Peter: Hi. I'm Peter... and this is Go Verb a Noun.

Today we're talking to Dr. Aaron Carroll from Healthcare Triage. What Dr. Carroll does is he basically demystifies healthcare issues. Anything from vaccines to whether or not sugar makes kids hyper. In a word- or in several words, he makes medicine and science accessible for people like you and me who aren't actually doctors, which I think is great.

In this first part of the interview, he is going to be talking to us about Healthcare Triage specifically, issues that the channel has faced, what it's been like doing the channel as somebody who comes from an academic perspective.

In the second part of the interview, even though he is an insider at this point, I mean he hosts Healthcare Triage, Dr. Carroll is going to give us the point of view of somebody who is, in a way, an outsider to the community. Which is really cool. And he is also going to talk to us about some of the importance of science communication. So, if this appeals to you, stick around! Now, let's get this show on the road. Okay.

Aaron: My name is Aaron Carroll. What I do is- oh god, I mean it's like there's- do you want like everything?

My name is Aaron Carroll. I am a pediatrician and a health services researcher. And, ah, that means besides going to medical school and becoming a pediatrician, I then did a fellowship and extra work and got a master's degree to also do health services research.

I spend a fairly large amount of time doing actual research, we do a lot of work with how people make decisions, we do a lot of work in looking at how we can use health information technology to improve how we care for kids, and we do a decent amount of work in health policy related areas as well. I am also an associate dean for research mentoring here at the Indiana University School of Medicine, so I, um try to help a lot of the junior faculty improve their mentorship so they can become better independent investigators as well. I do a lot of writing about health policy. We have pretty well-read blog, The Incidental Economist. I also write these days for the New York Times, at the Upshot on areas of health research and health policy. And I also have a show on YouTube, which is really why you're talking to me, uh, called Healthcare Triage, where we do very much the same thing with a lot of my writing, we talk about issues that are important for health and for health research and for health policy.

P: How did you get started with Healthcare Triage?

A: So... about a year ago almost exactly now, I was on Twitter one night, and someone tweeted at me that they had seen, oh look, John Green did a video using, you know, stuff from Aaron Carroll, two great, you know, two people he liked or whatever coming together and how exciting that was, and I was like, I have no idea what this is, what's he talking about, and I clicked though and I watched and it was John's Vlogbrothers video, on what makes the United States healthcare system cost so hard. Ah, cost so much. And a few minutes later John actually tweeted at me and said like, oh my god, I didn't know you were in Indiana, could we meet. And I was like, I'd be happy to. And so, you know, a lot of the stuff I think he'd taken from that post, he had read or used from our blog, with attribution, I mean it was all, it wasn't stolen or anything. But uh, but he was like, you know, I read -- I'm a big fan of your blog, can we uh, can I buy you a cup of coffee and thank you? And I said of course, like, who's gonna say no? Um, and so uh, we set up an appointment to have coffee at a local shop in Broad Ripple, and we talked a lot about the blog and sort of what I do, and what he was doing and what he was interested in doing. And he brought up after a while-- and we talked for a while-- they were interested in doing a new show on health policy. And would I be interested in, perhaps, working with them, and I'm like well, yes. And at this point, I swear to you, I thought I was going to, you know, my thought-- my goal for the meeting was like, maybe I could help write some episodes, maybe I could help contribute, maybe I could do something like that. He's like, no no no, we want-- basically he said they wanted me to do it. Did I wanna come back to the studio and meet Stan and see what's going on, and again, who's gonna say no? Um, and so, we walked over, and I talked with John and Stan for a while, and we thought Healthcare Triage would be great. We were talking about how we might be able to fund it or pay for it, and we threw around some ideas, and they said, let's write up some, you know, episode ideas, and stuff like that, and I left. And we sort of had plans for well, we'll work on this slowly, we'll see how it goes, we'll see if we can get some funding together. But as October 1st approached, I became convinced that we really needed to have something talking about how the Affordable Care Act would work when it... when open enrollment began that day. And so I started sending them some emails saying, maybe we should really get on board with an episode for this, uh, they agreed, they thought it would be a great idea, so we just started for that October 1st episode, wrote up a script. We did that so that would be ready to go, and then we said, you know what, we're doing this already, let's get this ready to go. I think it was in November. And we did. And that's that! It's like we've been going about weekly ever since. 

P: How do you decide what topics to cover? 

