Here we go again.  Another state, Texas, is going to try and keep physicians from talking to patients about gun ownership thanks to a bill newly-filed by a state representative named Stuart Spitzer, who happens to be a general surgeon with a medical degree from UT-Southwestern Medical School.  The proposed bill goes further than the celebrated Docs vs. Glocks Florida statute which prohibits inquiry into gun ownership but makes an exception in cases where the physician believes that a serious medical problem might arise if the patient has access to a gun.  The Texas law contains no such provision, and simply says that any physician, other than a psychiatrist, cannot ask a patient to disclose firearm ownership, period. The end.

The bill’s sponsor peddles the standard nonsense about how this law will protect gun ownership because, according to him, the moment that such information is entered into a patient’s file, the Federal Government will be able to find out who has guns and who doesn’t.  This outright lie has been floating around the paranoid internet since Obama took office, even though the NRA has refuted it on their website.   But if Glenn Beck can find customers to stock up on freeze-dried food for the coming apocalypse, how hard is it for a Texas legislator to make others believe that Big Brother is waiting to grab their guns after a visit to their local doctor?

                Even though studies show that most patients really don’t care if their doctor asks them about guns, people are sometimes susceptible to this blatant attempt at fear-mongering because they simply don’t understand the methods used by the public health community to define and treat medical risk.  It’s easy to get all worked up about Ebola because the danger is obvious; you don’t need to be a rocket scientist to figure out that with mortality rates above 50%, doing whatever is necessary to avoid this disease is a priority for government and citizens alike.  But is there a consensus on the medical risks posed by guns?  In a funny way there is such a consensus, but it’s based on the idea that guns don’t pose any medical risk at ball.

At the same time that public health researchers argue that the risks of guns outweighs the benefits, the NRA pushes the opposite point of view.  And while research clearly supports the public health position on gun risk, the NRA continues to use a bogus telephone survey by Gary Kleck and some thoroughly-discredited statistical nonsense from John Lott to sell the idea that guns are essential tools  in protecting us from crime. Using the fear of crime as a justification for guns is a master stroke of marketing because a majority of Americans now agree with the pro-gun point of view.

Know why the NRA and its allies have been so successful selling the positive utility of guns?  Because they have adopted a public health strategy for convincing the public and the lawmakers that what they are saying is true. First, identify the disease, which in this case is harm caused by crime.  Then identify how the disease is spread, in this case contact with a criminal.  Now develop a vaccine, i.e., the gun, and immunize as many as people as possible with concealed carry, now legal in all 50 states.

The problem in trying to sell the public health solution to any medical problem, as David Hemenway reminds us, is that unlike medicine, “the focus of public health is not on cure, but on prevention.” This usually requires a long, comprehensive strategy combining research, education and laws. Recognizing that most people aren’t usually responsive to solutions which don’t immediately work, the NRA has fast-tracked the process. The real problem in the gun debate is that the side which is totally resistant to an honest, public health approach to guns has shown itself remarkably adept at turning that same approach on its head and getting exactly what it wants.