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The Medical Plan To Reduce Gun Violence That Doesn’t Work.

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              Doctors for America is a liberal advocacy group that was formed in 2008 to help promote the Affordable Care Act and now continues to push for all kinds of goody-goody medical things. One of their goody-goody’s is reducing gun violence for which they have produced a video which depicts a physician talking to a gun owner about how he stores his guns.

              The gun owner is a young married guy with a daughter in the home. The physician asks him where he stores the guns when he’s not hunting, and he claims he puts them on a high shelf which is out of his daughter’s reach. The doctor tells him that what he should really do is lock the guns up because they otherwise there’s a risk of suicide or accidental injury. The guy playing the role of the patient agrees.

              There is not one, single study ever produced which shows any direct connection between safely storing guns and eliminating or even reducing gun violence – not one. The idea that safe storage represents an effective response to gun injuries is an assumption promoted by physicians and medical advocacy groups who actually believe that they can gain the confidence of gun owners by pretending that it’s okay to own a gun.

              It’s not okay. The research by Art Kellerman, Fred Rivara and their colleagues published more than a quarter-century ago clearly proves that access to a gun in the home represents a medical risk, and this research did not qualify those guns in terms of whether they were stored safely or not.

              The Hippocratic Oath requires physicians to identify and then work to reduce medical risks. Simply put: Medical groups which promote the safe storage nonsense are violating the Hippocratic Oath. They get away with this crap because their members and their audiences know as much about guns as they know about guns – zilch.

              Want to see another example of how the medical community is completely and totally divorced from reality when it comes to talking about guns? There’s an organization called UpToDate that publishes an online reference database which physicians can use to read the latest studies on any medical problem, as well as print out simple summaries and advice for patients to read. The website is probably accessed by just ab out every primary-care doctor in the United States.

              Here is how UpToDate describes what it does: “a global community consisting of thousands of physician authors and editors who share a singular passion: writing and editing evidence-based information that helps clinicians everywhere practice the best medicine.”

              So now let’s look at the section on gun violence and, in particular, the handout that physicians can print and give to patients regarding the risk of their guns: Patient education: Gun safety for families (The Basics) – UpToDate. Scroll halfway down the page and you’ll see what UpToDate believes a parent should tell a child in order to teach the kid about gun safety: Do not touch the gun. Move away from the gun. Tell an adult. 

              Now take a look at what the National Rifle Association says is the proper way to teach your child gun safety. You can see it right here: Eddie Eagle | NRA Explore.  Scroll down slightly and guess what you’ll see? You’ll see the exact, same safety message for kids that you’ll see on the UpToDate page.  The NRA has been pushing this nonsense for years but now they have an ally in the medical community to help spread their message around.

              How can any doctor utilize any messaging about guns which was developed by the same organization which got a law passed in Florida that would have criminalized any physician who counseled patients about gun risk? Groups like Doctors for America should be ashamed of themselves for even thinking that there’s some kind of common ground which they can occupy with gun owners to reduce gun risk without getting rid of the guns.

              If any physician would like to explain to me how promoting ‘safe storage’ of guns isn’t a violation of the Hippocratic Oath, I’m all ears.

An Important Reference Work On Gun Violence.

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              I have just finished reading and studying a collection of articles which together constitutes the most important reference work on gun violence which currently exists. The book, Pediatric Firearm Injuries and Fatalities, is a collection of 15 articles edited by Eric Fleegler and Lois Lee, both of whom are pediatric-ER doctors at Boston’s Children’s Hospital, so they’ve seen plenty of gun injuries over the years. You can buy the book here.

              The collection is described as a ‘Clinician’s Guide to Policies and Approaches to Firearm Violence.’ Each contribution is a summary of research on a particular aspect of gun violence, along with copious footnotes and ‘Take Home Points,’ the latter lists some basic strategies that clinicians can use for responding to injuries caused by guns.

              Let’s be clear. This isn’t a collection of original, evidence-based articles. It’s a collection of articles which summarize all of the research which has been done to date on specific aspects of gun violence, in particular gun violence which impacts kids. And don’t make the mistake of thinking that by limiting the contents to pediatrics, that you won’t get an overview of gun-violence issues as a whole. Because pediatrics happens to include everyone up to age twenty-four, and by that age you are looking at a majority of the gun-violence events which occur every year.

              This encyclopedic work is divided into two sections: risks and interventions. The risks are homicides and assaults, accidents, suicides, international comparisons, and school shootings. The interventions cover counseling patients before and after shootings, community-based programs, safety design for guns and legislative advocacies.

              Together, these articles cover just about every aspect of what clinicians need to know in order to develop effective responses to gun violence. Together, the articles cite more than 700 references to evidence-based research which means that this work is not ground in opinion but in facts, a welcome change from the way most gun discussions are framed.

