Blog | Friday, March 1, 2013

QD: News Every Day--3 in 10 doctors often deal with firearms issues in practices

Nearly three in 10 physicians sometimes or very often have to deal with firearms-related issues in their clinical practice, a survey found.

ACP Internist asked its readership how often, if ever, has the issue of guns come up with patients (i.e., screening/counseling on gun safety, treating injuries, domestic violence)?

In response, 72% said the issue comes up rarely or never in their offices, with 28% saying it comes up sometimes or very often in their practices.

Firearms violence has dominated the news since the shooting at an elementary school in Newtown, Conn., last year. The American College of Physicians has entered into the debate, in editorials and position statements.

An editorial in Annals of Internal Medicine outlined how the issue affects physicians. "Guns maim and kill. Even when we can repair torn tissue and prevent death, bullets permanently diminish the quality of life of persons caught in the line of fire. Gun violence also harms those close to the victims who often endure grief, depression, anxiety, and sometimes posttraumatic stress disorder. Furthermore, whether they experience single shootings or massacres, persons in affected communities and the widening circles around them suffer when gun violence makes them feel unsafe in their schools, streets, stores, workplaces, and recreational venues."

The American College of Physicians has restated its long-standing support for banning assault weapons and high-capacity magazines, as well as strengthening access to mental health services and research on the most effective approaches to reduce firearms-related injuries and deaths.

But the issue is political as much as clinical. In Florida, physicians faced a ban on discussing gun safety in the home. The legislation began after two residents complained that their physician wanted to dismiss them from the practice after they refused to discuss their gun ownership, reports the Miami Herald. After a year of litigation, ACP's Florida chapter won the case, restoring the rights of physicians to discuss health and safety issues with patients.

State legislatures often try to dictate the physician patient relationship, mandating conversations on topics ranging from gun control to dense breast tissue and mammography.

It's a perennial discussion, one that prompted the College to issue its own statement on the role of government in the exam room. The College has also joined other medical societies in protesting interference from state legislatures.