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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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February 25, 2025 | 3 min read

The weight of autonomy

Respecting patient autonomy means honoring their decisions even when they go against clinicians' medical judgment.

May 5, 2020 | 3 min read

Reconsidering Ethics of Home Birth During COVID-19

By Frances Wang, grad student at Johns Hopkins Bloomberg School of Public Health, George Zhang, grad student at Johns Hopkins Bloomberg School of Public Health, Marielle Gross, MD, Johns Hopkins Berman Institute of Bioethics, Sarah Frey, grad student at Johns Hopkins Medicine, Vivian Nguyen, Johns Hopkins medical student 2020

During the pandemic, many women are forced to consider alternatives to hospital births. It's vital for obstetric providers to be open to facilitating safe births regardless of the setting.

February 16, 2024 | 1 min read

Patients and politics

By Mike Fingerhood, MD, Johns Hopkins Medicine

Patient-initiated political statements may make healthcare professionals feel uncomfortable. Thoughtful strategies, like redirection, can keep the focus on patient care.

January 28, 2020 | 3 min read

Racism From Patients—an Ethical Dilemma

By Sonal Gandhi, MBBS, MD, Johns Hopkins Medicine

A cornerstone of clinical excellence is treating all patients with respect and dignity. This is true even when treating those patients who are not respectful to you.

July 22, 2020 | 4 min read

Virtue Ethics

By Awais Aftab, MD, Case Western Reserve University

Virtue ethics emphasizes the importance of self-knowledge and can help us to understand our patients in the context of the totality of their whole lives.

April 14, 2022 | 3 min read

Equity and Ethical Considerations With The Use of Psychedelics

By Ian Pocock, LICSW, Washington

Psychedelic medicines may help patients suffering with PTSD and treatment-resistant depression. As with many new therapies, ethical considerations and ensuring equal access for everyone are works in progress.

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. 

Plato, Greek philosopher. A disciple of Socrates and the teacher of Aristotle, he founded the Academy in Athens. This is his statue, located before the Academy of Athens, Greece.

June 29, 2022 | 3 min read

Being PerfecT in Healthcare 

By Mike Fingerhood, MD, Johns Hopkins Medicine, Scott Wright, MD, Johns Hopkins Medicine

Moral questions often arise in healthcare. Contemplating how our efforts might translate into the most good deserves our thoughtful consideration. 

"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. 

Employers must cultivate a nurturing culture that supports the emotional and physical needs of their employees.

February 9, 2021 | 3 min read

How to Support Patients With Chronic Pain and Substance Use Disorder

By Juliette Perzhinsky, MD, MSc, Central Michigan University

All patients must be treated with empathy. Those suffering with chronic pain and addiction may be especially deserving of compassion.

November 2, 2021 | 2 min read

What All Clinicians Must Know About End-of-Life Care

By Pringl Miller, MD, San Francisco, California

Initiating and withdrawing life-sustaining medical treatment is the patient’s or their surrogate's decision, not ours. We must always honor their wishes.

February 1, 2021 | 2 min read

The Emperor’s New Curtains

By Charlotte Squires, MBChB, Borders General Hospital, Scotland

Clinically excellent physicians consider the setting of private conversations with patients and families. Quiet rooms with a door that closes are ideal for sensitive discussions.

Clinician self-disclosure must be done thoughtfully if it is to strengthen the root of the patient-doctor relationship.

January 18, 2021 | 5 min read

The Pros and Cons of Clinician Self-disclosure

By Howard Chang, Medical Student, Johns Hopkins Medicine

Clinician self-disclosure, if done thoughtfully, may help some patients feel better understood and strengthen the patient-doctor relationship.

An example of a trompe l’oeil in a geriatric hospital setting. Copyright by the author.

January 27, 2020 | 3 min read

Ethical Dilemmas in Dementia Care Design

By Diana Anderson, MD, MArch, Clincial Geriatrics Fellow, University of California, San Francisco

Innovative dementia care designs raise moral questions about whether deception of patients is ever ethical. The clinically excellent physician tries to avoid deception at all costs.

December 19, 2023 | 3 min read

Spinoza and 21st-century medicine

By Jonathan McFarland, Medical Humanist, Autonomous University of Madrid & University of Pompeu Fabra

I learned about the mind-body connection from the philosopher Spinoza. A holistic clinical approach emphasizes the relationship between mental well-being and physical health. 

April 22, 2025 | 5 min read

Let the language live 

Daily clinical interactions, marked by honest communication and empathy, hold unique power for healing and justice. 

Many healthcare professionals make the sacrifice of quarantining from their families during the pandemic.

March 3, 2021 | 3 min read

Understanding the Sacrifices we Make in Medicine

By James Aluri, MD, Johns Hopkins Medicine

Giving excellent care to every patient requires you to make significant sacrifices. Acknowledging this can help you understand, and even accept, these sacrifices.

