How Should Doctors Talk About Gun Safety? Article from "The Doctor Weighs In"

[92G]

whether or not physician owns firearms is irrelevant.
the issue is well-intentioned (but ignorant) MD's prioritizing their feeble attempts to help "protect" over respecting the rights of their patients.

so long as we believe some of us "know better", this shit will continue. the fact is that everyone is equally clueless and the best possible scenario is for the blind to be left in a state of freedom than to be lead by the blind....pretty sure the founding fathers were on this track when they wrote the constitution and bill of rights.

 

[GlockJock]

I guess since I'm an MD, by your logic I am only an educated party if I also have a degree in firearms? I don't think I need one to figure out that this is a topic trying to address risk factors associated with mental health. If you're bipolar with schizophrenia and have unlocked guns in the house, it doesn't take a MENSA level IQ to figure out that you have a recipe for disaster.

Isn't it rather funny and interesting, "Doc", that the Journal of American Medicine states that " research suggests that gay men, lesbians, and bisexual persons have higher rates of suicidal ideation, suicide attempts, and completed suicides than do heterosexual individuals"

Yet I'm gonna go way WAY out on a limb and guess that those same intrusive "smarter than us, better than us" (etc etc) "doctors" don't and won't ask their patients "So, Joe, lemme ask are you gay? Lesbian? Bisexual?" etc etc... Or "Tell me, Tom, have you ever thought about taking a dive off of the Tobin Bridge after you've just buggered some teenage male escort at his apartment in the Fenway or South End??"

Right, "Doc" ???...Ask THAT of a patient? My good God, that would be "intrusive" and/or "mean spirited" and/or "politically incorrect" and/or "protected and confidential information" and/or ...(blah blah blah).
How about just taking my temperature, drawing some blood, testing my piss and staying the f*ck out of what goes on at my home, under MY roof and/or between MY sheets and stop following the liberal media mantra and thinking you're simply superior beings.

MANY of the doctors I know are without question absolutely some of the most f*cked up, insecure, socially maladjusted, neurotic (psychotic?) individuals I've ever met on the planet, so who the hell are they to be asking ME about my home life and my Constitutionally protected choices?

Instead, Doc, why don't you just stick to writing hundreds of prescriptions annually, for chemicals with potentially harmful and/or fatal side effects...chemicals manufactured by companies which YOU own a financial interest in (through direct payments and/or mutual fund and straight stock investments, etc etc etc). Y'know, maybe even a few more "scrips" for a few more opiates for my wife's nephew, which definitely got him started on a path that led to Oxy and heroin and led to a fatal overdose...

And please keep your collective, hypocritical noses out of MY (and OUR) personal life choices....and we'll try to make sure we keep our non-MENSA level IQ noses out of yours.

 

[thefreepster]

As a doctor in training who A) probably owns more guns than most of NES and B) is probably more extreme in my RKBA politics than most of NES, I thought I'd weigh in just a little.

I think in some cases the focus of medical professionals on firearms is politically motivated. I've sat through several meetings in which people repeated debunked statistics about how "owning a gun increases your risk of death by a factor of X" or in which physicians have been advised to tell anyone with children to "immediately remove all firearms from the home." Clearly this stuff is bullshit.

Do I think a PCP asking a 54 year old man coming in for a BP check is relevant...**** no

THAT SAID.... do think there are times when a physician is doing their due diligence by asking about firearms? Yes. For instance, first-time parents at an 18 month pediatric well-visit should be asked/counseled about basic safety. In this case asking about things like outlet covers, pools, gates located at the top of stairs, cars seats, and yes, unlocked firearms is entirely appropriate. Another example might be a patient being treated for Major Depression, with past suicide attempts, or with suicidal ideation. Face it, if you or a person sharing your home is suicidal you need to think long and hard about access to firearms. This doesn't mean giving them up entirely or involving the police. It may be as simple as addressing the access of the individual in question or temporarily storing them at a friend's home. Clearly firearms do not cause suicides (look at Japan with nearly no guns and a much higher suicide rate) but one cannot deny that they certainly make it easier in the hands of an unstable person.