              That being said, as usual I have several issues with specific content in this valuable collection which need to be raised. First and foremost is the degree to which public health gun research continues to focus the research on every issue except what I consider to be the most important issue, namely, how, and why gun violence actually takes place.

              The articles which define gun risk are overwhelmingly based on CDC data which tells us all about the victims of gun violence but nothing about the perpetrators of same. I don’t understand how public health researchers can refer to the ‘epidemiology’ of this particular health threat when little, if any time is spent trying to figure out how and why a certain population uses a gun in what the gun industry would call an ‘inappropriate’ way. After all, shooting someone isn’t the usual way that a dispute between two people is resolved.

              Because we know very little about who actually shoots guns inappropriately, how can we really create effective public policies and clinical procedures for reducing such behaviors? I don’t think, in fact, that we should assume that evidence-based research on gun violence can guide our policy strategies when the evidence tells us little, if anything about the people whose behavior we are trying to change. I should add, by the way, that in 4 of the 5 states which implemented comprehensive background checks after Sandy Hook, gun violence rates went up, not down.

              Finally, I have a big problem with the degree to which the entire gun-control community – physicians, researchers, advocates – invariably propose linking up to every relevant ‘stakeholder’ in the gun violence debate with the exception of the most important stakeholders of all – the companies who manufacture the guns.

              If you believe that companies like Glock or Smith & Wesson aren’t concerned about gun violence and gun safety, this only demonstrates that you haven’t gone into a gun shop and purchased a new gun. Because every gun shipped from a factory to a retailer must have a warning which says that the gun, if misused, could result in injury or death. And the warning is printed in big, red letters, okay?

              I’m not saying the gun industry isn’t culpable for many of the injuries and trauma caused by the products they make and sell. What I am saying is that I don’t understand how you can regulate any industry without bringing the representatives of that industry into the discussion as well.

              Those caveats aside, Fleegler and Lee have published a volume which everyone needs to read.  Got something better to do in the Age of Covid-19?

Want To Reduce Gun Violence? Try The ‘Non-Partisan’ Approach.

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              There’s a bunch of ER doctors out there who are promoting themselves as a group of gun experts who want to teach other doctors how to counsel patients about gun risks. The group says it has developed a ‘non-partisan’ approach to gun violence, shorthand for a narrative that will appeal to both sides.

               The head of this group, Chris Barsotti, claims to be a gun owner. In fact, the one gun he owns is an old hunting rifle that belonged to his father; a gun he has never shot. How do I know this? Because I gave him the ammunition for the gun.

              The other group leader, Megan Ranney, explained to me that the reason she never speaks out against the hundreds of thousands of dollars that the American College of Emergency Physicians donates every year to the political campaigns of pro-NRA Members of Congress is because “change takes time.”

              These self-righteous and arrogant promoters of themselves and a few other ER docs are going to hold a virtual seminar next month to explain how doctors and other caregivers should talk to gun owners about their guns. They claim to be developing a ‘preferred terminology’ so that clinicians can prevent firearm injuries and deaths.

              Let’s go back to the beginning, which is 1992 and 1993.  This is when two medical researchers, Fred Rivara and Art Kellerman, published evidence-based research which clearly and indisputably found that access to guns increases risks to health.

I read these articles when they first appeared in print and frankly, didn’t understand why this research needed to be done at all. Was there anyone out there who didn’t understand that if you pick up a loaded gun, particularly a handgun, and point it at yourself or someone else, that such an action wouldn’t increase risk? Isn’t that exactly what my Glock M-17 pistol is designed to do? Duhhh….

              How do you take a product like my Glock and reduce the risk inherent in its design and function without getting rid of the gun? You come up with some stupid or silly workaround like ‘safe’ guns or safe storage of guns or some other nonsense like that. And then you peddle that crap to a largely unsuspecting and ignorant audience and pretend that you have come up with a ‘consensus’ approach to reducing gun risk.

              There’s only one little problem, a problem which happens to make this approach not only wrong from a product design point of view, but also happens to be a violation of the Hippocratic Oath.

The Hippocratic Oath requires all physicians, even these ER docs, to use evidence-based research that will define medical risks, and then use the research to come up with a plan to reduce the risk.

              If you take the trouble to read the articles by Kellerman and Rivara cited above, you’ll notice that in neither category of gun risk – suicide, homicide – did the researchers find that gun risk was mitigated by adopting some kind of expedient like safe storage which would reduce the risk but still let a gun owner have access to his guns.

