Next Saturday, December 15, my friends at Worcester Memorial Hospital and U/Mass Medical School are going to sponsor their 17th annual gun buyback that will run all day in the city of Worcester and many of the surrounding towns. This effort is the brainchild of Dr. Michael Hirsh, the pediatric surgeon at Memorial who first started thinking about gun violence when his classmate in the residency program at Columbia Medical School, John Wood, was gunned down across the street from the hospital in 1981.  You can learn more about the Worcester buyback program here.

The Worcester buyback is a partnership between the hospital and the city’s Police Department, or what Dr. Hirsh calls ‘white coats – blue coats,’ and the pic above shows Worcester DA Joe Early handing Hirsh a nice check.  The same buyback with the same white coat – blue coat effort will take place on the same day at New Haven and Hartford with Yale and U/Conn medical schools/hospitals involved, as well as in Springfield, MA with the involvement of the city’s cops and teaching hospital, and maybe several more sites still to be announced.  The choice of dates is not accidental; the buybacks are always conducted on the weekend closest to the anniversary of Sandy Hook.

When Mike Hirsh did his first buyback in 2002, the concept of giving in unwanted guns for a cash card here and there had been going on for at least forty years, but generally speaking, such activities received a bad press. Some of this negative image came from the work of criminologists, other findings about the limited value of buybacks came out of public health. There has also been a lot of mixed news about the 1996 buyback in Australia, although comparing a government-mandated gun turn-in where owners are fairly compensated for giving up legally-owned property to a community-run, voluntary turn-in effort is like comparing riding to work in a car as opposed to riding to work on a horse.

One of the leading scholars who used to find little value in buybacks is Garen Wintemute, who is quoted in an interview with NPR as saying that the ‘symbolic impact’ of buybacks is ‘important,’ whatever that means. Wintemute published some research on the effect of buybacks held in Milwaukee in 1994-1996, he compared the collected guns to the types of guns connected to gun fatalities and concluded that most of the donated guns were not the types that were used in gun violence; hence, buybacks don’t work. In 2013, Wintemure revisited the issue again and this time decided that buybacks, if coordinated with other initiatives, such as increasing community awareness about gun violence, were an effective tool. 

With all due respect to Wintemute and his research colleagues, the December 15 buyback led by Dr. Hirsh and other clinicians not only meets all the criteria mentioned by public health scholars as making buybacks a credible pathway towards reducing gun violence, but by basing these buybacks on a collaboration with medical centers, they do something much more important as well.

In fact, it was Wintemute himself (and Marian Betz) who published an important essay calling for physicians to become versent in the language and culture that would help them counsel patients on gun violence, in particular patients who appear to be at immediate risk. This article is regularly cited in every professional medical journal which carries articles on physicians and guns.

The reason that Dr. Hirsh and his buyback team focus their attention on participation by medical centers is that their buybacks serve as a practical, hands-on teaching opportunity for medical residents, medical school students and hospital staff. When community residents show up to donate a gun, they are asked to fill out an anonymous form which gives them an opportunity to explain why they decided to get rid of the gun.  The form is IRB-approved, more than 500 have been collected to date, and at some point the entire collection will be analyzed and sent to a peer-reviewed journal to be read by the public at large.  You can download the form here.  

Without going into specific details because the pre-publication analysis is not yet done, I can say that roughly half of the people who have completed the questionnaire to date state that they wanted to get rid of the gun because it represents a risk to themselves and others in the home.  In other words, what the buyback does is give people not just an opportunity to think about gun violence, but to make a decision, without government intervention of any kind, that having a gun around the home is too much of a risk. Now it happens to be the case that a majority of Americans believe the reverse; namely, that a gun is more of a benefit than a risk. Beyond what Mike Hirsh has been doing for the last 17 years, I don’t know a single activity being conducted by anyone in the medical community  which gives gun owners an opportunity to vote the other way.

More important than just the message about gun risk is the fact that at every buyback location you will find physicians and medical students from the cooperating medical centers engaging community residents in discussions about why they showed up to get rid of a gun. It’s all fine and well for public health researchers to state that doctors need to be mindful of ‘cultural values’ when talking to patients about guns, but how many times have these public health researchers stood next to a gun owner and ask why he is turning in a gun?  And by the way, for all the talk about gun buybacks being more successful if the value of the gift cards were increased, in fact, probably half the donors who show up at the Worcester buyback don’t ask for a gift card at all. “I don’t like that store,” one guy said to me last year as he rejected my offer to give him a gift card.

For the first time since the last Ice Age (actually since 1993) Worcester didn’t suffer a single gun homicide in 2017, non-fatal shootings totalled 24. Three years earlier, there were 7 gun homicides, the number of aggravated gun assaults was 38.  This dramatic reduction isn’t a function of the buyback program by any means; the cops now have ShotSpotter technology, they deploy patrol resources in a more effective way, community programs keep the kids busy after school and repeat offenders are taken off the streets.

But the point is that Mike Hirsh’s buyback program has become part of the social fabric of the community, it is also an important activity for educating medical staff, and its value should not be judged in quantitative terms. Seventeen years ago one person decided to do something to help make his community a nicer place in which to live. And year after year, his idea and commitment continues to spread.