 

[WatchCityCPA]

As a doctor in training who A) probably owns more guns than most of NES and B) is probably more extreme in my RKBA politics than most of NES, I thought I'd weigh in just a little.

I think in some cases the focus of medical professionals on firearms is politically motivated. I've sat through several meetings in which people repeated debunked statistics about how "owning a gun increases your risk of death by a factor of X" or in which physicians have been advised to tell anyone with children to "immediately remove all firearms from the home." Clearly this stuff is bullshit.

Do I think a PCP asking a 54 year old man coming in for a BP check is relevant...**** no

THAT SAID.... do think there are times when a physician is doing their due diligence by asking about firearms? Yes. For instance, first-time parents at an 18 month pediatric well-visit should be asked/counseled about basic safety. In this case asking about things like outlet covers, pools, gates located at the top of stairs, cars seats, and yes, unlocked firearms is entirely appropriate. Another example might be a patient being treated for Major Depression, with past suicide attempts, or with suicidal ideation. Face it, if you or a person sharing your home is suicidal you need to think long and hard about access to firearms. This doesn't mean giving them up entirely or involving the police. It may be as simple as addressing the access of the individual in question or temporarily storing them at a friend's home. Clearly firearms do not cause suicides (look at Japan with nearly no guns and a much higher suicide rate) but one cannot deny that they certainly make it easier in the hands of an unstable person.

No part of that requires knowing that the patient owns firearms. Advice to the patients in need of it can be dispensed without that knowledge.

Plus, a patient that is not a firearm owner would not get the advice? Seems rather silly, seeing that one can purchase a firearm anytime and become a firearm owner. If the firearm advice is sound, it should be dispensed to all.

 

[GlockJock]

If you're bipolar with schizophrenia and have unlocked guns in the house, it doesn't take a MENSA level IQ to figure out that you have a recipe for disaster.

"Guns? In my home? Hell no, Doc, I don't own guns!!....Why do you ask??"



- - - Updated - - -

No part of that requires knowing that the patient owns firearms. Advice to the patients in need of it can be dispensed without that knowledge.

Plus, a patient that is not a firearm owner would not get the advice? Seems rather silly, seeing that one can purchase a firearm anytime and become a firearm owner. If the firearm advice is sound, it should be dispensed to all.

This +1

 

[thefreepster]

No part of that requires knowing that the patient owns firearms. Advice to the patients in need of it can be dispensed without that knowledge.

Plus, a patient that is not a firearm owner would not get the advice? Seems rather silly, seeing that one can purchase a firearm anytime and become a firearm owner. If the firearm advice is sound, it should be dispensed to all.

While this is certainly a valid point, actually engaging a patient is seen as preferable to lecturing them. It requires the patient to consider their behavior and allows the physician to assess risk and determine how they should focus their very limited time during an appointment. For instance asking about dietary habits, medication compliance, physical activity, home safety etc. and tailoring the appointment to any concerns is seen as superior to saying "you should eat lots of leafy greens, exercise at least three times a week, take all your pills, and lock up your guns." Doctors know that just lecturing a patient will often go in one ear and out the other. It is better to elicit a discrepancy between a patient's behavior and desired outcome and let the patient develop their own solution.

 

[GlockJock]

whether or not physician owns firearms is irrelevant.
the issue is well-intentioned (but ignorant) MD's prioritizing their feeble attempts to help "protect" over respecting the rights of their patients.

so long as we believe some of us "know better", this shit will continue. the fact is that everyone is equally clueless and the best possible scenario is for the blind to be left in a state of freedom than to be lead by the blind....pretty sure the founding fathers were on this track when they wrote the constitution and bill of rights.

