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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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April 20, 2020 | 3 min read

Gender-Affirming Care During the Pandemic

By Carl G. Streed Jr., MD, MPH, Boston Medical Center, Liam Hein, PhD, RN, University of South Carolina, College of Nursing, Paula Neira, JD, MSN, RN, CEN, Johns Hopkins Medicine

Postponing procedures safeguards public health but can be distressing, particularly for transgender patients. Be proactive and transparent about access limitations during the pandemic.

March 26, 2019 | 3 min read

Tunnel Carver

By Christopher Wolfgang, MD, PhD, Johns Hopkins University School of Medicine

"Carve a tunnel of hope through the dark tunnel of disappointment." ~ Reverend Martin Luther King Jr.

March 24, 2021 | 3 min read

Life, Death, and Taxes

By William Hornberger, CPA, JD, Dallas, Texas

As a patient who’s a lawyer, I’ve learned that lawyers and doctors have more in common than you might think. Finding a professional who is humble, kind, and trustworthy can make all the difference in your experience with law and medicine.

November 28, 2018 | <1 min read

Dr. Jim Black, A CLOSLER Look

By Gretchen Miller, Managing Editor

A favorite part of my job is telling patients when they, in fact, do NOT need surgery!

October 9, 2019 | 3 min read

Return to Play

By John Wilckens, MD, Johns Hopkins Medicine

While research findings are critical for clinical decisions, they only support the human art of empathizing with and understanding your patients.

December 19, 2022 | 2 min read

Female Leaders in Surgery

By Ming-Hsien Wang, MD, Johns Hopkins Medicine

More women surgeons will increase the diversity of ideas and perspectives needed for excellent patient care. 

August 29, 2022 | 2 min read

Takeaways From “The Making of a Surgeon”

By Richard Schaefer, MD, MPH, Johns Hopkins Medicine

Reading this book while I was in training inspired me to pursue a surgical career. Rereading it years later, I’m reminded of the importance of treating all patients with dignity.  

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.

September 5, 2019 | 2 min read

Book Review of “In Pain”

By Traci Speed, MD, PhD, Johns Hopkins University School of Medicine

Clinicians need to understand that patients' pain is real to build rapport and reassurance, which will help patients be open to the full range of treatment options.

June 12, 2019 | <1 min read

Dr. Jamie Wright, A CLOSLER Look

Making the time to ensure that patients understand what you are teaching them about their bodies will help them make better decisions about their care.

October 8, 2018 | <1 min read

Alleviating Patients’ Emotional Burden

By Paul Manson, MD, Johns Hopkins University School of Medicine

My approach to clinical care involves making a dual diagnosis for each patient: identifying the problem, and understanding how that problem affects the patient psychologically and emotionally.

The author with teammates.

August 30, 2018 | 1 min read

The Importance and Psychology of Facial Expression

By Patrick Byrne, MBA, MD, Johns Hopkins University School of Medicine

Carefully noting your patient's facial expression consciously helps you "be" with your patient more effectively, to meet them where they are in their emotional state.

October 27, 2022 | 2 min read

Connections Accelerated

By Jamie Schwartz, MD, Johns Hopkins Medicine

Some clinical encounters require establishing a patient-doctor connection quickly. Providing emotional support may improve your ability to create trusting relationships. 

February 24, 2021 | 2 min read

“Make You Feel My Love”

By Amy Vinson, MD, Boston Childrens Hospital

Seeing the love in a patient’s life can be moving. It can also remind us just how important close relationships are in life.

September 19, 2022 | 1 min read

What I’ve Learned as an ESL Physician

By Ming-Hsien Wang, MD, Johns Hopkins Medicine

Growing up with non-English speaking parents, I know first-hand the challenges that these patients face. Being able to communicate is imperative for connecting and creating effective treatment plans. 

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.  

"When a patient is riding the wave of anger, instead of defensively explaining your kind intention and clinical justification for decisions, validate their experience."

