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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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August 16, 2023 | 1 min read

The Other Medical History

By Jeffrey Millstein, MD, Penn Medicine

Learning about the history of medicine can help put current health system challenges in perspective. I was especially struck by the enduring primacy of the patient-doctor relationship. 

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,

"The Doctor's Visit," Jan Steen. Philadelphia Museum of Art. Publicly shared via the Fair Use Act.

June 15, 2021 | 4 min read

How Art History Can Improve Your Care of Patients

By Siobhan Conaty, Art History Professor, La Salle University

Focusing on visual cues from our patients can help us to better understand them. Closely looking at art is one way that a clinician can improve their observation skills.

May 3, 2022 | 5 min read

10 Pearls From Clinician Exemplars

By Ralph Hruban, MD, Johns Hopkins Medicine

We have much to learn from those who came before us. One example is working toward equity in healthcare, including fighting sexism and racism. 

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.

September 13, 2021 | 4 min read

Only Connect

By Susrutha “Sus” Kotwal, MBBS, MD, Johns Hopkins Medicine

Missing a diagnosis made me realize the value of a thorough physical exam. It can often illuminate the cause of the illness.

June 9, 2022 | 3 min read

Gender And Sexual History 2.0 

By Rebekah Fenton, MD, Northwestern University

To help LGBTQIA+ individuals feel more welcome, I introduce myself with the pronouns I use. This seems to invite them to do the same.  

March 18, 2019 | 2 min read

The Truth About Sex

By Khalil Ghanem, MD, PhD, Johns Hopkins University School of Medicine

How you phrase questions when obtaining a sexual history can mitigate the impact of social desirability bias and enhance the accuracy of the information that is obtained.

June 23, 2020 | 1 min read

Connecting Despite Physical Distance

By Carey Roesler, PA-C, Johns Hopkins Medicine

Telemedicine visits are an opportunity to hone our listening skills, thus improving the care of our patients.

December 8, 2021 | 2 min read

Hitting Home Runs in Healthcare

By Colin West, MD, PhD, Mayo Clinic

Clinicians often struggle with errors and imposter syndrome. Just like in sports, coaching helps clinical performance and promotes well-being.

WWI Battle of Verdun Cemetery, Verdun, France.

March 23, 2020 | 4 min read

Finding the Right Words—Lessons From Nurse Mary Borden

By Iro Filippaki, PhD, Johns Hopkins University School of Medicine

WWI Nurse Mary Borden's autobiography provides inspiration to search for the right words to describe our experience, and perhaps, find solace as we face the challenges of medicine.

January 27, 2021 | 2 min read

Gin And Tonic—Cultural Footprints of Disease

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

To mitigate incorrect assumptions about patients who have been infected with COVID-19, we must work to spread truths and to minimize inaccuracies—particularly those that may be shameful or demeaning.

April 14, 2022 | 3 min read

Afraid to Tell The Truth

By Kirsten Elin Smith, PhD, National Institute on Drug Abuse

When I shared with my clinician that I had previously been a heroin user, she made me feel ashamed. This taught me the importance of listening to patients with nonjudgmental curiosity. 

January 10, 2019 | 3 min read

How to Improve Your Physical Diagnostic Skills With a Digital Database

By Samuel Durso, MD, Johns Hopkins Medicine

To sharpen diagnostic skill, take a minute to cross check the physical exam against images and lab results in the electronic record - if not congruent, then why?

May 17, 2018 | 2 min read

How To Avoid Complacency in Diagnosis

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

Top tips to avoid complacency when faced with a common clinical presentation that may have an uncommon medical diagnosis.

February 12, 2019 | 6 min read

The Balancing Act: Learning to Thrive in Multipatient Environments

By Alim Pardhan, MD, McMaster University, Ken Van Dewark, MD, University of British Columbia, Teresa Chan, MD, McMaster University

We must ensure junior doctors can give one patient excellent care before asking them to balance caring for more than one patient.

November 5, 2019 | 3 min read

A Series of Biases: Murphy’s Law at Play

By Sonal Gandhi, MBBS, MD, Johns Hopkins Medicine

Biases get in the way of our clinical reasoning. When the data doesn't fit, clinically excellent providers re-examine their assumptions.

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.

Three common zebras (Equus quagga), Kruger National Park, South Africa.

August 18, 2020 | 2 min read

Zebras Are Out There

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

Looking at the big picture and verifying details will help you consider diagnoses that may be unlikely, but still possible.

February 28, 2018 | 4 min read

Asking Patients About Adverse Childhood Experiences

By Brent Beasley, MD, University of Oklahoma

Ask. It's scary. But ask anyway.

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.

July 16, 2020 | 3 min read

Being Human

By Kamala Tamarisa, MD, Southlake, Texas

When you notice that something is amiss with a patient or your reaction to them feels off, this is a clue to dig deeper. With time and enhanced trust in the doctor-patient relationship, things usually become clear.

July 12, 2022 | 1 min read

When I Doubted my Patient

By Mengyi "Zed" Zha, MD, Othello, Washington

When patients are labeled as “poor historians,” it implies that they’re not to be trusted.

Newly Renamed Black Lives Matter Plaza NW, Washington, D.C., June 2020.

June 30, 2020 | 1 min read

Learning to be Antiracist

By Ashlyn McRae, Medical Student, Johns Hopkins Medicine

We must acknowledge the ways in which we have been, and are racist. This will allow us to provide the most equitable care to all of our patients.

