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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
Topic Search
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.

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.

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.

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.

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.

"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.

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.

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.

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. 

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.

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 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.

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.

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.

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.

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.

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.

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.

November 12, 2018 | 3 min read

Insights From “A Whole New Mind”

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

Daniel Pink's "A Whole New Mind" highlights the importance of cultivating empathy, humor, and the ability to create meaning.

March 1, 2018 | 2 min read

Most Physicians Sit Down at the Bedside When Entering a Patient’s Room

By Scott Wright, MD, Johns Hopkins Medicine

Choice architecture, framing, herd behavior, and feedback—how to nudge your patient towards healthier choices.

September 28, 2020 | 2 min read

Practicing the Art of Listening

By Jeffrey Millstein, MD, Penn Medicine

Listening is essential for humanistic patient care. Listening without interrupting may strengthen the patient-clinician relationship.

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.

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.

January 28, 2021 | 3 min read

Purple Nail Polish

By Shauna Maty, MPH, Medical Student, St. George University

Always remember that your patient is a person with a family, friends, and a unique story. Your first responsibility as a healthcare professional is to heal your patient and your second is to learn.

"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.

August 6, 2020 | 3 min read

5 Tips for Supporting People With Autism

By Roma Vasa, MD, Johns Hopkins Medicine

It’s critical to make time to understand how your patient communicates best, learn their strengths, empathize with their challenges, and give them as much autonomy and choice as possible.

January 21, 2021 | 1 min read

Lost in Translation

By Sonal Gandhi, MBBS, MD, Johns Hopkins Medicine

When you and your patient don’t speak the same language, clear communication is critical. When an interpreter is unavailable, reach out to staff and others for help.

July 29, 2020 | 2 min read

Jumping Into Redeployment

By Richard Schaefer, MD, MPH, Johns Hopkins Medicine

Caring for very sick patients during the pandemic can help you to reconnect with the meaning and purpose of medicine. Sign up to serve if the opportunity presents itself.

December 16, 2020 | 2 min read

The Danger of Stereotyping Specialties

By Sarah Temkin, MD, Greater Baltimore Medical Center

Clinicians must critically evaluate the stereotypes that they assign to one another. A diversity of training and backgrounds is beneficial to patient care.

Author Susan Lehmann listening and talking with one of her senior patients.

August 28, 2018 | 3 min read

6 Things You Need to Know About Geriatric Psychiatry

By Susan Lehmann, MD, Johns Hopkins Medicine

In older adults, as in younger people, poor mental health undermines general health, quality of life, and overall functioning. Given the dearth of specialty-trained geriatric psychiatrists and geriatricians, it is crucial for all clinicians to have skills in the diagnosis and management of common mental health conditions affecting older adults.

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.

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.

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