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Comment by CaliforniaKarl | Hacker News Reader

As I was reading, I started thinking, “What if all insurance plans budgeted 45 minutes for a Primary Care Provider visit instead of 15?”

(To be clear, I don’t know if ‘15 minutes’ is hard-codes anywhere, I just know that most appointments I’ve gone to are budgeted that much time.)

I say this, because of the multiple mentions of doctors spending multiple hours talking with patients.

If there was more time budgeted for PCP visits, then there would be time to have these conversations, and maybe address issues (real or perceived) before bad things happen.

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It's not a good use of a doctor's time to educate the public about how vaccines work. That is high school biology stuff. And if you didn't learn it in high school, visit the CDC website or watch a Khan Academy video or just try getting your information from somewhere outside an uneducated person's Facebook page.

That's true. But what about the people that never do take the time to educate themselves on their own? Could it be worth the extra expense to society to have a (presumably) trusted individual take a bit of time to explain some basic concepts about health?

I don't know the answer, but I do think it is an interesting question.

If they trusted the doctor, they would have gotten the vaccine already. I think doctors need to stop seeing people that refuse vaccines (I only visit provider groups whose policy is to refuse unvaccinated people), and also a government initiative to educate people about how a vaccine works and the history of its development, use, and efficacy. And removing any non medical exemptions.

We have thousands of people watching out for terrorist attacks, when the biggest biological threat is our neighbor.

That's a good point. Trust seems to be built on repeated interactions no? Could the doctor spend that time building the trust so that the education sticks?

In Germany you typically have two options to get vaccines. Generally recommended vaccines are given by any general doctors. For other vaccines, usually for traveling, you can visit a "tropical institute".

I've had extraordinary good experience with the treatment in those cases. They perform a personalized risk assessment and thoroughly inform about risks of both the vaccination and the disease.

The problem are the people who do educate themselves and after reading the CDC decide to try and get a "balanced view" and fall down an Internet hole into the antivaxx Upside Down. If they hadn't educated themselves and just done what their pediatrician recommended it wouldn't be a problem.

  decide to try and get a "balanced view"

I think this is myth. Nobody weighs opinions in search of a "balanced view" in other realms of medicine: "treat cancer, yes or no?" "Smoking bad, yes or no?" "Meth bad, yes or no?" "Splint and cast broken bone, yes or no?"

Your comment has changed several times, so i apologize if my reply is out-of-date!

The CDC web site is good, but a portion of people will say “That’s the Government” and thus be turned off. I don’t like it, but that’s the way it is, so we need to account for that (while working to change it, of course!).

As for Khan Academy, I didn’t know they had videos on this, and that’s cool! But there’s a large population who doesn’t know about it, and so won’t rank its videos any higher than other videos.

I am curious, does Khan Academy advertise on Fox News? I’m not trying to be flippant, I’m just noting that repetition breeds familiarity, and familiarity breeds trust.

Ideally, your PCP would be able to direct you to specific videos, and vouch for their content. But that might result in a conversation, and conversations take time that they don’t have. If Khan Academy was better-known among all segments of the population, then a quick pointer to one of their videos would be better-received!

I think it's the content of the sites that turns people off. I.e., it's not just the messenger, it's the message.

When I see an anti-vax website, I immediately dismiss it as just another anti-vax site.

I imagine when an anti-vax person sees a pro-vaccination site, they feel the same way "Just another pro-vax site, and it's not going to address this serious issue that I saw on the anti-vax site."

I'll accept an "appeal to authority", if I saw an anti-vax doc on the CDC's website, I'd definitely read it (critically). But since the "establishment" is so pro-vax, I suspect that the only authority an anti-vaxxer would accept is someone well known to be against vaccinations.

It might be helpful if some of the parents groups that have been steadfast against vaccinations would reverse course when their children get the measles, but sounds like they are just digging in and dismissing the risk of measles.

The primary care/family doctors I know seem to think that education and proactive counseling is very much a part of their jobs and a good use of their time.

It's not a good use of a doctor's time to educate the public about how vaccines work.

The idea that a doctor should be removed from general health care concerns seems as poisonous as just about any other other part of the modern American dysfunctional health care system.

A doctor isn't on the top of the health care system merely to provide specialized services. They are there to do exactly this, give the broad public a sense of what science, medicine and general health are. Who else can speak as authoritatively? Especially when you crackpot authorities putting out wholly destructive ideas.

I meant a academic breakdown of how they work. Evolution, probability, herd immunity, history, etc. Doctors are in short supply and if they start acting as one on one teachers for the public, how are they going to have time to treat people.

There are plenty of researchers and PhDs who are subject matter experts on vaccines who can help educate, but I don’t think it’s possible with 1 on 1 interactions.

"Doctors are in short supply and if they start acting as one on one teachers for the public, how are they going to have time to treat people."

Uh, there's no doubt doctors treat people "one on one." A significant part of a doctor's treatment of a person is proscribing a behavior. And human beings being what they are, any wanting to elicit a behavior needs to spend some time educating a person on why they should behave this way.

I'd agree that the standard for how doctors should operate has become something like what you describe - a frenetic technician rather than an educator, counselor and authority along with the technician part. I'd say that's degraded the quality of American health care, along with all the other it's been degraded.

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