'This is Our Lane': Doctors Work to Close Firearm Loopholes

Marcia Frellick

April 16, 2019

PHILADELPHIA — The need for funding to support research that will identify ways to prevent gun violence and close loopholes that allow some domestic-violence perpetrators to purchase guns — and ultimately reduce firearm-related injuries and deaths — tops the list of lobbying efforts by the American College of Physicians (ACP), leaders report.

"We need data" to move forward with strategies that work, ACP President Ana María López, MD, said during a news conference here at the ACP Internal Medicine Meeting 2019.

The organization is advocating for at least $50 million for the Centers for Disease Control and Prevention, said Robert Doherty, senior vice president for governmental affairs and public policy at the ACP.

The ACP also supports the reauthorization of the Violence Against Women Act (VAWA), which closes a loophole for domestic-violence offenders.

Currently, "if you've been convicted of domestic violence against your spouse or a member of your household, that's reportable under the background-check system and you're barred from purchasing firearms," Doherty told Medscape Medical News.

But federal law does not prevent someone with a misdemeanor conviction on domestic abuse or stalking from possessing or purchasing guns if the target of the abuse lives outside the abuser's house.

Domestic-Violence Loophole

That puts some women — such as an ex-partner or an intimate partner who does not live with the abuser — at substantially increased risk for gun violence, Doherty said.

Earlier this month, the House resoundingly passed reauthorization of the updated VAWA, but its fate in the Senate is less clear, he pointed out.

The National Rifle Association (NRA) has opposed expanded provisions in the "boyfriend bill," saying they go too far.

But López said the mounting number of shootings will compel congressional change. "It's the momentum. There just seems to be an outcry from the profession, an outcry from the general public," she told Medscape Medical News.

So far in 2019, there have been 3868 deaths from gun violence in the United States, according to Gun Violence Archive, a nonprofit organization that makes accurate information about gun-related violence in the United States available to the public. And 83 of those victims were killed in mass shootings.

The ACP also supports the efforts of several states to pass Extreme Risk Protection Orders, or "red flag" laws, that set the legal framework for temporarily removing a person's access to firearms if family or police deem the person an immediate threat to themselves or others.

On April 12, Colorado became the fifteenth state to institute such a law.

Colorado Latest to Pass "Red-Flag" Laws

"We've developed an action plan for our chapters to advocate on these issues at the state level," Doherty said.

The ACP updated its position paper on preventing firearm injuries and deaths late last year (Ann Intern Med. 2018;169:704-707).

The update states that "the medical profession has a special responsibility to speak out on prevention of firearm-related injuries and deaths, just as physicians have spoken out on other public health issues. Physicians should counsel patients on the risk of having firearms in the home, particularly when children, adolescents, people with dementia, people with mental illnesses, people with substance use disorders, or others who are at increased risk of harming themselves or others are present."

The position paper was quickly met with a rebuke from the NRA, directing "anti-gun doctors" to "stay in their lane," which set off a social media storm, as reported by Medscape Medical News.

"We saw an incredible organic response from the medical profession," Doherty said. "It is now one of the most cited papers by Annals on any subject."

Doherty and López h ave disclosed no relevant financial relationships.

American College of Physicians Internal Medicine (IM) Meeting 2019. Presented April 11, 2019.

Follow Medscape InternalMed on Twitter @MedscapeIM and Marcia Frellick @mfrellick