Dear Readers:

              Let me warn you that today’s column is longer than my usual 600-700 words. So, I hope you will set aside a bit of time to read the entire thing and spend a moment reflecting on what it says.

              Before I get into the specifics, I want to say that on at least two occasions, I had the great fortune to be able to talk candidly and completely with skilled and responsive physicians about disquieting medical symptoms which were affecting me and one of my kids. I couldn’t have gotten this kind of advice and foreknowledge from anyone else, and I will never (read: never) join with any of those shitheads, including a former President, who rant and rave about the ‘fraud’ of modern medicine or how immunizations should all be banned.

              However, I also believe that if doctors are going to deliver remedies to medical risks, then they need to understand what those risks really involve, and in the case of gun risk, doctors don’t know enough about guns to promote themselves as the professionals whose beliefs and treatments should be accepted in that regard.

              I refer to an article which just appeared in a medical journal, “Firearm Screening and Counseling in General Medicine Primary Care Clinics at an Academic Medical Center” and can be downloaded here.  The article’s authors asked 109 medical providers in 10 Michigan clinic sites to answer questions about counseling patients on gun risk and found “a generalized resistance from patients and providers alike to discuss firearm safety,” which is similar to other, similar studies on gun counseling conducted over the past years.

              For guidance in creating this survey, these researchers cite an article published by one of the gurus of gun violence prevention, Garen Wintemute, along with several other alleged gun  violence experts, an article which has become the non plus ultra resource for helping doctors learn how to talk about guns, and you can download that article here.

              How do Wintemute and his colleagues advise physicians to counsel patients about guns? First, they present an ‘epidemiology’ of gun risk, which is totally based on the demographics of people who are shot with guns. Now I’m not an M.D., I’m only a lowly Ph.D., but I always thought that epidemiology is a method which is used to help determine how a threat to health moves from one victim to another, which when it comes to gun violence, you won’t get even the slightest hint if your data only covers information about the people who get shot.

              The WHO defines violence as any conscious attempt to injure yourself or someone else. But when it comes to gun violence, less than 20% of all shootings involve the victim also being the person who shoots the gun. So, if you do research on gun violence and only look at the demographic profile of people who get shot with guns, you happen to be missing at least 80% of all gun violence events.

              The Wintemute group then goes on to tell us about why people own guns, the idea being that if you are going to counsel gun owners about gun risk, you need to deal with their interests, concerns and fears which made them go out and buy a gun. And what data is used to figure this problem out? The same data which has been used in virtually every research done on guns over the past twenty years that shows a majority of gun owners buy a gun in order to protect themselves.

              The next sentence is the single, most important sentence in this entire column, so please read it slowly, perhaps read it several times and spend a few moments thinking about what the sentence says, okay?

              There has never been one, single study produced by public health, physicians or medical caregivers about guns which asks gun owners to describe the type of gun which they own. Not one. Not one, single study.

              And unless you know what kind of gun(s) you are talking about, getting into a discussion with a patient about gun risk is a total and complete waste of time. Because even though all guns represent some degree of health risk once they are loaded with ammunition that really works, the difference in lethality of different kinds of guns can be extreme.

              You don’t buy a Glock 17 with a hi-cap magazine which holds 16 rounds of tactical ammunition (the word ‘tactical’ is a polite way of saying that someone might get killed) to knock a birdie out of the tree. You also don’t buy a 22-caliber, bolt action, single-shot rifle to walk around the neighborhood carrying a gun.

              Gun owners are very sensitive to this issue and love to walk into a gun shop and talk on and on with anyone else in the shop about the design and use of different kinds of guns. I know this because I have sold guns to somewhere around ten-thousand-gun owners in the gun shops I have operated in three states.

              Physicians admit in survey after survey that their reluctance to counsel patients on gun violence often stems from their lack of knowledge about different types of guns. Does Wintemute’s article or the study out of Michigan even raise this point or God forbid advise doctors to spend some time learning about the different types of guns? Of course not.

              There must be a couple of hundred books on gun design listed on Amazon. There are also YouTube videos, including this very informative, hour-long video by a clever, young man which could easily be converted into a one-credit CME online course, if one of the so-called medical gun experts would even mention anything about why doctors should learn at least a few specifics about the guns which create the risk about which they are so concerned.

              And what is the remedy for gun violence that these medical and public health experts promote clinicians to advance? Store those guns safely – that will do the trick. Now the fact that there has never been one, single study showing any change in gun violence rates after a control group of patients reports they are paying more attention to gun safety than before, big deal, right?

              Probably the most detailed study of how and why Americans own guns was published by the Harvard gun-research group in 2015. You can download that article right here. This piece goes into great detail about how many Americans own guns, what kinds of guns do they own, when was the last time they purchased a gun and when was the last time they sold or gave one of their guns to someone else.

              This article made all kinds of noise in the media because it identified a group of ‘super owners,’ representing just three percent of the adult population who together own half the country’s guns, for an average of 17 guns apiece.

              There was only one little problem with this article, a problem which basically renders the research totally meaningless for understanding or counseling on the risk of guns. Men and women who are legal gun owners by and large rarely commit violence of any kind with their guns. Maybe once in a great while some gun owner and his wife get into a brawl, and he decides to finally get the old lady out of his hair by popping her with a gun.

              But the reality of guns as representing a threat to health happens to be when someone who is unable to legally own a gun gets their hands on a gun. Who are these individuals and what kinds of questions do they need to be asked in order to determine whether they represent any degree of gun risk? You won’t find one, single word about this problem in any published research from the medical community which allegedly explains to clinicians how they should talk to patients about guns.

              Last point. I don’t see in any of the advisories about how health professionals should discuss gun risk any mention simply to get rid of the guns. Which, by the way, happens to be the one, guaranteed strategy that will reduce gun violence.

              Oh, I forgot.  My bad. Americans have a Constitutional ‘right’ to own guns. Know what? Article 1, Section 8, Clause 3 of the Constitution also gives Americans the ‘right’ to buy and smoke cigarettes. It’s called the ‘commerce clause.’

              So how come physicians have no trouble telling their patients who smoke to get rid of the cigarettes?

Should physicians talk to their patients about guns? Maybe they should first take the trouble to learn something about what they want to say.