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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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May 29, 2018 | 2 min read

Love At First Sight

By Margaret Chisolm, MD, Johns Hopkins Medicine

A clinically excellent physician always takes the time to ask his/her patient about the history of substance use in their parents and siblings, as well as aunts, uncles, grandparents, and cousins; and always asks about adoption.

September 28, 2021 | 1 min read

Considerations When Talking With Patients About Cannabis

By Mike Fingerhood, MD, Johns Hopkins Medicine

The medical literature on cannabis use is not clear, making it difficult to know what to tell patients. Share both positives and negatives about using marijuana, and help your patient make the best care plan for them.

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.

December 11, 2019 | <1 min read

Medication for Opioid Use Disorder

By Mike Fingerhood, MD, Johns Hopkins Medicine

Building a therapeutic relationship with people with substance use disorders is critical when supporting them on their journey to health.

The author hiking on the Pacific Crest Trail. Copyright by the author.

November 17, 2023 | 5 min read

Hike Your Own Hike

By Lillian Hayes, Medical Student, Johns Hopkins University

Medical training and practice are marked by constant change, which can feel uncomfortable. Embracing discomfort as an opportunity for growth can help us to improve our care of patients.

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

June 24, 2024 | 2 min read

Partnering with patients with intellectual and developmental disabilities in medical decision-making 

By Sara Mixter, MD, MPH, Johns Hopkins Medicine

When caring for patients with intellectual and developmental disabilities, explore supported decision-making options and prioritize communication needs. These steps should offer them more control over medical choices. 

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.

Miami, FL, USA - March 23, 2024: Passing out Narcan nasal spray at the Ultra Music Festival Miami.

April 23, 2024 | 1 min read

Outside the clinic walls: making Narcan accessible to everyone

By Panagis Galiatsatos, MD, Johns Hopkins Medicine

Addiction is a chronic disease that requires a combined approach of medical treatment and community engagement. Clinicians must work to educate their community about addiction and provide them with resources like Narcan.

May 18, 2020 | 2 min read

Remembering Our Call to Medicine

By Aidan Crowley, Medical Student, University of Pennsylvania

Remembering why we chose a career in medicine can perhaps bolster our sense of well-being and mitigate burnout.

Audrey Hepburn. Photo by Bud Fraker, 1956. Public Domain.

August 24, 2020 | 4 min read

A Calling to Medicine From Hollywood

By Jade Cobern, MD, Johns Hopkins Bloomberg School of Public Health

Who ever thought watching Turner Classics could inspire a career in medicine? Reflecting on what drew you to healthcare may restore your sense of purpose.

May 21, 2020 | 1 min read

The Importance of Writing For Popular Media Outlets

By Koushik Kasanagottu, MD, Johns Hopkins Medicine

In this era of misinformation, we have a moral responsibility as physician-citizens to write for media outlets that our patients read. Sharing accurate health information with the general public can inform decision-making and improve health.

October 1, 2020 | 3 min read

3 Tips to Improve Your Body Language

By Adam Koenig, Medical Student, University of Toledo

To build a strong patient-clinician relationship, position your body with an open posture and make good eye contact.

June 25, 2018 | 2 min read

Identity Part II: Knowing Your Own Past

By Panagis Galiatsatos, MD, Johns Hopkins Medicine

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.

July 8, 2024 | 2 min read

Suturing stories 

By Andrea Merrill, MD, Boston Medical Center

By using writing to process patient care experiences, I'm able to learn from challenging events at work and find more meaning in medicine. 

September 22, 2020 | 1 min read

Voting as part of clinical excellence

By Margot Kelly-Hedrick, MD, University of Washington

Voting is a way you can advocate for your patients and improve health outcomes.

February 18, 2019 | 1 min read

A Tense Moment in the ER

By Danielle Ofri, MD, PhD, New York University School of Medicine

There are no easy solutions for conflicts of race, class, gender, societal roles, and economics. It’s only our individual work chipping away that will get us to a new place. It’s up to each of us to bring change.