This!
+1

 

[WatchCityCPA]

While this is certainly a valid point, actually engaging a patient is seen as preferable to lecturing them. It requires the patient to consider their behavior and allows the physician to assess risk and determine how they should focus their very limited time during an appointment. For instance asking about dietary habits, medication compliance, physical activity, home safety etc. and tailoring the appointment to any concerns is seen as superior to saying "you should eat lots of leafy greens, exercise at least three times a week, take all your pills, and lock up your guns." Doctors know that just lecturing a patient will often go in one ear and out the other. It is better to elicit a discrepancy between a patient's behavior and desired outcome and let the patient develop their own solution.

Could you give me an example of a discrepancy between a patient's behavior and desired outcome in a firearm based scenario?

 

[Chevy 2 65]

They should STFU, and do what doctors do. Make sure people are physically healthy and cure them when sick. (if possible)

 

[thefreepster]

Could you give me an example of a discrepancy between a patient's behavior and desired outcome in a firearm based scenario?

behavior- has unlocked gun in home
desired outcome- has 14 year old son with multiple past suicide attempts living at home that they want to be safe

 

[WatchCityCPA]

behavior- has unlocked gun in home
desired outcome- has 14 year old son with multiple past suicide attempts living at home that they want to be safe

And you think that:
A)a person that wants their suicidal kid to be safe never thought about locking a firearm
B) would admit this to a doctor
C) would then change behavior based on an MD's advice?

If that is one of the scenario where MD advice might be useful, why is the question asked of all patients, when the vast majority do not exhibit any risk factor?

Also, how do you balance the help one can provide to a patient in this amazingly unlikely scenario with the harm coming from the loss of trust between the doctor and patient caused by such intrusive questions, especially given that medical information is already being used to deny people their constitutional rights?

 

[Tim L]

I trust doctors as much as I trust the government. Anything you tell a doctor is documented for big brother to see.Ask anyone with a CDL about their medical privacy.

 

[thefreepster]

And you think that:
A)a person that wants their suicidal kid to be safe never thought about locking a firearm
B) would admit this to a doctor
C) would then change behavior based on an MD's advice?

If that is one of the scenario where MD advice might be useful, why is the question asked of all patients, when the vast majority do not exhibit any risk factor?

Also, how do you balance the help one can provide to a patient in this amazingly unlikely scenario with the harm coming from the loss of trust between the doctor and patient caused by such intrusive questions, especially given that medical information is already being used to deny people their constitutional rights?

YES, YES, YES....you would be shocked with how many people lack the basic common sense that you and I take for granted. I specifically stated that I thought it WAS NOT a question that should be asked of all patients. It is simply a question that is indicated in certain circumstances. From my personal perspective, asking if someone owns a firearm (which I do rarely) is much less intrusive than many other questions I ask on a daily basis. If you think telling a doctor that you own a gun is somehow going to jeopardize your constitutional rights, just lie, people do it every day.

 

[Picton]

If you think telling a doctor that you own a gun is somehow going to jeopardize your constitutional rights, just lie, people do it every day.

It took 44 posts for this to come out? Seems like the easiest solution to me.

 

[xtry51]

I'm 99% sure you misinterpreted what I was saying Trip. My comment was directed at the author of the posted article, who was rehashing someone else's stance. My comment was in no way directed at the OP.

On the docs asking about guns thing I'm still against it. The doc doesn't ask if I wear a seatbelt or have airbags in my car. He doesn't ask if I have a swimming pool at home. The gun thing is just another back door. If they really cared, they'd ask about everything.

 

[Sniper (+)]

Never had one ask but heres how that conversation would go...

MD: So, do you have any guns in the house?
ME: So, does your wife have any jelly dongs over 12 inches at home?
MD: Uhm.. what? EXCUSE ME?
ME: Well if you can ask questions that are none of your f'in business at all, so can I.

 

[Roy Rogers]

MDs genuinely concerned for patient safety and well-being will want to bring up guns, counsel patients on the benefits of taking up ownership.

