Every year in the U.S., more than 32,000 people die due to gun-related violence, suicide and accidents. That number includes the deaths of seven children and teens every day. So it’s not surprising that health care providers — those who witness the tragic results of gun violence — are often vocal proponents of gun safety reform. But when it comes to the intimate patient-provider relationship, do people want to discuss gun safety with their doctors?
A group of researchers set out to explore that question in what may be the first nationally representative survey on whether Americans feel it’s appropriate to discuss guns in a doctor’s office. In an online survey of nearly 4,000 adults conducted in April 2015, researchers asked: “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?” They asked the same question regarding alcohol, seat belts and cigarettes. Overall, 66 percent said it is “at least sometimes appropriate” for providers to discuss firearms with their patients. The survey results were published yesterday in the Annals of Internal Medicine.
More specifically, the survey found that 23 percent of respondents thought provider discussions about firearms were “always appropriate,” 14 percent thought they were “usually appropriate,” 30 percent said “sometimes appropriate” and 34 percent believed they were “never appropriate.” Among those who thought such discussions were at least sometimes appropriate, 95 percent also thought talks about seat belts, tobacco and alcohol were at least sometimes appropriate.
Breaking down responses by gun ownership, the survey found that 54 percent of gun owners thought such discussions were at least sometimes appropriate, compared to 67 percent of respondents who didn’t own a gun but lived with someone who did and 70 percent of those who did not own a gun. Among gun owners, 62 percent with at least one child at home believed such discussions were at least sometimes appropriate, compared to 52 percent of gun owners without a child in the home. Gun owners were also more likely to say such discussions were at least sometimes appropriate if they believed having a gun at home was a risk factor for suicide or made the home more dangerous.
Overall, more women, at 71 percent, thought firearm discussions with a doctor were at least sometimes appropriate, compared to 61 percent of men. Study authors Marian Betz, Deborah Azrael, Catherine Barber and Matthew Miller write:
The observed heterogeneity in opinions highlights the need for communications research to better understand the viewpoints of all types of firearm owners when creating targeted firearm safety educational materials and interventions; the assumptions that may underlie these views; and what information may help open up the possibility of dialogue for different people, especially in higher-risk situations, such as when a patient is experiencing a mental health problem. It is important that any messaging about firearm safety be factually accurate and presented in a way that neither overstates risks nor alienates patients.
Several leading medical associations, such as the American Academy of Pediatrics and the American Academy of Family Physicians, already recommend that providers talk with patients about firearm risks and how to prevent gun injuries. And last year, eight professional health organizations joined forces to support a number of policy measures to reduce the toll of gun violence. Unfortunately, some doctors are legally restricted from discussing guns with their patients — Florida was the first to enact such a doctor “gag order” law and a number of states are trying to follow suit. Such laws come despite the fact that doctors are often highly effective messengers of safety information, and previous research finds that up to 1.69 million children and teens in the U.S. live in homes with loaded and unlocked guns.
“For the practicing clinicians…some patients may be uninterested in or resistant to discussing firearm safety in a clinical setting, at least initially,” the new Annals of Internal Medicine study stated. “Finding ways to routinize these discussions or, more generally, to optimize approaches to addressing firearm safety may help clinicians and their patients navigate these conversations in the clinical setting in ways that lead to more informed decision making.”
Visit the journal to request a full copy of the new gun safety survey results.
Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for nearly 15 years.