April 16, 2025 | 1 min read

Shared decision making 2.0

We need a new shared decision-making paradigm where all possibilities for care are out on the table, including unconventional ones. A clinician’s humility and openness are especially important now that patients are more emboldened to question the opinions of experts.

July 19, 2021 | 3 min read

Diversifying the clinician workforce (archives 2021)

By Pringl Miller, MD, San Francisco, California

Diversifying the clinician workforce is associated with improved patient satisfaction and outcomes. So, what are we waiting for?

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

May 20, 2020 | 4 min read

Lessons From Ebola Outbreaks

By Linda Mobula, MD, MPH, Johns Hopkins Medicine

Prior epidemics, like Ebola, have taught us much about caring for patients. While PPE creates a barrier between ourselves and our patients, it’s still possible to give excellent care.

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.

"Studies of the Fetus in the Womb," Leonardo da Vinci, c. 1511, Royal Collection of the British Royal Family, United Kingdom, public domain.

June 18, 2019 | 5 min read

Stepping Away From Stories

By Nadia Jajja, MBBS

Journalism and medicine have both taught me the privilege of having a voice and knowing when to use it.

June 23, 2021 | 6 min read

Aducanumab: The Clinical Wisdom of Being Conservative, Careful, And Transparent

By Constantine Lyketsos, MD, Johns Hopkins Medicine

Clinicians frequently face thorny ethical dilemmas when caring for patients. Take time to reflect on all components of these issues before discussions with patients.

"Crassula ovata," the jade plant, is a succulent that traditionally represents monetary prosperity.

October 8, 2020 | 2 min read

The Do’s and Don’ts of Discussing Monetary Donations With Patients

By Joseph Carrese, MD, MPH, Johns Hopkins Medicine

Unless patients initiate the discussion about philanthropy, it’s wise to be cautious on this topic. Such practices will preserve a trusting patient-clinician relationship.

October 12, 2022 | 1 min read

Equity and Inclusion: Beyond The Recognition Phase

By Vivian Altiery De Jesus, MD, MBE, Johns Hopkins Medicine

Increasing the diversity of minority clinicians is a first step in combatting racism in medicine. We must also ensure that curricula are free of stereotypes and bias. 

"Odysseus in front of Scylla and Charybdis." Henry Fuseli. 1794-1796. Public domain.

November 7, 2019 | 4 min read

Responsible Opioid Prescribing

By Travis Rieder, PhD, Johns Hopkins Berman Institute of Bioethics

Responsible opioid prescribing requires navigating between the Scylla of over-prescribing and the Charybdis of under-prescribing. Clinicians can work toward this goal by initiating prescriptions when (and only when) appropriate, managing them over the long-term, and knowing how to compassionately deprescribe when the time comes.

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.  

March 12, 2018 | 3 min read

13 Principles for Daily Living

By Rosalyn Stewart, MD, Johns Hopkins University School of Medicine

A primary care physician and clinician educator shares her core values for living a good life.

The Osler Club of London's Osler Coat of Arms.

June 15, 2018 | 2 min read

Osleriana

By Margaret Chisolm, MD, Johns Hopkins Medicine

Enjoy our regular contributor Margaret Chisolm's fun exploration of all things Olser.

Image by Diana Anderson.

September 16, 2019 | 2 min read

Is Hospital Design Equitable?

By Diana Anderson, MD, MArch, Clincial Geriatrics Fellow, University of California, San Francisco

Design impacts our emotions, behaviors, and overall health. To ensure design equity for all, the culture of healthcare advocates for patient-centered design, and needs to do so for spaces that affect staff.

July 2, 2019 | 5 min read

Shock, Grief, and Arrival

By Paulo Selber, MD, Columbia University

In the process of decisions regarding children’s welfare, listening to the parent’s feelings will always be the right thing to do.

June 1, 2018 | 2 min read

Fewer Assumptions, Better Care

By Carl G. Streed Jr., MD, MPH, Boston Medical Center

Assumptions may speed our diagnoses, but they hinder our interactions with our patients. Our assumptions and expectations of what a patient wants from their care can lead to missed opportunities to providing comprehensive and compassionate care.

A crowd organized by the Student Non-Violent Coordinating Committee sang “We Shall Overcome” in Farmville, Virginia, in 1966, after a speech by Stokely Carmichael.

January 18, 2019 | 9 min read

From Clinic to Senate

By Kali Cyrus, MD, MPH, Johns Hopkins Medicine

Advocacy does not have to mean changing legal precedents; it can also be taking a mentee out for coffee, giving feedback about your colleague’s stereotyping of a patient, or not patronizing restaurants with unfair wage practices.

