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Abstract
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I read with great interest Dr William Wadland’s commentary in the October issue of Family Medicine,1 in which he discusses the essential nature of open and honest discussions between doctors and patients regarding risks to their health, including the potential harm from exposure to firearms. He points out data that indicate death and injury from gun violence in our country has reached the level of a public health crisis worthy of a broad and coordinated programmatic attack. One element of such a program must include recognizing those of our patients who are at particular risk, such as children, depressed individuals, and those exposed to interpartner violence. The use of standard questions about the presence of firearms in the home (particularly when at-risk people are involved), and safe storage thereof should be one basic component of patient assessments. Simultaneous sharing of useful safety and storage information with patients and families must logically follow during a patient encounter.
Several challenges have made such a practice difficult. As Dr Wadland points out, there has been legislation in several states to prevent discussions of gun-related health risks similar to those which now routinely inquire about the use of seat belts, smoking, and bicycle helmets. The controversial “Gag” law in the state of Florida would have had the effect of prohibiting physicians from asking about guns in the home and how to safely store them. I am pleased to inform your readers that this law has now been ruled invalid. Upon review in February, 2017 by the 11th US Circuit Court of Appeals, the law entitled The Firearms Owners’ Privacy Act was ruled in violation of the first amendment rights of doctors.2 Physicians can and should include guns in their discussions about health risks.
Other challenges to making such discussions routine are the manner in which physicians present the topic to their patients, and how to obtain and provide useful information to them regarding safety and storage. There is evidence that simply encouraging patients and families to avoid or safely store firearms has a beneficial effect for as long as six months.3 There are also a number of educational materials available to help them identify options such as gun locks and gun safes. One such handout is provided by the University of Michigan Injury Center available at www.injurycenter.umich.edu.4 Several training modules are now available to assist physicians in managing office-based discussions related to firearms. The University of Michigan Departments of Pediatrics and Emergency Medicine have created online case-based video tools to assist clinicians in navigating the sometimes difficult discussions about firearms in the home. These tools are available at https://open.umich.edu/find/open-educational-resources/medical/firearm-injury-prevention ...
Language: en |