 

[tr!pwire]

I'm 99% sure you misinterpreted what I was saying Trip. My comment was directed at the author of the posted article, who was rehashing someone else's stance. My comment was in no way directed at the OP.

On the docs asking about guns thing I'm still against it. The doc doesn't ask if I wear a seatbelt or have airbags in my car. He doesn't ask if I have a swimming pool at home. The gun thing is just another back door. If they really cared, they'd ask about everything.

This totally makes more sense.


That aside, I don't understand why people think the question is such a big deal... its a simple physical health update answer the question as you wish - it's utility lies in those who actually have no idea that their loaded 12 gauge above the couch might attract their young child's attention. This is by no means in application to the educated firearms community.

To the doctors trying to encroach - every profession has it's evil politicians.

 

[Coyote33]

... I don't understand why people think the question is such a big deal... its a simple physical health update ...

I guess I am not quite getting how this has anything to do with curing my athlete's foot, or whatever reason I'm at the doctor.

 

[MachineHead]

A lot of valid points brought up here. The latest ruling from the en banc 11th Circuit Appeals Court: https://www.nraila.org/articles/201...ient-privacy-hands-nosy-doctors-second-defeat is a huge step in keeping noses out of our business.

My only concern is that the doctors in the above article will pass down the "gun safety" question down the chain of command. Possibly even requiring it to be asked by RNs, PCAs, etc during their initial assessment of the patient along with the "Do you feel safe at home?" question.

Never underestimate the power of the antis to pull something like that.

 

[seanc]

That aside, I don't understand why people think the question is such a big deal... its a simple physical health update answer the question as you wish - it's utility lies in those who actually have no idea that their loaded 12 gauge above the couch might attract their young child's attention. This is by no means in application to the educated firearms community.

To the doctors trying to encroach - every profession has it's evil politicians.

What is the % of people that have knives not locked up in their house and easily accessible to the % of firearms?
Why is this NOT a question?

The other valid questions raised above are not asked, why?

Where is this data being stored and who has access to it? And what is that data being used for?

If you are collecting and entering this data into a database, then you are collecting this data for the insurance companies and the government. For what use?

 

[Dadstoys]

A question for the Docs here.
How much longer do you think medical records will be private?
I mean I don't think that they are as much as we think even now, but how long before it's an open book for any Govt. agency or anyone else the Govt. thinks "Needs" to have full and open access?

I don't recall the AMA protesting the NY state police combing through records looking for reasons to deny 2A rights to folks there.

 

[seanc]

A question for the Docs here.
How much longer do you think medical records will be private?
I mean I don't think that they are as much as we think even now, but how long before it's an open book for any Govt. agency or anyone else the Govt. thinks "Needs" to have full and open access?

I don't recall the AMA protesting the NY state police combing through records looking for reasons to deny 2A rights to folks there.

They are NOT private. Get real.

You/ we all need to get our heads around this....
We may call them them doctors..

They are all insurance company service providers. They all work for the insurance company.

 

[Dadstoys]

I should have phrased it , How long before we just drop the pretention that HIPAA means anything.

 

[GlockJock]

This totally makes more sense.


That aside, I don't understand why people think the question is such a big deal... its a simple physical health update answer the question as you wish - it's utility lies in those who actually have no idea that their loaded 12 gauge above the couch might attract their young child's attention. This is by no means in application to the educated firearms community.

To the doctors trying to encroach - every profession has it's evil politicians.

It's a "big deal" (and NOT a "simple physical health update question," any more than "Does your partner moan softly or scream as they orgasm?" is) in that it's just yet ANOTHER, small, sublime, seemingly-harmless, seemingly-innocuous invasion and assault on our privacy and subliminal demonization of law-abiding legal gun owners in the "United" (? not really sure that adjective applies in 2015) States of America.....

