COMMENTARY

#VoteKids: An Interview With AAP President Benard Dreyer on Gun Safety and Key Issues for Kids This Election

Hansa Bhargava, MD; Benard P. Dreyer, MD

Disclosures

October 20, 2016

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Hansa Bhargava, MD: Hello. I am Dr Hansa Bhargava, a medical advisor for Medscape. Today we have the honor and privilege of having the president of the American Academy of Pediatrics, Dr Benard Dreyer, here with us to answer some questions about some interesting topics. Dr Dreyer, could you introduce yourself?

Benard P. Dreyer, MD: Sure. I am Benard Dreyer. I am a pediatrician in New York City. I am a professor of pediatrics at NYU School of Medicine and I am the director of pediatrics at Bellevue Hospital Center.

Gun Safety: The Pediatrician's Role

Dr Bhargava: Thank you very much for being here today with us. I am going to get right to it. In a 2015 poll conducted on Medscape, 39% of our healthcare professionals, almost 2 out of 5, said that counseling on gun safety was not their job. In the comments, those readers were vehement, with many saying that counseling about everything that could cause injury was nearly impossible and that it likely does not work anyway. What does the evidence say? Does counseling on gun safety by healthcare professionals make kids safer?

Dr Dreyer: Definitely. There are good studies that show that counseling families about gun safety is effective and it makes children safer. The dangers of guns in the home are accidental injury or death, primarily from children playing with guns, as well as suicide. Suicide is going to be primarily among adolescents who are depressed. We know that a depressed adolescent with access to a gun is much more likely to die from a suicide attempt.

Dr Bhargava: How do you respond to the professionals who say that they just do not know enough about guns to counsel about safety?

Dr Dreyer: The American Academy of Pediatrics recommends[1] to all pediatricians to counsel about gun safety and gives them specific points to make with families. I know that many pediatricians are very eager to counsel families.

Dr Bhargava: Are there any tools or questions that you would advise physicians and other clinicians to use in the office about gun safety?

Dr Dreyer: Yes. We have a policy on firearm safety that gives specific recommendations. It is available online and is open-access to all, including all pediatricians. We specifically focus on the message to lock the guns and the ammunition up separately—the key specifics about gun safety. Our policy says that the safest home does not have a gun, but recognizing that many families do have a gun, we at least recommend that they focus on making that gun inaccessible to children and adolescents.

Dr Bhargava: One obstacle that pediatricians and healthcare providers have encountered is legal obstruction. We know about the gun-gag case that is going on in the 11th Circuit Court of Appeals. What is the status of that gag order case and what are your thoughts?

 
At the present time, all physicians in the United States can counsel all families about gun safety.
 

Dr Dreyer: That case was decided against the pediatricians initially, but a review by the full panel seems very promising. That order reinstated the physician's right to counsel until this case finally gets decided. Hopefully, they will decide this in the right direction because we think this is a First Amendment/free speech issue. At the moment, pediatricians and other physicians in Florida can counsel all families about gun safety. Eleven other states have had legislation put forward to prevent counseling, but none of them have passed. At the present time, all physicians in the United States can counsel all families about gun safety.

Dr Bhargava: That is really good to hear. Obviously, counseling makes a difference. We saw that in the case of SIDS (sudden infant death syndrome), where we were able to make a real difference just by counseling parents with the Back to Sleep campaign.[1]

#VoteKids This Election

Dr Bhargava: Gun safety is just one of the many issues affecting children this election year. The American Academy of Pediatrics is encouraging its members and all of us who care about kids to be politically active with the #VoteKids campaign. Can you describe this campaign for us?

Dr Dreyer: Of course. It has a couple of components. First of all, vote yourself. I do not know what the percentages are for pediatricians or physicians who do not vote, but I think every election is important for kids, and this one certainly is. Second, we have a prescription to vote that you can give to your families, to get them to go out and vote. Third, there are social media tools that we provide people, including a Twibbon that people can use on their Twitter account. Probably most important is to know the issues, know what the issues are for kids. Ask the candidates or look at what the candidates are saying. Then make sure you vote for the candidate that seems to have kids front and foremost in their policies.

To that end, we produced the Blueprint for Children, [a report discussing how the next president can build a foundation for a healthy future]. It is a very large document, but it has a short summary that outlines all of the government programs that are critical to children and families. Every pediatrician should have that document in their hands. They should be familiar with those issues and think about how to vote for candidates, not only at the national level but at the state and local levels as well. We are also giving this to other organizations and to candidates. We have asked the two presidential candidates to respond to some general but important questions about their policies for kids, and we have both Hillary Clinton's and Donald Trump's responses on our website. I encourage people to read their responses and use that in making their decision as well.

Dr Bhargava: I just want to congratulate the American Academy of Pediatrics for all the work that they are doing in the advocacy of children and their health. Your message is to pay attention to the children's issues and make sure you know those before you go and vote, but definitely go out and vote.

Dr Dreyer: Children's issues are very government-based because almost half of children are poor or near poor. These kids are from primarily working families; these are not people who do not work. But all those families and all those kids depend upon the government having programs for them at the federal, state, and local levels that support them. Kids are particularly vulnerable to problems with government programs.

Let me give a plug for our website, which has a lot of information. Everything is there, including the Blueprint for Children.

Dr Bhargava: Thank you, Dr Dreyer, for all of that great information. I think we talked about some very important issues. Certainly we do need to keep children's issues in mind. I hope that everyone who is watching us today is going to go and vote, but again, also consider the issues of gun control. Thank you very much for your time.

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