Can Doctors Help Reduce Gun Violence?

Doctors can help prevent gun violence by asking their patients whether they own firearms and counseling them on safety, a new report states.

A common misperception among physicians is that it’s illegal for them to ask their patients about firearms, according to the report, published Monday in the peer-reviewed Annals of Internal Medicine. In fact, several groups advise doctors to ask about guns when the information is relevant to their patients’ health or that of others.

Last year eight medical specialty societies and the American Bar Association issued a recommendation that physicians ask and counsel about firearms during routine patient care visits or as an element of risk assessment.

“Some physicians believe that it is against the law to discuss firearms with their patients, but no federal or state statute prohibits physicians from asking about firearms when that information is relevant to the health of the patient or others,” Garen J. Wintemute, professor of emergency medicine and director of the UC Davis Violence Prevention Program, said in a release.

Doctors can also disclose information that their patients tell them about firearms to third parties when necessary, researchers said.

Doctors at UC Davis, Brown University and the University of Colorado, who are working to prevent firearm-related injuries in the U.S., reviewed literature on guns and physicians to compile the report.

The review is intended to be a resource for physicians, clarifying state and federal statues, addressing commonly cited barriers to practicing preventive medicine for firearm-related injuries and providing recommendations on how and when to talk with patients.

“A large body of evidence has established that having firearms in the home and purchasing a handgun can be associated with a substantial and long-lasting increase in the risk for a violent death,” said Wintemute, a co-author of the report.

“Education, counseling to support changes in behavior and more direct efforts, such as disclosing to others situations involving patients at high and imminent for firearm violence, can help prevent death or serious injury.”

It’s uncommon for doctors to ask their patients about firearms, the researchers said. In one study that the report cites, only 15 percent of providers documented whether veterans with suicidal thoughts had access to firearms.

The authors recommend that, at a minimum, clinicians determine access to firearms for patients who fall into any of the high-risk categories for firearm violence. These include patients expressing suicidal or homicidal ideas or intent; those with a history of violence to themselves or others; those with alcohol, drug abuse or serious mental disorders, or other conditions that impair cognition and judgment; and patients who are members of high-risk demographic groups, such as children and adolescents, young African American men, and middle-aged and older white men.

The doctor’s attitude is critical when speaking with patients about guns, the researchers said. Patients are more open to firearm safety counseling when it is not prescriptive but is focused on wellbeing and safety, especially where children are concerned, according to the report.

Physicians should provide education to patients, not just gather information, and include an extensive list of resources and information for patients on gun safety and children, firearms and suicide, and safe-storage options.

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