A: I would say most of them, you know, originally I came up with a big list, because we were like, we were thinking like, if we had to pitch this, we were trying to get funding or anything else. And so uh, we usually batch them in groups of three or four, um and, at this point, usually I'll either draw from the list or come up with something new. Sometimes we can really use some of the stuff I've written for other things. But usually what happens is I'll come up with a list of a few topics that I think would be interesting, I will usually pitch these to Stan and Mark, and we'll going through them every once in a-- and I'll always ask them, like "Do you guys have anything you want?" and every once in a while, they'll be like, this would be great or that would be great. But usually, it's pretty permissive (laughs). Whatever I pitch seems to go through. At which point, I'll write up the scripts, try to get them to them at least a couple of days ahead of time so they can take a look at them. And then we sort of edit them, get them ready, and go. But it's mostly, I think we -- I try to come up with, I think, most of the script at least topics, vet them with Stan or Mark and make sure that they make sense, and then we go. 

P: Are there any topics that you've chosen not to cover, and if so, why? 

A: Once or twice, there's been a topic that I think someone has said, and I swear to you, I wish I could remember, because I'd be happy to share, where I've said you know what, there just isn't good data. There's just not -- There are not good data on that. And I don't wanna therefore cover it, 'cause I don't wanna give my opinion. But there's nothing that's too controversial, I think, for us to cover. I have -- there's been a number of episodes where I've, you know, prepared myself for the barrage of hate mail. Be that, uh, you know, vaccines and autism, I was sure was gonna bring in people out of the woodwork, GMOs. Organic food. You know, these are sometimes the topics that people get riled about. But it hasn't happened. I mean, um, I don't get nearly as much hate mail from Healthcare Triage as I do from, say, CNN. Or even the New York Times. There's the group of people, I think, that watch the videos on YouTube seem to be much nicer. I don't know. It's by far the nicest group of commenters I have ever been in contact with. By far. Polite. Reasonably thoughtful. Educated. Much, so much better than... even the trolls are a whole different class of people. Um, but, there are a few things and topics where I think people have suggested it, and I have said there's just not enough data or evidence or studies to make this a Healthcare Triage topic. It would come off too much like it's my opinion. And we try to avoid that. 

P: Do you think that maybe you don't see too much hate in the comments because people share your videos on other platforms like Facebook, and that's where the vitriol happens? 

A: Yeah but expect that I get uh, believe me, plenty of people can track down my email and send me their thoughts. And I get them. And when I write... if I write a piece for CNN, which I used to do more often than I do now, the comment section was brutal. When I write a piece for the New York Times, it's not as brutal. But it is still brutal. But in YouTube, at least on the Healthcare Triage comments, they're not! They're just not. I mean, even the people who disagree are pretty civil about it. And I get still email. Or tweets. Or things like that. And people are free to say whatever they like. And the stuff that gets back about Healthcare Triage isn't nearly as angry as some of the other things I get. And I swear to you, I have plenty of friends who disagree with me about the Affordable Care Act, I have plenty of friends who disagree with me about organic food and GMOs and everything else, and who are free to say-- and say things that, you know, to me all the time about how they just think I'm absolutely utterly wrong. But it's not that I'm not exposed, I think, to people who disagree, it's just that in-- on YouTube at least at Healthcare Triage, they're just so much nicer about it. I don't know why. I've actually-- it's funny because I mentioned this to John yesterday, I don't... I don't get you know, why they just seem to be nicer or more thoughtful about it. I appreciate that. I think our fans are great. Um, but, yeah they're a pleasure, I got nothing bad to say.

I get a lot through Twitter, but um, not as much. I think, it's, you have to, again, it's, you have to remember, I'm in the academic world, where -- you know, my regular job is so far behind what this is. I mean, email is a new construct in the, you know, real world. Most people that I work with on a daily basis probably aren't on Twitter. You can see that's changing somewhat, but not as much. So I think that you know-- and you also have to remember that the YouTube crowd probably trends a little younger and more technologically savvy than the population in general. The population in general has been getting in contact with me for a long time. Based upon things that I've said on TV, and things I've written in newspapers, or you know, online. And they go email. 'Cause that is, I think, the mode by which most people contact me. So still a ton of feedback comes in by email. Um, but, uh, there's no question, I think, that YouTube people, they do come through Twitter. I either get most of their feedback either through Twitter or through comments themselves. But I get plenty of feedback, still, by email. And every once in a while, no joke, by mail. And that blows me away. When people take the time to put pen to paper. It's amazing. But it still happens, quite a bit.

