, 2018 | 2 min read

Sleep solutions (archives, 2018)

People see sleep as a luxury, but it's a basic human need. As clinicians, we should ask patients how they're sleeping. Here are nine things you can recommend to help them feel more rested.

December 27, 2018 | 2 min read

“Charm City” Movie Review

The upcoming film "Charm City" emphasizes that the struggles of each patient who comes to clinic extend far beyond a medical diagnosis. We must be conscious of our patients' many challenges and mindful to address them. Making time to ask about your patient's day-to-day concerns, worries, and fears about their homes, neighborhoods, and communities can help you to get a fuller perspective of their medical and social determinants of health. This will allow you to reach relevant goals of care together.

The new 2018 members of the Gold Humanism Honor Society chapter at Georgetown University School of Medicine.

June 12, 2018 | 6 min read

Transcending Quality In Pursuit of Clinical Excellence

By Jack Penner, MD

This is an excerpt of the keynote speech given by Jack Penner at the 2018 induction ceremony for the Gold Humanism Honor Society chapter at Georgetown University School of Medicine. Dr. Penner will be entering residency in Internal Medicine at UCSF as a member of the UCPC Primary Care Track.

November 26, 2018 | 1 min read

You are special – but not when it comes to sleep!

Healthcare providers are no different than anyone else - if you shortchange your sleep, there will be consequences!

February 22, 2018 | 3 min read

Family History and Addiction Risk

By Margaret Chisolm, MD, Johns Hopkins Medicine

For some patients the risk of becoming addicted to prescription opioids is extraordinarily high and may outweigh any pain control benefit.

April 11, 2022 | 6 min read

Effective Partnering With Medical Interpreters

By Cecilia Murach, Medical Interpreter, Johns Hopkins Medicine

A medical interpreter can support successful communication between limited English proficiency patients and the other clinical team members. This collaboration helps build cross-cultural connections with patients and improve care. 

March 10, 2022 | 2 min read

Balanced conversations about weight

By Colleen Schreyer, PhD, Johns Hopkins Medicine

Clinicians can treat weight as simply one more piece of health information that they incorporate into a holistic care plans. This can mitigate stigma and foster empathy. 

"I’ve relived that moment many times in my head. I wonder what I would have done differently today."

February 1, 2022 | 2 min read

Finding my Voice

By Jennifer Eitingon, MD, Johns Hopkins Medicine

As a trainee, a distressing clinical experience taught me that I must always be the patient’s advocate. Now as a teacher, I help my learners to feel confident speaking up for what they know is right. 

November 4, 2025 | 2 min read

The way we live 

Lifestyle medicine involves co-creating plans with patients for diet, physical activity, sleep, stress, and social connection. This can have an impact on both prevention and treatment of disease.

July 28, 2021 | 2 min read

4 Things You Can do to Support Patients Facing Hard News

By Rebekah Fenton, MD, Northwestern University

In medicine, we sometimes have to share horrible news. When doing so, hold the conversations in a private space, make sure the patient and family understand what you’re saying, acknowledge emotions, and answer questions.

September 18, 2025 | 3 min read

Continuity in ADHD care

Life transitions, such as starting college, can be especially challenging for patients with ADHD. Ensuring continuity of care during these times is essential.

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.

Pregnancy loss ribbon.

July 7, 2025 | 5 min read

Hemorrhaging trust 

Being a physician wasn’t enough for my symptoms to be taken seriously during a life-threatening miscarriage. It was a stark reminder that any patient—especially those without privilege—can be dangerously dismissed. Remember to acknowledge a patient’s distress and validate their experience. 

May 8, 2018 | 3 min read

Compassion is Contagious

By Colleen Christmas, MD, Johns Hopkins Medicine

Patients are observing us while we interact with others in the hospital, and this can have a tremendous impact on the trust they put in our care.

Asking about stress levels, mood, sleep quality, and coping strategies in routine medical discussions can provide insight into a patient’s emotional well-being and open the door for further discussion. 

March 31, 2025 | 2 min read

Care of the mind 

By Paige Seegan, PhD, Johns Hopkins Medicine

By proactively discussing mental health, using non-stigmatizing language, and having a list of resources on hand, healthcare professionals can help patients get the support they need. 

August 12, 2020 | 2 min read

Chief Complaint: Racism

By Syeachia Dennis, MD, University of Oklahoma

Patients are increasingly recognizing the impact of racism on their health. We should be prepared to help patients confront this and consider this core to our work to systemically address this public health crisis.

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.

July 23, 2020 | 3 min read

Stepping Back Before Moving Forward

By Moises Auron, MD, Cleveland Clinic

Considering multiple diagnostic possibilities and not anchoring on the incoming diagnosis may increase the chance of getting it right.

One way to fight ableism it to ensure that all conferences and events are wheelchair accessible.

October 14, 2020 | 2 min read

How Language Can Fight Ableism

By Harry Paul (he/him), MD/PhD student, Johns Hopkins Medicine

The first step to being an ally for the disabled community is to educate yourself about the meaning of your word choice.

The Bluebird Cafe, Nashville, Tennessee. Copyright by the author.

May 11, 2020 | 3 min read

Redefining Rounds—Will The Circle be Unbroken?

By Chase Webber, DO, Vanderbilt University Medical Center

A patient care team performs best when all voices harmonize and creative approaches are applauded.

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