January 16, 2025 | 2 min read

Talk to her 

By Uma Balachandran, medical student, Ichan School of Medicine at Mount Sinai

My blind aunt's encounter with a clinician highlighted the problem of ableism in medicine. Her experience is a reminder to always communicate directly with disabled patients and ask about their preference for identity-first or person-first language. 

October 21, 2024 | 2 min read

Micro-kindness, macro-impact

By Sadiqua Sadaf, MBBS, Deccan College of Medical Sciences, Hyderabad, India

To make others feel like they belong, practice small acts of kindness—for example, offering a warm greeting. Such efforts can significantly contribute to another's well-being.

May 1, 2019 | <1 min read

Dr. Ed Kraus, A CLOSLER Look

By Gretchen Miller, Managing Editor

"Whenever I sit with a patient, I try as hard as I can to see the world through their eyes." ~ Dr. Ed Kraus

June 1, 2021 | 2 min read

The Lifelong Journey in Professional Identity Formation

By Margot Kelly-Hedrick, MD, University of Washington

We must work toward defining our identities throughout our careers as we strive to give excellent care to every patient.

March 9, 2021 | 2 min read

Self-Compassion: A Resilience Strategy For Stressful Times

By Jennifer Hartmark-Hill, MD, University of Arizona

Cultivating self-compassion can combat stress and burnout, and improve your overall well-being.

February 26, 2024 | 2 min read

The art of medicine: lessons from shadowing 

By Aurora Grutman, medical student, Johns Hopkins Medicine

In one morning of shadowing, I learned the importance of conveying engagement with patients through both words and body language. 

"The Doctor," Sir Luke Fildes 1843-1927, Tate Museum.

December 12, 2018 | <1 min read

Dr. Ivor Berkowitz, A CLOSLER Look

By Gretchen Miller, Managing Editor

"I approach comforting my patients and their families by sitting at my patient's bedside with kindness and respect, aware of religious and cultural customs, and use a vocabulary that everyone in the family will understand."

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. 

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. 

April 16, 2020 | 1 min read

Designing Your Life in Medicine

By Lynae Conyers, MD, Johns Hopkins Medicine

Thoughtful career exploration may promote well-being and protect against burnout. Life design practices may guide you along your career journey.

A team of sled dogs works together just like a healthcare team.

March 16, 2023 | 2 min read

Communication And Collegial Care

By Howard Chang, Medical Student, Johns Hopkins Medicine

We can be more effective communicators by understanding and appreciating the expertise of all members of the healthcare team. 

December 9, 2019 | 1 min read

Presence in Final Moments

By Panagis Galiatsatos, MD, Johns Hopkins Medicine

Traditionally, we have "protected" families from witnessing abrupt or unexpected death in our hospitals. This assumption may be incorrect; offering families the chance to be present can be what is wanted and needed.

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.

"The Persistence of Memory," Salvador Dali, 1931, The Museum of Modern Art.

November 19, 2018 | 2 min read

Learning from Learners

By Margaret Chisolm, MD, Johns Hopkins Medicine

Teaching is the best way to learn. In the end, I am not only a teacher and my residents are not only learners, but we are both a little of each.

May 16, 2018 | 2 min read

The Stigma of Opioid Use Disorder

By Margaret Chisolm, MD, Johns Hopkins Medicine

Building a strong therapeutic alliance between patient and clinician—via open communication, mutual respect, and trust—is a lifeline for the individual patient with an Opioid Use Disorder.

"Corridor in the Asylum," Vincent van Gogh, 1889. The Met Museum.

March 5, 2018 | 3 min read

Demystifying Psychiatry

By Margaret Chisolm, MD, Johns Hopkins Medicine

Demystifying psychiatry for patients is the heart of my work. In its existential aspects, psychotherapy calls for the imagination of alternative possibilities.

13 Norham Gardens, the Osler's home in Oxford from 1907 until their deaths.

June 6, 2018 | 1 min read

Open Arms: The Welcoming Spirit of the Osler Residence

By Margaret Chisolm, MD, Johns Hopkins Medicine

Although we might not all live in a “substantial Victorian house” like William Osler’s, we can all embrace the welcoming spirit of “The Open Arms,” and invite more of our learners into our homes for informal meetings, mentorship, and maybe even tea.

