Our friends at The Trace emailed an article yesterday about the decision by the American Medical Association to debate and possibly adopt some gun-control measures when the organization gets together for tor their annual meeting in June. According to the AMA President, David O. Barbe, a family physician out of Missouri, the grand poo bah of all grand medical organization poo bahs will debate a nearly a dozen proposals to reduce gun violence and then put its “considerable lobbying clout behind legislation heading into November’s mid-term elections.”
The AMA is already on record backing such ‘commonsense’ strategies as comprehensive background checks, handgun licensing and waiting periods and ‘mandated penalties’ for gun crimes, whatever ‘mandated’ means. According to Doctor Barbie, this year’s grab-bag of proposals includes banning bump stocks, strengthening the background check system, banning assault rifles and high-cap magazines, and increasing the legal age for gun purchases from 18 to 21. All of these ideas and others stem from a basic notion, says Dr. Barbie, that “gun violence in America today is a public health crisis, one that requires a comprehensive and far-reaching solution.”
I am going to be rather blunt and somewhat descriptive by saying that I think Dr. Barbie and his AMA colleagues are once again reducing the issue of gun violence to just another talking-point which, if debated and adopted at the annual meeting, will accomplish absolutely nothing at all. In other words, it’s a load of crap. God knows we have enough decent, dedicated and devoted gun-control advocates and organizations promoting these same issues all the time. Why should the medical profession, which represents the most objective and science-based approach to how their responsibilities and practices are defined, just get on line behind everyone else who wants to do something about the 125,000 deaths and injuries suffered each year because of guns? What the AMA should be doing is insisting that the issue of gun violence be taken seriously within the practice of medicine itself.
Every medical school curriculum contains teaching modules about violence – how to define it, how to spot it, how to counsel about it and who needs to be contacted if the patient is at immediate risk. Guess what? You can search all these treatment protocols and you won’t see the word ‘gun’ or the term ‘gun violence’ even once. And gun violence isn’t the same thing as picking up a baseball bat and whacking your younger bother over the head. It’s not the same thing as getting into a fight. It’s a random and highly lethal type of behavior that creates a level of injury which at best requires a significant outlay of medical resources and at worst leaves the victim dead.
What do we get from the medical profession these days when it comes to discussions about what to tell a patient who says that he or she has access to a gun? We get this nonsensical and ill-advised bromide about safe storage because, after all, we need to ‘understand’ and ‘appreciate’ the culture of patients who believe they are safe if they own a gun.
The studies which show that guns are a risk to safety and health do not distinguish between stored and unstored guns. And as far as I’m concerned, a physician who does not advise patients to get rid of their guns, pari passu, is teetering on the brink of violating the Hippocratic Oath, which does not (read: not) make exceptions for patient ‘culture’ as regards the doctor’s responsibility to reduce harm. Doctors should join and lead the gun-violence discussion by talking about what they know, which is the issue of medical risk. And medical organizations like the AMA should be promoting one very clear message, namely, that guns are a risk to health. This means all guns, no matter how they are stored or how many background checks are required before owning a gun. I know this, and even though I’m also a doctor, I’m just a lowly Ph.D.
May 31, 2018 @ 10:46:20
I suspect my motorcycle is a bigger risk to my health than my firearms, but that’s just a hunch.
May 31, 2018 @ 11:06:23
They can advise that all they want. The problem is that with many gun owners (including myself), the conversation ends there. We fall into that same “no liberal from the east or west coast is going to tell me what to do” narrative.
More effective counseling would be to show the risks of leaving a loaded gun accessible to a child or unstable person. Encourage people to lock up their weapons and remove them from the homes of suicidal people would be more effective.
May 31, 2018 @ 11:46:52
I agree with you that a nuanced discussion makes more sense. If one has never owned a gun, a discussion of the pros and cons makes a lot of sense, especially to separate the horsefeathers rhetoric from reality. If one is a casual gun owner, a discussion of risk factors makes a lot of sense if a casual gun owner has not thought stuff through. For dyed-in-the-wool gun owners like Michael, me, and others, I think a doctor who tries to dumb it down would sound as preachy as a door to door bible salesman trying to save my soul.
I brought up the motorcycle thing because if you ride a lot, you are not only vulnerable to your own mistakes (my Motorcycle Safety Foundation instructor told us “just remember: your motorcycle is always trying to kill you. Its your job to stop it.”) but to those of other people. I suppose with firearms, same is true. My brother in law once shot at a deer that ran between us and I heard the slug crack into a tree so close to me I hit the deck. And we all took mandatory NYS hunter safety training…
My stepdad, a life NRA member, has lived 85 years, most of those with guns. He is a pretty careful gun owner. He used to be a pretty careful motorcyclist but one day he reached down to put the gas line on Reserve on his BMW just as a lady made a left turn in front of him. Bam, and two shattered legs. He now gets around with the help of bionic knees.
I had shoulder surgery a couple years ago to reattach a severed rotator cuff tendon. Shooting too soon after I got out of the sling and my arm still weak, I lost my grip on my double stack 9mm 1911 while drawing it out of the holster. I reflexively grabbed for it as it fell and caught it by the business end. Ooops. Thank Browning for all those safeties.
Motorcycles and guns have one thing in common: mistakes can be deadly and neither have a WABAC machine option you can engage to reverse a mistake. I guess that is my takeaway.
May 31, 2018 @ 13:34:13
Great points, but such nuanced discussions require understanding the complex issue of guns and gun laws in America.
When my doctor asks me if there are guns in the home, I don’t lie. They then ask if they are locked up…..to which I point out that NOT locking them up is a Felony in the state of Massachusetts…and I’m greeted with a blank stare, and often that’s the end of the gun talk.
It would be a lot more useful if the Doctor was asking a real question, rather than simply following a script, AND it might be helpful for those people who do own guns and don’t lock them up to know that you could not only get into trouble if somebody gained access to an unsecured gun, but there are additional legal penalties here.
Of course when you look at anti-gun groups you don’t see much teaching about guns, gun laws, or gun safety. Hell we often hear lies from the anti-gun corporate lobby about how few laws there are, or how fast the background check system is.
People like Mike who are anti-gun, but also know the difference between Semi-auto and full auto, and the difference between a Colt Single Action Army .45, and a Colt M1911A1 .45, is such a rarity that he gets speaking requests just on that resume point alone!
For most people diving into the weeds on guns and gun laws most often sews distrust and resentment for the corporate anti-gun agenda.
I should know, that’s how I came to be on this side of the issue.
May 31, 2018 @ 14:06:58
The AMA represents few real life MDs and would be irrelevant if they did not get windfall royalties from their ownership of CPT codes everyone must use for billing federal payors.
Besides, with computerized medical records, whatever you tell your doctor might not be as private as you might hope. Folks seem to understand this and they routinely lie about anything like guns at home. Heck, no one drinks alcohol or has ever smoked weed If you read their EMRs.
This thing by the ama is just lame posturing.