Serena Williams playing mixed doubles at Wimbledon, 2019. Public domain, Wikipedia. Photo by Brian Minkoff, London Pixels.

June 24, 2020 | 1 min read

3 Things You Can do to Fight Racism

By Christle Nwora, MD, Johns Hopkins Medicine

We must each take personal responsibility for educating ourselves about racism. Increasing our understanding will allow us to improve health outcomes for all of our patients.

August 3, 2020 | 1 min read

Book Review of “Elderhood”

By Michelle Gyenes, MS, Columbia Mailman School of Public Health

Ageism is a form of discrimination that contributes to poor health outcomes. To mitigate its effects, we must enact policies that address biases in ourselves, our workplaces, and our communities.

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.

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.

October 13, 2020 | 3 min read

Attending to the Story

By Mollie Marr (she/her), MD/PhD student, Oregon Health & Science University

It’s important to approach each patient with a fresh perspective. While prior diagnoses should be considered, anchoring to them introduces bias that may cloud your vision.

August 17, 2022 | 1 min read

Lessons From “A Field Guide to Getting Lost”

By David Kopacz, MD, University of Washington

Many clinicians feel burned out at some point in their careers. While this may feel disorienting, it’s possible to learn and grow from this experience.

January 15, 2020 | 1 min read

Extra Minutes

By Scott Newsome, DO, Johns Hopkins University School of Medicine

Every extra minute a clinician spends with a patient is worth it.

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.

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.

September 13, 2023 | 1 min read

Firearm Suicides on The Rise

By Katherine Hoops, MD, Johns Hopkins Medicine, Paul Nestadt, MD, Johns Hopkins Medicine

To stem the increase in self-inflicted gun deaths, we must work toward early and accurate diagnosis of mental illness, as well as advocate for better firearm laws.

September 12, 2023 | 2 min read

The Gift of Time

By Meshulam Twerski, medical student, Penn Medicine

Medical students have more time than doctors to get to know patients as people and uncover unspoken fears about their illness and treatment. 

May 19, 2022 | 2 min read

Recognizing Relapse

By Susan Lehmann, MD, Johns Hopkins Medicine

The earlier that the return of psychiatric symptoms is detected, the more quickly a patient’s mental well-being can be restored. 

February 21, 2019 | 1 min read

Substance Use Disorders in Later Life

By Mike Fingerhood, MD, Johns Hopkins Medicine

Substance use disorders in older adults often go undiagnosed because screening is frequently overlooked. Key to supporting patients to make a change is developing rapport and trust.

March 22, 2022 | 1 min read

Navigating my First Patient Death

By Elissa Abou Khalil, MD, University of Pittsburgh Medical Center

Acknowledging feelings and asking for support may help when dealing with loss.  

March 14, 2023 | 2 min read

Laughter is The Best Medicine

By Marion McCrary, MD, Duke Health

A smile, a touch, eye contact, and a jovial laugh can be a lifeline for patients in a stressful situation. 

"The practitioners who surround the student during his or her transition into the clinical world show the student how to live out out his or her oath. During this stage of formation, the trainee is simultaneously a sponge and a clay sculpture, soaking up the minutiae of the clinical environment while honing the skills that will shape his or her character as a physician."

March 1, 2021 | 4 min read

How to be an Excellent Clinical Mentor

By Aidan Crowley, Medical Student, University of Pennsylvania

Mentorship is essential to healthcare teaching, learning, and practice. Excellent mentors lead by example and guide mentees, informed by empathic listening and reflections on their own journeys.

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.

December 13, 2018 | 2 min read

Interprofessional Collaboration Improves Care

By Vineet Arora, MD, University of Chicago Medicine

Improving teamwork in hospitals is key to giving clinically excellent care to our patients.

"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.

November 9, 2021 | 3 min read

Giving Exceptional Care Without Exception

A one-liner works in comedy but leads to biases in medicine. Listening, getting to know, and learning from each patient will allow you to serve them best.

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.

October 3, 2019 | 4 min read

The Fault in our EHRs

By Jeffrey Millstein, MD, Penn Medicine

The clinically excellent clinician makes an effort to know each patient’s unique story, moving beyond the confines of the content within the EHR.

The Juneteenth Star.

June 17, 2021 | 5 min read

Lessons From 1865: What Clinicians Can Learn From Juneteenth

This weekend we can work toward unlearning inaccurate history, practice critical reflection, engage in transformative conversations, and plan to take action that will promote health equity for all patients.

June 11, 2018 | 5 min read

Caring For The Patient

By Michael Carducci, MD, Johns Hopkins University School of Medicine

An oncologist shares his inspiring clinical mission and values statement on noticing beauty and knowing his patients.

September 18, 2018 | 3 min read

No Blushing! How to Talk About Sex With All Patients

By Helene Hedian, MD, Johns Hopkins University School of Medicine

Engaging in open, nonjudgmental discussions about patients’ sexual health provides an opportunity to assess risk, screen for sexual dysfunction, provide counseling, and offer appropriate vaccinations.

January 16, 2019 | 8 min read

An Ode to the Herculean Heart

By Sam Kant, MD, Johns Hopkins University School of Medicine

"Heart: A History," elevates our appreciation of how our predecessors worked to better patient lives, as well as the psychosocial aspects of heart disease.

Our Mission

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

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