March 3, 2022 | 1 min read

Listening to my Patient’s Anger

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

When encountering an angry patient, validate feelings rather than becoming defensive.  

July 13, 2021 | 1 min read

4 Things to Consider When Supporting Patients Through Difficult Times

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

When breaking the news to a mother that she had only a few weeks to live, I discovered that empathy was be the most impactful and meaningful way to serve.

The Rolling Stones in concert at the British Summer Time Festival in Hyde Park, July 6, 2013. Wikimedia, Public Domain.

January 2, 2020 | 1 min read

A Commonly Uncommon Patient

By Jeffrey Trost, MD, Johns Hopkins Medicine

Asking colleagues for help and re-reviewing data are essential in identifying clues to an accurate diagnosis.

"I was so excited to go home, be with my infant twins, sleep in my own bed, and eat homemade food."

November 30, 2020 | 2 min read

I Didn’t Know it Was You

By Rohini Harvey, MD, Baystate Health, Springfield, MA

My experience as a patient who didn’t get attention until I was identified as a physician is a reminder that every patient is important and deserves respect.

August 7, 2018 | 3 min read

When Decision-Making Isn’t Clear: A Patient-Centered Approach

By Lee Akst, MD, Johns Hopkins University School of Medicine

When faced with a difficult choice, making a Punnett's square decision-making tool with your patient might help.

November 29, 2021 | 3 min read

Being Your Patient’s Advocate

By Sabrina Chen, medical student, New York University

Some supervising physicians may occasionally seem annoyed by medical students’ questions. As a trainee, I’ve learned to speak up anyways, as my question can make the difference between life and death.

October 30, 2019 | 13 min read

Partnering With Parents—An Appraisal of Familial Feelings

By Monique Webber

The clinically excellent clinician understands that each family responds to and copes with chronic illness or disability differently. Being open-minded when partnering with families, and especially parents, is critical for ensuring a trusting relationship and providing support.

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. 

September 10, 2018 | 2 min read

Defusing Patients’ Emotional Stress

By James Black, MD, Johns Hopkins University School of Medicine

I believe it's my first responsibility to recognize my patients' emotional stress and start to defuse it. I do this by framing the ongoing issue in a way that is understandable to the patient and their family.

July 7, 2020 | 1 min read

Curbside Care

By Marianne Fingerhood, NP, Johns Hopkins Medicine

Whether seeing patients in-person or virtually, one of the most important aspects of care is the human connection.

March 22, 2018 | 7 min read

Fundamentals for Caring for Transgender Patients

By Paula Neira, JD, MSN, RN, CEN, Johns Hopkins Medicine

Improve your skills as you work to support your transgender patients and interact with your transgender colleagues.

July 9, 2018 | 2 min read

Educator, Advocate, Surgeon, and Caregiver for Life

By Matthew Weiss, MD, Johns Hopkins University School of Medicine

As a cancer surgeon, my approach to care focuses heavily on communication with patients and their loved ones. Quite simply, I treat patients as I would want to be treated myself as a patient. 

August 17, 2022 | 2 min read

Listening to The How Can Reveal The Why

By Jeffrey Millstein, MD, Penn Medicine, Meshulam Twerski, MS3, Penn Medicine

The way patients express their reluctance to pursue screening can help uncover truths that guide meaningful conversations and build trust.   

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. 

"Blue Rider," Franz Marc, 1911.

May 14, 2019 | 4 min read

Review of “Critical Crash”

By Andre Lijoi, MD, York, Pennsylvania

We all have our woundedness, and our own story is important in the context of caring for our patients. These stories and wounds operate in the background of our consciousness and we must recognize and manage them.

Wye Valley, Wales, by Taylor Purvis, October 2018.

February 28, 2019 | 2 min read

From Film School to Medical School, (Part 2 of 3)

By Margaret Chisolm, MD, Johns Hopkins Medicine

Using both words and images, John Berger and Jean Mohr's photo-essay, "A Fortunate Man," provides an intimate glimpse into the role of the doctor: ‘To cure sometimes, to relieve often, and to comfort always.’