P: How is Healthcare Triage funded? 

A: So, I, you know at this point I think it's almost entirely through, you know, the advertising that we do through, um, through either YouTube or anything else, or I think that some people can make donations. But um, it's definitely not a show we're doing at this point for profit. Um, you know, as you can see, it's like I have a day job. And you know, I think I'm decent at it, and uh, I like doing that too. And I think you know, the other people working on the show, like Stan or Mark also work on tons of other shows. And there's no question that I don't think we can exist without uh, you know, the studio and the equipment and everything else existing because of the massive success of all the other shows there, including, you know, Crash Course, The Art Assignment, Mental Floss, everything else that uh, that John's studio does in Broad Ripple. So uh, it -- that is mostly how it is funded. We have -- I have-- I get, like I get the research world, I know how to fund research, like, I'm-- I can get grants from the NIH and foundations, but I have not yet cracked the idea of how do we get uh, Healthcare Triage like, well super funded. Um, I don't... I don't truly know if it's covering its costs at the moment. Um, but I think everybody loves doing it so much and finds value in doing it that we almost don't care. And if and while it involves some donation of time, uh, then everybody's okay with that. And that's, that is the biggest cost at the moment. It's opportunity cost, it's time cost, it's whatever time it takes to write the scripts, for me, to write the scripts, to go down there and shoot through everything else. Whatever time it takes, you know, for Stan to film it and to edit it, whatever time it takes for Mark to do the graphics. I think probably most of the infrastructure, luckily, is already there. The studio, the equipment, the rent, the lighting, everything else. We exist, you know, somewhat on the largess of the larger studio. Um, but, uh, I think at this point, it's mostly funded either by those who are working on it donating some amount of time, and whatever money we bring in through advertising. Which is, you know, we try to keep the advertising to a minimum, but you know, at least it helps cover some of the cost. 

P: How was the first year? Anything exciting planned for the next year? 

A: First year was awesome! I mean, I used to joke before we even like figured out advertising and everything else, I was like, they pay me in joy. I ... it's probably the most-- one of the most fun things I do. And I love doing it. And I feel so much value out of it that, you know, if the advertising trickles to zero, I -- I'm... John would hate me for saying this, but I'm okay, I'm sure they're not, I'm sure no one else is, but it's like, I'm not... Everyone says this, but I mean it, I'm not doing it for the money. I, as I said before, I have um, I do other work that pays. That I love. That's great. So this is not about, it's never been about money. That doesn't mean it wouldn't be great to make more money, because I would love for everybody else involved in the show to make more, and I'd love to be able to feel like we're you know, funding it and maybe think like how we could grow. But it's not about salary. In that respect. So it's been fantastic, you know, I think the feedback has been great, the visibility has been great, the exposure-- you know, I'm amazed sometimes at how far it reaches, or who gets it, like the people that will write me email, you know, people like, I cite seminal papers by economists talking about them, and then a day or two later, I get an email from them. And that blows me away. Because the idea that they're actually watching this, is amazing. So that is great. So nothing but awesomeness in the first year. I think we're going to try to expand in year two. I think we're going to try to add in more shows, maybe try to change things up to do more topical news stories, maybe like have two episodes a week? Where like one is sort of regular Healthcare Triage and the other is news story of the week, it'll be a little more um, it'll be shorter, it'll be a little easier, it'll be a little quicker. That will require us changing our shooting schedule somewhat. We don't shoot every week right now, but that will require us to do so. So that'll be new. But I'm nothing but excited. I... as I always said before, I'd like to find out new ways of getting this uh, funded, but uh, we're all moving forward with that. 

P: Now, obviously I think that what Dr. Carroll does is huge. What he does it he goes and finds topics that have a lot of misconceptions surrounding them, and he takes them, and he collects the research, and he presents the research to everybody who is willing to listen, in a way that people can understand. That is huge. That is science communication. So, if you had your say, what would you like to see demystified by Dr. Carroll? Let me know in the comments below or on Twitter, or Instagram, or whatever the heck. Keep in mind, he's already made a whole bunch. Check his channel out here. Right there. And when you're ready, go ahead and click over to part two, of this interview, where Dr. Carroll is going to talk to us more about just YouTube in general. And kinda what it's like being an outsider, or somebody with a "day job." Doing YouTube. Alright, thanks for watching and I'll see you guys next time.