It's a completely irrelevant invasion into a "patient's" privacy, as would be the orgasm interrogation. It's none of Doctor Bloomberg's business, period.

People, especially the under-40s down to pre-kindrgarten, now and increasingly get their "information" and in many cases their entire "education" more from the Mainstream Media and social media than ever before. These young zombie-drones walking in front of you as they cross the street nowhere near a crosswalk (and while you're speeding through a green light) have their heads buried in Facebook, Twitter, Tumblr, Instagram, Messenger etc, where the overwhelming message and mantra is "Obama is cool, Hillary is heir, Anyone who thinks differently than us is a 'hater', and oh, by the way, Guns are bad and gun owners are nutcase, mean-spirited evil whackjobs" etc.

And if these young paraders-through- Hamlin branch out to the Internet (outside of the FB and Twitter apps) and log on to WebMD etc, the "big deal" there is that partially hydrogenated palm oil should be banned, and so should guns. And hopefully "You don't have any at your possibly-suicidal-inhabited home, do you young Zombie?"

They can then click the link that says "No, Big Brother, I don't. Cuz those icky things are BAD" and quickly switch apps and answer the incoming text from Mom, reminding the young 33 year old legal secretary or nurse to "make sure you bring your laundry over on Sunday and we'll wash everything before dinner"....

"Cool! Yippers!!.. Hey Mom, by the way, you and Dad don't own any g-g-g-GUNS, do you?"

 

[Stape]

I think we all paint our own picture in regards to how this scenario would play out with our PCM asking this question. When I would do annual screenings or physicals, I followed a set of health risk assessments. If I knew the guy rode a motorcycle, I'd ask about PPE. Routinely I'd talk about healthy sexual practices and prevention that covered hetro and homosexual practices without pointing a finger or insinuating which way their door swung. If blood pressure/lipids/fasting glucose were high, I'd talk about HTN prevention so on and so on. I had a very small patient population and knew them very well. Many were shooters and they knew I was as well, and yes I would talk about safe firearm storage, hearing and eye protection. My question might be put forth as "If you own firearms, do you securely store them in a way to prevent unwanted access" And the answer would either be "yes", "no" or "not applicable" and I was fine either way. You try to cover as much social, occupational, and family risk factors as possible.

It was mentioned above, that if a guy came in for athletes foot he doesn't want his Dr. asking about firearms.... I never did that. The review of systems and preventive health screenings where these types of questions are addressed were on well being visits, physicals, and routine check-ups. Pt encounters are tailored to the presentation at hand. Guy comes in from a chainsaw accident, I'm going to talk about power tool safety, PPE. If someone comes in with an alcohol related illness/injury, they might get the CAGE questionnaire.

There's no way to really sum it up with one blanket policy or method. I think the intent is well, but it's such a personal issue and a very hot topic that is interpreted differently by many.

 

[Ringworm]

"hey doc, how big is your dildo?"
...
"No? Not pertinent? Neither is asking about what I have in my home. Now, are you going to be my doctor or not?"
...

 

[Coyote33]

I think we all paint our own picture in regards to how this scenario would play out with our PCM ...

What the heck is PCM?

 

[Stape]

Primary Care Manager (your assigned or chosen doctor through your healthcare network. (for most individuals)

 

[pastera]

Primary Care Manager (your assigned or chosen doctor through your healthcare network. (for most individuals)

My primary is completely useless as far as I am concerned so I am my Primary Care Manager (as every able minded person should be)

Last physical exam stupidity

Doc: Any issues?
Me: having an issue with my left hand while driving. It's going numb with pins and needles plus loss of strength.
Doc: Sounds like a pinched nerve, don't worry about it. Are you having issues with intimacy? if you are I can prescribe something for it.
Me: No, but I am concerned about my hand because I'm left handed.
Doc: Okay, no issues then.

Thanks for nothing Doc!

Chiropractor took care of the issue with the hand and was actually interested in identifying and fixing my issues instead of giving me a dick pill.