April 2, 2019 | 5 min read

Connecting to Historical Roots

By Lee Akst, MD, Johns Hopkins University School of Medicine

There are a number of important physicians in history, and an appreciation of our past can further our quest for clinical excellence in the present.

May 24, 2018 | 2 min read

My Professional Totem

By Margaret Chisolm, MD, Johns Hopkins Medicine

A psychiatrist shares her story of how a painting by Raphael has reminded her of of why she wanted to become a doctor and what the profession of medicine is all about.

Evelyn in her nursing uniform.

December 18, 2018 | 4 min read

Evelyn’s Story

By Mariah Robertson, MD, Johns Hopkins University School of Medicine

Keeping in touch with patients and their families in the days, weeks, and months following an encounter makes the practice of medicine meaningful and rewarding.

May 14, 2020 | 3 min read

Stay at Home When Possible as Restrictions Ease

By Nina Shapiro, MD, University of California Los Angeles

It’s important to remind patients and loved ones that avoiding unnecessary socialization and travel can save lives.

August 20, 2018 | 1 min read

Giving Family-Centered Care

By Richard Redett, MD, Johns Hopkins University School of Medicine

Taking care of children means giving family-centered care, where we nurture a partnership between the family, patient, and healthcare team. 

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.

March 17, 2021 | 3 min read

Making Unconscious Bias Training Work

By Verna Monson, PhD, Minneapolis, Minnesota

To be an antiracist, you must be aware of your own biases and learn from your missteps. And remember that unconscious bias training is only a starting point for dismantling discrimination.

February 23, 2021 | 3 min read

Tips For Giving Medical Updates to Families

By Joshua Budhu, MD, Mass General

A physician’s disappointment in hearing surprises about his loved one’s condition sparked new insights on the value of regularly updating families about the patient.

December 23, 2020 | 5 min read

Holiday Rounds

By Samuel Durso, MD, Johns Hopkins Medicine

If you're called on to work through Christmas and New Year’s, there's a bright side. This is typically a quieter period and may allow more time to learn from clinically excellent role models.

Maintain eye contact with your patient if and when you're typing in the electronic medical record (EMR).

December 15, 2020 | 1 min read

Embracing the EMR

By Alice Rothchild, MD, Seattle, WA

The best gift we can give our patients is our undivided attention. Maintain eye contact with your patient if and when you’re typing in the electronic medical record during the encounter.

September 1, 2022 | 2 min read

“Ticking Time Bomb”

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

If you use a metaphor when speaking with patients, make sure to choose ones that don’t cause unnecessary alarm. 

November 2, 2020 | 4 min read

Prescription For a Healthy Future—Vote

By Deanna Behrens, MD, Advocate Children\'s Hospital, Elizabeth Mack, MD, Jenna Miller, MD, Katherine Hoops, MD, Johns Hopkins Medicine

Clinicians have a responsibility to advocate for policies that can improve the health of all. We must take our civic responsibility seriously and make a plan to vote. 

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.

September 14, 2022 | 2 min read

The Hippocratic Oath’s Reminder to be Artful

By Ming-Hsien Wang, MD, Johns Hopkins Medicine

Caring for diverse families, I remember the Hippocratic Oath: “. . . There is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.”

September 19, 2019 | 2 min read

The Importance of Partnering With Patients

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

What patients and families need is a clinician advocate who is available to listen, translate complex medical language, and support both the physical and mental health of the patient.

June 21, 2022 | 2 min read

“Can’t you put him down?”

By Ivor Berkowitz, MBBCh, MBA, Johns Hopkins Medicine

Medical decision making for critically ill patients is complicated and difficult for everyone involved. It is our responsibility to ensure that patients and families are adequately informed to make choices that align with their values.   

July 9, 2019 | 5 min read

Pain, Opioids, and the Constant Shadow of Stigma

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

When a patient reports pain, their words need to be met with listening, compassion, and a discussion of how best to address the pain.

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.

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