It's Not a Doctor's Duty to Discuss Gun Safety With Patients

Greg A. Hood, MD

Disclosures

April 01, 2014

In This Article

Most Doctors Are Not Firearms Experts

There are key distinctions between firearms education from a structured program, conducted by trained individuals, and the delivery of a message from a physician or nurse who has received no formal firearms education. Patients are keenly aware of these distinctions.

A study of patients across urban, suburban, and rural settings found that only 14% of patients believed that their physician was knowledgeable about firearm safety.[4] An overwhelming 71% did not expect that they would follow physician advice regarding firearms.

Physicians have the public's trust when discussing medical conditions -- for example, heart disease -- because of their recognized formal education and personal experiences in managing the details of the coronary anatomy and the medicines and techniques inherent to the condition. Internists commonly describe cardiac bypasses and other complex medical concepts to patients even though they themselves have never performed a bypass. Certainly physicians do not need to become proficient in firearm use or all firearm terms in order to advise patients. However, if you are considering educating a patient on firearms, where is the line of your personal expertise and competence in this matter drawn?

A physician may tend to tune out patients who bring in inaccurate "medical information" about their conditions (or ones they perceive they have). It is immediately obvious to a physician when a patient speaks about medical issues in a manner that clearly demonstrates that the patient is out of his or her league. Similarly, patients who are firearms owners or enthusiasts are all too likely to tune out a physician who does not know the basic terminology, functioning, and issues related to firearms. Frankly, many of our colleagues do not possess this knowledge.

Courts have preserved the First Amendment rights of physicians to counsel patients on preventable injuries and deaths from firearms, as well as the safe storage and handling of firearms. It is essential that such counseling happen via "best practices." Unfortunately, the reality is that a significant percentage of physicians do not have enough (if any) education about firearms in order to effectively counsel families on these critically important issues in an objective, best-practices manner.

It is critically important for physicians and educators to understand how their words are perceived when delivered to those who are uneducated on a particular subject, and even more so when the audience is educated and may have an inherent suspicion of the physician's intent.

Doctors Have Time Constraints!

An additional, legitimate, and practical reality for physicians and nurses in clinical practice is the constraint of time. Today the quantity of necessary and required elements to squeeze into a primary care visit is nearly insurmountable. The insertion of an effective discussion of firearm safety to an already overfull docket is plainly unrealistic.

Furthermore, most clinicians will admit that when they are addressing issues that they are not well versed in, the discussion frequently gets bogged down and runs over the appointment time. Interjecting issues that are politically charged and potentially adversarial invites the creation of nightmares within the daily operation of one's practice.

Dr. Caplan posed, "One thing you have to ask patients is whether they own guns and whether they know how to keep them safely. Do you keep ammunition stored separately from the guns? Just as we might say, 'Lock your medicine chest so that kids don't get in there and steal medicines.'" If, for example, one has not learned the 3 major reasons why simply having even a 1200-pound safe in one's home may provide little to no effective deterrence or prevention of criminals stealing one's firearms (or other safe contents), then simply counseling patients to lock up their guns may not be sufficient to represent effective education.

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