November 14, 2023 | 3 min read

Authenticity

By Charlene Gamaldo, MD, Johns Hopkins Medicine, Rachel Salas, MD, Johns Hopkins Medicine

Bringing your full self to work is a purposeful strategy for flourishing. This may also allow you to connect more deeply with patients and colleagues. 

April 6, 2018 | 1 min read

The Human Tragedy of the Opioid Crisis

By Margaret Chisolm, MD, Johns Hopkins Medicine

Addiction impacts more than just my patient, but their entire family. And our job as doctors is—in some way—to care for all of them, to bring them in close, and to try to relieve their suffering in some way.

June 15, 2020 | 1 min read

Getting CLOSLER: A Note to Our Readers

By Margaret Chisolm, MD, Johns Hopkins Medicine, Scott Wright, MD, Johns Hopkins Medicine

For two years, CLOSLER has been stimulating healthcare professionals and trainees to reflect on giving exceptional care to every patient.

April 14, 2021 | 2 min read

Helping Parents Navigate The Return to School

By Kate Connor, MD, MSPH, Johns Hopkins Medicine, Megan Collins, MD, MPH, Johns Hopkins Medicine, Sara Johnson, PhD, MPH, Johns Hopkins Medicine

As children transition back to in-person learning, encourage parents to monitor their children’s well-being and behaviors to determine if they need more support.

The author having fun ice skating with colleagues at Patterson Park, Baltimore, Maryland.

February 25, 2019 | 5 min read

General Internal Medicine: An Opportunity to Engage Holistically

By Paul O'Rourke, MD, MPH, Johns Hopkins University School of Medicine

General internal medicine focuses on the importance of knowing and treating the whole patient. The entire patient, in their biopsychosocial context, must always be considered to provide high-quality, patient-centered care.

November 13, 2019 | 4 min read

The Art of Scaffolding Conversations

By Robert Trevino, MD, PhD, Medical College of Wisconsin

Scaffolding when communicating is meeting the other person where they are in their understanding. This is essential for healthcare discussions to best meet the needs of our patients.

October 13, 2021 | 2 min read

Social Media During The Pandemic

By Carol Vidal, MD, PhD, Johns Hopkins Medicine

While social media is contributing to increased rates of depression during the pandemic, it also keeps us socially connected during challenging times.

August 5, 2019 | 2 min read

Training and Identity

By Laura Hanyok, MD, Johns Hopkins Medicine

What parts of yourself do you want to bring back into your life that you may have lost during residency?

December 10, 2018 | 3 min read

Immigrants Should Not Have to Choose Between Health and a Green Card

By Lochan Shah, Neha Anand, Priyal Gandhi

We urge you to leverage your voice as an agent of change by submitting a comment opposing the proposed rule to the U.S. Department of Homeland Security before the deadline, TODAY, December 10, 2018. Make your voice heard so that families across the country do not have to choose between their health and their immigration status.

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.

February 11, 2020 | 2 min read

Moving Mountains

By Susan Huff, RN, MSN, Johns Hopkins Homecare Group

In end of life care, excellent clinicians can and should move mountains to get patients home if that's where they want and need to be.

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,

March 12, 2020 | 4 min read

What I learned from my primary care mentors

By Colleen Farrell, MD, New York University

All of us can learn from primary care clinicians, who know that listening, compassion, and connection are the foundations of clinical excellence.

The Baltimore Museum of Art. Wikipedia.org. Photograph by Eli Pousson, 2018 March 25.

April 7, 2020 | 3 min read

The Personal Responses Tour in Medical Education

By Howard Chang, Medical Student, Johns Hopkins Medicine

Arts-based medical education improves fundamental clinical skills, including ambiguity tolerance, reflective ability, bias awareness, and empathy. It can also enhance the well-being of healthcare professionals.

February 29, 2024 | 1 min read

“It could happen to you”

By Hayley Sparks, MD, Johns Hopkins Medicine

When talking with vaccine-hesitant patients, I bring up the recent measles outbreaks. It can be effective to use current events to motivate better compliance with immunization guidelines. 

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?

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