July 27, 2021 | 3 min read

Lessons From My Experience as a Grandpa And Clinician

By Ivor Berkowitz, MBBCh, MBA, Johns Hopkins Medicine

My experience of feeling helpless through my grandchild’s illness reminded me that kindness, empathy, and honesty are central to giving clinically excellent care.

November 5, 2018 | 2 min read

Providing Holistic Care

By Nancy Hutton, MD, Johns Hopkins University School of Medicine

Excellence in clinical care requires intellectual rigor, keen observation, empathic communication, an understanding of the context in which the patient lives, and consideration of the individual patient as the center of care. 

February 28, 2018 | 3 min read

Sacred or Stigma? A New Realm of Expression

By David Efron, MD, Johns Hopkins University School of Medicine

In 2018, do not resuscitate options are broad—distillation of the letters DNR do not provide enough guidance, and tattoos have yet to be validated as a definitive expression of this wish.

March 2, 2018 | 4 min read

The Joy of Mentoring

By Ivor Berkowitz, MBBCh, MBA, Johns Hopkins Medicine

Making time to mentor a high school student can be refreshing and rejuvenating for all clinicians.

February 26, 2018 | 3 min read

Creating a welcoming experience for LGBTQ patients and families

By Carl G. Streed Jr., MD, MPH, Boston Medical Center

Doing what has been done before will only lead to more of the same for patients who have been discriminated against in society and in healthcare. Be prepared to enter uncharted territory, seek to educate yourself about the unique healthcare needs of your patients.

Gardening creates an opportunity to take a mini-rest from the world, connect with nature, and experience the healing power of plants.

April 12, 2021 | 4 min read

Making the Most of Your Daily “Nervous Breakdown”

By David Kopacz, MD, University of Washington

A century ago, a “nervous breakdown” was a socially acceptable way to just take a break and recharge. Now, it’s not. In order to refresh yourself and mitigate burnout, consider scheduling regular time off.

May 19, 2025 | 3 min read

The moral injury of divergent healthcare goals 

Moral injury can arise when there’s a tension between business goals and clinicians' mandate to serve patients. Encouraging transparency and commitment to reconverging these goals may improve understanding and lessen distress among hospital administrators, healthcare professionals, and patients.  

March 11, 2021 | 1 min read

How to Create Sanctuaries for Patients

By Michelle Ogunwole, MD, Johns Hopkins Medicine

To create safe spaces for historically marginalized patients, slow down and gather more information when conflicts arise. Be aware of your biases and give patients the benefit of the doubt.

January 26, 2021 | 2 min read

How to Talk With Patients About Misinformation

By Stephanie McGann Jantzen, Strategic & Crisis Communications Professional

Educating yourself about misinformation circulating on social media will help you talk with your patients about false claims. This may prevent dangerous behaviors and promote health.

April 8, 2025 | 3 min read

“Can you help me die?” 

By Carolyn Rennels, MD, University of San Francisco

When a patient asks about medical assistance in dying, prioritize deep listening and exploration of fears and hopes over immediate procedural responses. This can help reassure them that you’ll accompany them to the end. 

April 30, 2018 | 4 min read

The 15 Values of a Pediatric Anesthesiologist

By Ivor Berkowitz, MBBCh, MBA, Johns Hopkins Medicine

A pediatric anesthesiologist shares the 15 values that have guided his career.

March 17, 2025 | 7 min read

Caring and uncaring in medicine and beyond 

By David Kopacz, MD, University of Washington

Every moment in medicine, and in life, we have the choice to base our actions in caring.  

November 23, 2020 | 3 min read

Working With Perpetrators of Intimate Partner Violence

By Galina Portnoy, PhD, Yale School of Medicine

In addition to identifying survivors of Intimate Partner Violence (IPV), complementary efforts are needed to detect those at risk of perpetrating IPV to prevent future incidents.

March 11, 2025 | 4 min read

When sex isn’t binary 

Providing exceptional care to intersex patients requires us to shed the outdated idea of sex as a binary. Instead, we should normalize diversity in sex presentation and encourage families to unconditionally love, support, and listen to their loved one. 

"Helping Hands," by David Kopacz. Copyright with the artist.

November 3, 2020 | 4 min read

Beyond Resilience: Fighting the Causes of The Burnout Pandemic

By David Kopacz, MD, University of Washington

Clinician wellness should be a shared responsibility between individuals and institutions. Beyond facilitating clinician resilience, institutional transformation is needed.

Clinically excellent healthcare professionals maintain a growth mindset.

January 6, 2025 | 2 min read

Defining exemplary care 

By Kristopher Keppel, medical student, Johns Hopkins Medicine

Exceptional patient care requires "pragmatic empathy"—the artful blend of compassion and candor—combined with a holistic approach that considers the patient's broader life context. 

Our Mission

Stimulating healthcare professionals and trainees to reflect on giving exceptional care to every patient.

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