Not only do these ER docs intend to hold a seminar to explain a ‘consensus’ approach to gun risk which has no basis in evidence-based research, but the seminar also features an appearance by a guy named Rob Pincus, described as an “educator with 20 years of experience in the gun industry.”

Pincus’ educational activity consists of peddling a bunch of books and CD-ROMS on his website which promise to show the average gun owner how to protect himself, his family and his home with a gun. Want to reduce gun risk? Go out tomorrow, buy yourself a Glock or a Sig, then sit on your rear end and watch a video and you’re good to go.

The physicians who are promoting this nonsense should be ashamed of themselves. I can’t say it any other way.

If any of them would like to reply to this column and explain why they believe they are doing what needs to be done to reduce gun violence, I’ll give them all the space they want. 

Don’t hold your breath, folks.

Is COVID-19 Social Distancing A Template For Dealing With Gun Violence?

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For all the talk by physicians about gun violence, the only doctor in the entire United States who is actually doing something tangible to reduce this public health threat is Mike Hirsh, a pediatric surgeon at the University of Massachusetts Medical School in Worcester. He has been running a region-wide gun buyback which is now in its 18th year. The city of Worcester is now into its third year without having suffered a death from penetrating trauma, and while the buyback is certainly not the only reason for the city’s lack of gun violence, what Mike has really achieved is a remarkable degree of coordination and respect between physicians on the one hand, and uniformed services on the other.

If there is one thing about the public health and medical response to gun violence which I find wrong to the point of absurdity, it’s the refusal of both groups to talk about the fact that more than 80% of all gun injuries happen to be crimes. What I hear the gun-control medical groups and public health folks saying again and again are variations on the theme of ‘we need to do more research.’ What I never hear them saying is ‘we need to work with the cops to deal with the illegal use of guns.’

The story in Worcester is very different. The story in Worcester is that every year there is an active collaboration between doctors and cops to spread the word about gun risk which now occurs not just in the city of Worcester, but in more than 20 surrounding towns. It didn’t happen overnight. It wasn’t just a one-shot deal.  It took a year-after-year commitment on the part of white coats and blue coats to bring this about.

This year Mike Hirsh was named Medical Director for Worcester and has found himself in the middle of a new threat to community health which still doesn’t seem to be understood as a threat by Schmuck-o in the White House. But at least in Worcester and surrounding towns, a coordinated effort is being done to make sure that everyone who has to play a frontline role in responding to the COVID-19 virus knows what they have to do. Whether it’s responding to emergency calls, or organizing and coordinating facilities, or getting the word out via social media and other communication venues, the bottom line is that the Worcester hospitals have not experienced the kind of patient ‘crush’ that is happening elsewhere and creates serious roadblocks for dealing with this disease. In other words, the degree of citizen compliance seems to be having a positive effect.

Yesterday, the State Board of Health updated their numbers on viral infections and mortality and reported 8 new deaths in Suffolk County (Boston) and 2 new deaths in Worcester County. The population of both counties is roughly 800,000 and of course these number could change. But Boston doesn’t have anyone coordinating the activities of all medical and uniformed first responders, even though the city has 1,200 employees working for its Health Commission, Worcester has 28.

The more I think about how to implement and manage a social distancing strategy to deal with COVID-19, the more I think it’s what we should be doing about gun violence as well. After all, social distancing simply means that we take it upon ourselves to behave in a certain way based on an informed awareness of what needs to be done. Isn’t that what everyone should be doing in response to gun violence – behaving in a certain way with guns based on an informed awareness that guns represent a risk to health?

If the latest estimates are correct, the COVID-19 virus will begin to disappear after we suffer some 60,000 deaths. We suffer more than 100,000 deaths and serious injuries from guns, year after year after year. Maybe what Mike Hirsh is doing in Worcester for COVID-19 could become a national template for dealing with guns.

The ‘Consensus-Based’ Approach To Gun Violence Is Wrong.

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              Now that physicians no longer have to fear being prosecuted for talking to their patients about guns, a whole cottage industry appears to have sprung up within the public health and medical communities to explain to doctors how they should talk to patients about guns. Because most doctors don’t own guns, and while the medical associations have all issued statements deploring gun ‘violence,’ such statements don’t give doctors any real insights into talking about a particular consumer product found in many of their patients’ homes. It’s easy to talk about seatbelts – every doctor drives a car. It’s not so easy to talk about guns.

              Now it just so happens that guns as a medical risk has been understood for more than twenty-five years, thanks to the two New England Journal of Medicine articles published by Kellerman, Rivara and colleagues in 1993 and 1994. When these two articles appeared, Gun-nut Nation went on the offensive, a political assault which included getting CDC gun-research money thrown out. Nevertheless, from a medical point of view, what Kellerman and Rivara said back then still stands now.

