More than two-thirds of adults in the United States — including half of people who own guns — believe it is at least sometimes appropriate for doctors to talk with their patients about firearm safety, according to a study published Monday in the Annals of Internal Medicine.
This finding suggests that many patients are open to having their doctors raise the issue of gun safety during their medical check-ups. The finding also underscores the need for research on how doctors can best approach different groups of patients on the often politically charged issue of gun safety, say the study’s authors.
Earlier surveys of health-care providers have found that doctors do not routinely discuss gun safety with their patients, even when they believe such discussions are important — and even though the American Academy of Pediatrics, the American Academy of Family Physicians and many other major medical organizations support such counseling. Doctors cite several reasons for their reluctance to do so, including a lack of training on how to discuss the issue, time constraints and a fear about alienating or offending patients.
Yet gun safety is a major public health issue. As background information in the new study points out, more than 34,000 gun-related deaths and an additional 81,000 non-fatal firearm injuries occurred in the U.S. in 2014.
Most gun deaths in the U.S. (59 percent) are suicides. Research has shown that many suicide deaths could be prevented if guns were kept out of — or inaccessibly locked up in — the homes of at-risk individuals.
Such actions would also reduce the steady and tragic stream of children in the U.S. who are injured or killed by firearms. So far this year, guns have maimed or killed 354 children under the age of 11, according to the Gun Violence Archive. The latest tragedy occurred on Tuesday, when an 8-year-old Utah boy became the victim of a murder-suicide.
Most gun-related deaths and injuries involving children are, however, unintentional shootings — ones that parents and other adults could prevent if they took gun safety seriously.
Children who live in homes where gun safety isn’t practiced — a group that numbers at least 1.69 million in the U.S., according to a 2005 study — are not only at a significantly increased risk of accidentally shooting themselves, but also of shooting friends and members of their family.
As the Washington Post has reported, toddlers — children under the age of 4 — shot people in the U.S. at a rate of about once a week in 2015. That pace accelerated during the first few months of this year.
For the current study, Dr. Marian Betz of the University of Colorado and her colleagues surveyed a nationally representative sample of almost 4,000 adults in April 2015.
Participants were asked the following question: “In general, would you think it is never, sometimes, usually, or always appropriate for physicians and other health professionals to talk to their patients about firearms?”
Sixty-six of the respondents said it was at least sometimes appropriate for doctors to talk about guns with patients.
Specifically, 23 percent said it was always appropriate, 14 percent said it was usually appropriate, and 30 percent said it was sometimes appropriate.
Thirty-four percent said such discussions were never appropriate.
The respondents’ views varied significantly by firearm ownership. Among gun owners, 54 percent said that discussions of gun safety between doctors and their patients are sometimes appropriate. That compared with 70 percent of people who lived in households without a gun.
Interestingly, 67 percent of people who didn’t personally own a gun but who lived with someone who did also said that it was sometimes OK for doctors to talk about gun safety with their patients.
More women (71 percent) than men (61 percent) were likely to support the idea of doctors bringing up the topic of gun safety. Gun owners with a child at home — or who viewed a gun in the house as a risk factor for suicide — were also more likely to support the idea.
The political affiliation of the respondents also affected their opinions on this topic. This finding was true even for gun owners. Sixty-eight percent of gun owners who described themselves as politically liberal said it was at least sometimes OK for doctors to talk about gun safety with their patients, compared with 44 percent of those who said they were politically conservative.
‘Respectful and non-judgmental’
In a prepared statement, Betz said the study’s results may encourage more doctors to talk to patients about guns in the home.
“A doctor working with a patient with depression or risk factors for suicide should suggest that the patient consider making firearms less accessible until they recover — for example, by storing the guns away from home,” she said. “And doctors are wise to recommend to parents of children or teenagers that they keep any household guns locked.”
Although 66 percent — not 100 percent — of the study’s respondents were accepting of doctors raising the issue of gun safety, that gap doesn’t mean doctors should avoid such discussions with their patients, Betz added.
“Patients can always decline to answer those questions,” she said. “But that shouldn’t deter a physician from bringing up the topic — in a respectful, non-judgmental way — when relevant.”
FMI: The study is, unfortunately, behind a paywall, but you’ll find its abstract on the Annals of Internal Medicine website. You’ll find information about how to protect children from firearm violence on the American Academy of Pediatrics website.