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Op-ed: Health care providers should promote firearm safety

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  • Op-ed: Health care providers should promote firearm safety

    Op-ed: Health care providers should promote firearm safety

    In the seemingly endless debate over guns in America, we often hear the line, "Guns don't kill people, people kill people." Regardless of one's personal beliefs on gun control, guns are dangerous and must be treated with the utmost respect. In 2015, Utah deaths from gun violence exceeded deaths from automobile crashes, highlighting the need for all sectors of our society to take action, with health care being one of them.

    Multiple medical professional societies recommend that physicians and other health care providers counsel patients and parents about firearm safety. The American Medical Association (AMA) encourages physicians to access evidence-based data regarding firearm safety to educate and counsel patients about firearm safety. In addition they encourage physicians to become involved in local firearm safety classes as a means of promoting injury prevention and the public health. Additionally, the AMA encourages dissemination of educational materials related to firearm safety to be used in medical school curriculum.

    The American Academy of Pediatrics' 2012 Gun Violence Policy advocates for safe gun storage (guns unloaded and locked, ammunition locked separately) to reduce unintentional injury and suicide risk for children and adolescents. The American Psychiatric Association recommends that physicians and other health professionals undergo training to assess and respond to individuals who may be at increased risk for violence or suicide, and such training should include education about speaking with patients about firearm access and safety. The APA also recommends that physicians and other health care providers make clinically appropriate inquiries of patients and others about possession of and access to firearms, and take necessary steps to reduce the risk of loss of life by suicide, homicide and accidental injury.

    It's not just physician organizations that are galvanizing support and action surrounding the prevention and reduction of gun violence and injuries. The American Nurses Association (ANA) published a "call to action" to find a cure for gun violence. The call includes recommendations around access to mental health care, firearm safety as a component of routine health screening, community outreach, and research.

    Given these recommendations, one would expect that firearm safety is a common component of health education and clinical practice. However, a study published in 2014 in the Annals of Internal Medicine found that while a majority of physicians surveyed supported a physician's right to counsel patients about gun safety (66 percent), less than half reported currently doing so (42 percent).

    In addition to recommendations from these and other professional societies regarding firearm safety, there is a clear call to action to increase access to mental health programs for individuals and families; and to develop and implement evidence-based violence intervention programs focusing on intimate partner violence, behavioral health including anti-bullying, in an effort to stem the violence, injury and death rate related to inappropriate firearm use.

    At least 11 states have passed laws aimed at silencing physicians with respect to education and discussion around firearm safety with patients. The laws range from a ban on documenting gun ownership in a patient's medical record to Florida's law which states that a doctor violates the patient's right to privacy by asking about firearms. No such law exists in Utah, leaving physicians the opportunity to have these important conversations with patients and family members to promote safety for patients, their families and the broader community.

    There are many competing demands in a typical 15-20 minute office visit with a physician. Taking the time to ascertain the presence and safe storage of firearms in the home is good medicine, and sound public health. Furthermore, physicians, and the healthcare team must also address the contributors that lead to gun violence including domestic and intimate partner violence, mental health issues, and substance abuse.

    Liz Joy, M.D., MPH, is a family and sports medicine physician in Salt Lake City. Greg Elliott, M.D., is a physician who has served the community for 40 years.

    Pat ------> NRA Lifetime Endowment Member #FAAFO