Yes, You Can: Physicians, Patients, and Firearms

Developing implementation strategies for firearm safety promotion in paediatric primary care for suicide prevention in two large US health systems: a study protocol for a mixed-methods implementation study

“…For example, the Florida Privacy of Firearm Owners Act, passed in 2011, stipulated that providers must refrain from enquiring about firearm ownership and documenting firearm-related information in patients’ medical record except under specific circumstances, such as when the healthcare practitioner determines that this information is relevant to the patient’s safety or the safety of others. Of note, despite the stipulation permitting providers to enquire about and/or document firearms-related information when relevant to matters of safety, many providers mistakenly believed that it was illegal to discuss firearms during healthcare visits under any circumstances,30 and thus refrained from doing so. Key provisions of this legislation were overturned in 201731; however, similar legislation has passed in other states (eg, Montana, Missouri and Minnesota), and more restrictive legislation has been proposed elsewhere (eg, a pending proposal in Ohio prohibits any enquiries related to firearm ownership or possession without exception) 30.…”

Continuing Medical Education and Firearm Violence Counseling

“…Fulfilling this imperative requires the cultural competence and nuance necessary to have dedicated and respectful conversations with patients [13]. While low rates of gun safety counseling and lack of physician training to provide counseling are established [6,12,28,30,32], the present research is the first to illuminate the potent role that CME may play in increasing counseling. CME was strongly associated with providing firearm counseling often or very often, including asking patients with depression about their firearm access as well as increased knowledge of how to counsel.…”

“…It is increasingly clear that addressing firearm safety in clinical situations constitutes an ethical imperative that physicians should satisfy, particularly as physician skills in counseling patients about firearm violence prevention are increasingly considered key to helping prevent firearm deaths [12,31]. Fulfilling this imperative requires the cultural competence and nuance necessary to have dedicated and respectful conversations with patients [13].…”

“…Many medical organizations and physicians have discussed the roles clinicians should play in preventing firearm injury and deaths [4][5][6][7][8][9][10][11][12][13]. Surveys of family physicians, internists, psychiatrists, pediatricians, and surgeons have revealed that between 65 to 93 percent believe gun safety counseling is within a physician's scope of practice [14][15][16][17][18][19][20].…”

Curbing Firearm Violence: Identifying a Specific Target for Physician Action

“…In their article in this week's Annals, Wintemute and colleagues make 3 important points to health care professionals: First, there are only rare occasions when physicians cannot ask a patient about firearms; second, physicians may counsel patients about firearms; and third, physicians may disclose information to other parties as necessary (9). The authors focus on the particular importance of addressing firearms with patients when there is information, behavior, or individual factors suggesting a risk for violence to self or others.…”