Although many physicians report believing that health care professionals should play an active role in helping to protect patients from ﬁrearm-related violence, few do so. This article addresses important barriers physicians face in discussing ﬁrearm safety with their patients, as well as when to ask patients about guns, what questions to ask, and what to do with the answers.
- Does presence of firearms in the home pose a risk to patients or their families? Who is at increased risk for firearm related violence? What are the risk factors for suicide?
- What firearm storage practices increase and decrease the risk for accidental harm to children in the home?
- Should you ever ask your patients about the presence of firearms in their homes? Why or why not? What do you know about physician “gag laws?”
- Would you be comfortable asking and counseling patients about firearm safety? Is a lack of experience in this area an acceptable excuse for not doing so? In what other potentially “difficult” areas, or subjects about which you have no personal hands-on experience, have you learned to counsel patients (how about intravenous drug use, risky sexual behavior, or end-of-life care)? Should firearm-related safety be any different?
How can you learn to effectively counsel patients? Look at the resources listed in Table 5. For example, go the “Means Matter” website, register and start the on-line course for health care providers, “Counseling on Access to Lethal Means” (CALM). Use the pre-course questions to assess your knowledge.