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 While just 23 percent of people surveyed thought it was always OK
for doctors to ask about guns, another 14 percent said this was
usually appropriate and an additional 30 percent considered it
reasonable in some situations.
Overall, people who didn’t own firearms were more supportive of
doctors bringing up the topic, compared to gun owners.
“I think that some gun owners may have had (or heard of) negative
experiences with doctors who were judgmental or offensive, and some
may worry that doctors are trying to confiscate guns,” said lead
study author Dr. Marian Betz of the University of Colorado Anshutz
Medical Campus in Aurora.
“Conversations about gun safety between providers and patients
should be nonjudgmental, educational, and focused on improving the
health and safety of the patient and those around him or her,” Betz
added by email. “Unfortunately, the larger political debate over gun
control laws can spill over into healthcare settings.”
In 2014, there were more than 33,000 gun deaths in the U.S., most of
which were suicides, and an additional estimated 81,000 non-fatal
firearm injuries, researchers note in the Annals of Internal
Medicine.
Previous research has found many gun owners keep at least some of
their guns unlocked and loaded, even when children live in the home,
Betz and colleagues note.
But doctors often don’t discuss guns with patients, due in part to
time constraints and inadequate training on how to broach the
subject, they add.
To assess whether patients would be open to these conversations,
researchers examined data from a nationally representative online
survey of about 3,900 adults conducted in April 2015.
On average, participants were about 49 years old. Roughly half were
men and around 30 percent had at least one child under the age of 18
living at home.
About 45 percent said there had been at least one firearm in their
home during childhood.
Most weren’t gun owners, but 23 percent said they owned firearms and
an additional 12 percent said they lived with a gun owner.
Half of the adults surveyed were unsure whether having a gun in the
home would make the home safer or more dangerous; they thought it
depended on the circumstances. The rest of participants were roughly
split between thinking guns enhanced safety or posed a danger.
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One limitation of the study is that the survey didn’t ask patients
about the context of gun discussions with doctors, the authors note.
For example, a parent with young children or a patient at risk for
suicide might need a different conversation about guns than other
people, the authors point out.
“This conversation is all about context,” said Dr. Eric Fleegler, a
specialist in emergency medicine at Boston Children’s Hospital who
wasn’t involved in the study.
Guns should be on a list of routine uncomfortable questions doctors
ask patients during routine check-ups, the same way physicians may
ask about things like sex or smoking or drug use, Fleegler said in a
phone interview.
“In context, a doctor doesn’t just walk right into the exam room and
ask you about guns,” Fleegler added.
It’s understandable that patients may resist counseling, but doctors
should still be aware of specific situations when it’s important to
have the discussion anyway because firearms might pose a greater
risk to patients or people they live with, said Ziming Xuan, a
public health researcher at Boston University who wasn’t involved in
the study.
For example, parents of young children need to know kids might try
to play with firearms left loaded and unlocked. And having guns in
the home can increase the risk of suicide attempts for people who
have severe mental illness.
Whenever patients have guns in the home, doctors need to cover
safety basics like making sure any firearms are locked up and stored
unloaded, Xuan added by email.
“We need to think of gun safety as both an individual and public
health issue,” Xuan said.
SOURCE: http://bit.ly/1i46lF7 Annals of Internal Medicine, online
July 25, 2016.
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