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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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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.

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. 

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.    

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. 

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 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.

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.

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.

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.

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. 

April 4, 2019 | 3 min read

Top 10 Tips for Talking With Your Patients About Food

By Roxanne Sukol, MD, Cleveland Clinic

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

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.

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,

"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.

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. 

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. 

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.

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.

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.

July 11, 2024 | 2 min read

Protecting the most vulnerable from heat-related illnesses (archives, 2024)

By Joanna Cohen, MD, Johns Hopkins Medicine

When caring for patients during heat waves, healthcare professionals should be aware of social determinants of health—like no air conditioning at home. Clinicians should know the available resources to recommend, such as cooling centers within the communities they serve. 

July 9, 2024 | 3 min read

Takeaways from the book “Progress Notes” 

By Abraham Nussbaum, MD, Denver Health

Excellent clinicians understand patients not just as bodies, but also as individuals within a community. Healthcare professionals should be trained in both for a more holistic approach to patient care. 

June 27, 2024 | 2 min read

Lessons from earlier in life: from public school teaching to doctoring  

By Tyler Mains, MD, University of California, San Francisco

I apply the principles I learned as a public school teacher to patient care: asking insightful questions, seeing the whole person, and fostering motivation for positive change. 

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.

June 17, 2024 | 2 min read

Beyond superficiality

By Eric Last, DO, Northwell Health, Wantagh, New York

A few minutes genuinely listening to a patient's story can make a world of difference. It can foster authentic connections and translate into enhanced trust. 

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.

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.

March 4, 2024 | 2 min read

Getting the diagnosis right 

By Colleen Christmas, MD, Johns Hopkins Medicine

After arriving at what you think is the diagnosis, pause and consider alternative explanations. For patient populations at high risk for misdiagnosis (women and historically marginalized groups), examine how biases might be influencing your conclusions. 

March 30, 2018 | 4 min read

An EPIC Tale

By Wilma Ferthler, MD, Rural Country Doctor, Northeast Kingdom, Vermont

A warm welcome to our new regular contributor, Dr. Wilma Ferthler, a rural country doc from the Northeast Kingdom, Vermont.

April 30, 2020 | 4 min read

Letting go of Your Agenda

By Allison Chrestensen, MPH, OTR/L

Compassionate care requires that we trust our patients to guide us.

October 17, 2023 | 1 min read

Partnering With Pharmacists in Ambulatory Care

By Heather Folz, PharmD, Notre Dame of Maryland University

Clinicians and pharmacists can work together to give holistic and comprehensive patient care. This requires understanding each other’s expertise. 

February 18, 2020 | 3 min read

4 negotiating tips from “Never Split the Difference”

By Scott Wright, MD, Johns Hopkins Medicine

We regularly negotiate with patients en route to shared decision making. Tips from Voss' book "Never Split the Difference" can improve your communications with patients.

June 1, 2023 | 3 min read

Meditations For Pride Month

By Hailey Haffey, PhD, University of Utah

LGBTQ2S+ Pride Month can provide us with a time not only to celebrate but also to reflect on questions related to shame and alliances in medicine. 

May 3, 2023 | 1 min read

Love And Loss

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

When a patient is unresponsive, loved ones may have differing ideas about the patient’s condition. We can hold these contradictions with compassion and see them as expressions of love.

November 27, 2019 | 3 min read

Clouds and Codes Aren’t Care

By Gisele Waters, PhD, Founder and President of Symbiotica Consulting

The promise of artificial intelligence is that it gives healthcare professionals the opportunity to improve the quality of care by allowing humans to focus on humans.

April 18, 2023 | 2 min read

Caring for patients who are Muslim during Ramadan (archived 2023)

By Zaina Siraj, medical student, Albany Medical College

Learn the basics about this important holiday. Ask your patients if they are fasting and how you can support their practice if medically possible. 

November 18, 2019 | 1 min read

What Characterizes the 21st Century Clinically Excellent Clinician?

By David E. Kern, MD, MPH, Johns Hopkins Medicine

The truly clinically excellent clinician of tomorrow cannot only give excellent care one-on-one to each patient they encounter. They also need to have the knowledge and skills that enable them to work collaboratively and effectively to improve the healthcare systems in which they work.

October 14, 2019 | 4 min read

The Struggle Between Occam’s Razor and Hickam’s Dictum

By Kittane "Vishnu" Vishnupriya, MBBS, Johns Hopkins Medicine

Occam's razor and Hickam's dictum are both helpful tools when engaging in diagnostic reasoning.

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.

July 1, 2019 | 1 min read

Looking Under the Hood

By Daniel Minter, MD, University of California, San Francisco

Promoting a culture of thinking out loud can demystify the process of clinical reasoning and make it accessible to all learners.

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.

March 28, 2019 | 6 min read

Integrating Psychology and Primary Care

By Benjamin Bensadon, PhD, University of Florida College of Medicine

Person-centeredness holds great potential to maximize healing in the way Osler envisioned more than a century ago. But to translate this concept clinically, psychology and medicine must come closer together. The closer we can come together, the closer we can come to Osler.  

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. 

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