More Than 1000 Doctors Pledge to Talk to Patients About Guns

Editors of the Annals of Internal Medicine recently urged physicians to sign a formal pledge committing to having conversations with their patients about firearms. So far more than 1000 physicians have signed on.

The editors cite data showing that people who commit firearm violence often have notable risk factors that bring them into contact with physicians.

The campaign began in the wake of the Las Vegas shooting October 1, with an editorial by Garen J. Wintemute, MD, MPH, from the University of California School of Medicine in Davis, and gained momentum after the February 14 school shooting in Parkland, Florida.

"[T]here is a critically important and beneficial action that we physicians can take, right now and on our own initiative," Wintemute wrote. "Fundamentally, it's quite simple. We need to ask our patients about firearms, counsel them on safe firearm behaviors, and take further action when an imminent hazard is present."

The Annals editors say conversations with patients may offer a chance for prevention and are part of good preventive care.

Doctors who take the pledge commit to talking to their patients about firearms, counseling them on safe behaviors, and taking further action when danger is imminent.

Amy Barnhorst was among those who signed the pledge. In the comments section on the pledge website she writes, "Doctors think they should ask about guns. Our patients want us to talk to them about guns. And there are steps doctors can take to decrease risk if they think a patient with their gun is dangerous. So let's start doing something!"

Katryn Tyler also signed, writing, "Older male patients are especially at risk of gun suicides, and it would be so wonderful if we could help heal that heartache and prevent another family experiencing the death of a loved older family member."

Marian Betz writes, "We can prevent suicides and other firearm injuries and deaths through respectful, nonjudgmental discussions with patients. This is not gun control — it's helping our patients and their families stay healthy and safe."

"Even if just one firearm fatality or injury is prevented because a doctor talked to an at-risk patient, then I would consider the signature campaign effective," Christine Laine, MD, MPH, editor-in-chief of Annals of Internal Medicine, said in a press release.

This isn't the first effort by the American College of Physicians and other medical societies to reduce gun violence. In 2015, eight medical organizations and the American Bar Association published a "call to action" that advocated for specific measure aimed at reducing the health and public health consequences of firearms.

Also, last week, more than 70 medical and health organizations, led by the American Academy of Pediatrics, urged the US Senate to find a bipartisan path toward solutions relating to firearm-related injuries and fatalities.

Authors of the letter wrote, "Strengthening firearm background checks and supporting funding for federal research and public health surveillance on firearm-related injuries and fatalities would provide meaningful progress in achieving a public health solution for this issue."

Art Caplan, PhD, medical ethicist at New York University, told Medscape Medical News that he favors adding firearms to the list of things physicians should talk to their patients about.

"I favor it, but do I think it would have stopped [Florida shooting suspect Nikolas] Cruz? Who knows? I don't know if he ever went to a doctor."

Having the conversations can remind people to store guns safely and ask whether there are guns in the homes their family members visit, Caplan said.

Physicians will also need to prepare themselves with evidence for questions patients will likely ask, such as "Am I safer because I keep a gun in my house or not?"

And doctors should admit to patients when they have little knowledge about guns, he added.

"If you don't know how fast an AR-15 fires or what a bump stock is, then say so. Nothing will undermine patient trust faster than you claiming to be a gun expert if you're not," Caplan said.

Because not all physicians feel knowledgeable enough to talk about guns or gun risks to start a conversation with a patient, Annals has made its gun-related content available for free.

Those interested in signing the pledge can do so here.

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