In the new (Sept-Oct, 1999) issue of The Journal
of the American Board of Family Practice (vol 12, #5).
an article about physicians discussing gun
safety with patients.
The article is titled “Family Practice Patients’ Attitudes Toward Firearm
Safety as a Preventive Medicine Issue: A HARNET Study.” (“HARNET” is the
Harrisburg Area Research Network, a coalition of family practice clinics in
the Harrisburg, PA, region. 2 are in downtown Harrisburg, 5 in suburban or
semi-rural areas, and 2 in “distant rural” areas.) Authors are Allen F.
Shaughnessy, Joseph A. Cincotta, and Alan Adelman; pages 354-359.

First, of course, we get the recitation about how many deaths and
injuries guns cause, then a summary of other research about how physicians
handle the issue of gun safety in clinical settings.

Patients in these clinics were asked to complete a 23-question survey
anonymously before being seen by their doctor. They received back 1214
out of 1359 surveys, a very good response rate of 89%.

And the results?

92% of respondents disagreed with the statement, “My doctor has a
responsibility to talk to me about firearm safety.”

“Only 9% of respondents selected their physician as a source for
information regarding gun injury prevention.” But 55% identified “a gun
organization” as a reliable source.

Only 40% overall agreed with the statement, “I am likely to follow my
doctor’s advice about storing guns,” and only 29% of gun owners agreed with
that statement.

“Neither gun owners nor nonowners seemed to have much faith in the
firearm knowledge of their physicians or responded that gun safety was an
appropriate topic during an office visit. Only 14% of respondents thought
that their physician was knowledgeable regarding gun safety, a response rate
that was similar among gun owners and nonowners.”

57% agreed that “Gun safety should not be discussed during my visit since
there are so many other things to do.”

Even though there was no space provided on the questionnaire for comments
from respondents, 44 of them added notes in the margins. One of three major
themes of these spontaneous offerings was “privacy; firearm safety was most
definitely not a medical issue, and gun ownership and storage were therefore
not appropriate matters for their physician to discuss. In the words of one
patient, ‘I would not ask my doctor about gun safety or the NRA about my
blood pressure.’”

“The issue of a hidden agenda and privacy reached a crisis stage in one
practice located in an extremely rural county. The practice provides the
only medical care available for this community, and some patients became
concerned that the demographic information collected on the survey–age,
race, and education level of the heads of household–would be used to
identify and possibly persecute gun owners. After approximately 1 week of
data collection, the medical director of the office was approached by a
local magistrate, who started the conversation by stating his strong belief
in the second amendment to the constitution and suggested that there would
be legal ramifications if the survey were continued. Despite the objections
of the medical director, the board of directors of the health center voted
to discontinue participation in the study.”

The following three paragraphs are the entire “Conclusions” section of
the paper (except that references are omitted):

“At least 65% of unintentional firearm injuries occur in the home. There
is scant evidence, however, that physician counseling regarding firearm
safety is beneficial. No studies have evaluated the effectiveness of
counseling on the rate of unintentional injury or suicide.

“The results of this study seem to be at odds with efforts of medical
associations to increase firearm safety counseling by physicians.
Although counseling by physicians regarding gun storage and sometimes gun
ownership is recommended by these groups, patients in our study did not
appear to be receptive to this information.

“In contrast to the results of a study of parent attitudes in pediatric
clinic populations, patients in this study, especially those who owned guns,
responded that they would not be receptive to physician counseling regarding
firearm safety. These findings, combined with the lack of evidence
supporting firearm safety counseling, suggest that, rather than trying to
convince physicians to talk to their patients about firearms and convince
patients to listen to them, efforts to decrease firearm-related injury would
be more fruitful if focused elsewhere.”