If only the current-day physicians clamoring most loudly for increased concern about gun violence would follow the evidence-based findings of Kellerman and Rivara – but they don’t. Instead, the narrative being promoted within the medical community is to take a ‘consensus-based’ approach to counseling patients about guns.

              With all due respect to my many friends in the medical and public health communities who are trying to find some way to reduce the 125,000+ intentional and unintentional gun injuries which occur every year, this ‘consensus-based’ approach is not (read: not) supported by any evidence-based research. Instead, it reflects the adoption of a narrative designed to shield these physicians from what they believe would otherwise be another assault from Gun-nut Nation and the alt-right.

              If doctors actually believe that by saying they respect the ‘rights’ of their patients to own guns, they will somehow protect themselves from criticism from gun-rights groups, they have absolutely no idea how Gun-nut Nation views any attempt to question access to guns, particularly by people who, for the most part, don’t own guns. Much of the evidence-based data on gun violence comes from solid studies done at the Bloomberg School. That’s B-L-O-0-M-B-E-R-G.  You think there’s a single gun owner out there who would ever believe anything coming from a program funded by the person now being referred to in gun magazines and gun blogs as the head of the ‘nanny state?’

              And once the physician who wants to counsel his patients on gun risk makes it clear that he ‘respects’ the patient’s ‘right’ to own guns, he then can continue building his consensus-based approach by telling the patient that all he has to do is safely store his guns. To be sure, there are studies which find that when patients are counseled about safe storage, they go home and sometimes store their guns in a safer and more secure way. Is there one, single study which compares before-and-after safety counseling to changes in gun-violence rates? Not one. The assumption that safe storage leads to a significant decrease in gun violence is a nice idea, but medical treatments and counseling aren’t based nice ideas.

              Let me break it gently to all my medical friends who find it easy and convenient to believe that once they tell a patient to go home and lock up his guns, that they have done what they need to do in this area of public health.  The Kellerman/Rivara studies which indisputably found both a suicide and homicide risk from guns in the home did not – ready? – did not find any significant difference between stored and unstored guns. A slight difference perhaps in suicides; no mention of storage issues in homicides at all. Nor is there any mention about the need to be concerned about those beloved 2nd-Amendment ‘rights.’

              Take it from a lifetime gun-nut like me. Want to reduce gun violence? Cut the bullsh*t. Get rid of the guns that create this violence – semi-automatic pistols, assault rifles and tactical shotguns.

That would only leave about 250 million guns floating around the United States.  That’s not enough?

What Should Doctors Say To Patients About Guns?

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Today a group of well-meaning and thoroughly ignorant physicians are getting together in New York City to discuss for the umpteenth time the appropriate medical response to what is called a ‘national public health crisis;’ i.e., injuries caused by guns. They will no doubt draft yet another set of proposals to deal with the problem which will include all the usual things – more research funding, comprehensive background checks, ‘red flag’ laws, assault rifle ban, maybe even a mandatory delay in gun transfers or mandatory training before someone can walk around with a gun.

The reason I say these medical professionals are ‘thoroughly ignorant’ is because none of them know anything about guns. If they did know something about guns, they would understand that you can’t make something ‘safe’ which is designed not to be safe. How do we define the word ‘safe?’ It means that when we use something the way it’s supposed to be used that no injury occurs.

That being said, let me break the news gently to all those folks shooting their mouths off at today’s meeting in New York: The guns which are used to commit virtually every act of gun violence happen to be designed for one purpose and one purpose only – to kill or injure either the user of the gun or someone else. To use such guns in a ‘safe’ way is to invent a narrative that could only be taken seriously by people who know absolutely nothing about guns.

Want to ban assault rifles? Fine. Such a ban might result in reducing the number of people killed or injured with guns by, at best, 2 percent. What about the other 98 percent? Oh no, we can’t ban Glocks, we can’t ban tactical shotguns, the Constitution says Americans can own  those guns. And the last thing that medical professionals would ever want to be accused of doing is coming up with a response to a public health problem that didn’t align with 2nd-Amendment rights.

I have never understood how or why physicians need to be concerned about what the Constitution says or doesn’t say about guns when the evidence-based research that physicians are supposed to use to define all medical practice clearly proves that access to a gun is a significant health risk. Is the risk somehow lessened by locking the guns up or locking them away?  Sorry, but I have to gently break something else to my medical friends: There is not one, single study which has ever shown any connection whatsoever between ‘safe storage’ and the injuries caused by guns.

There are studies all over the place which find that when patients are counseled on safe behavior with guns, many of them later report that they have taken the doctor’s advice and are behaving with their guns in a safer way. But none of these studies are based on a before-and-after analysis of gun violence rates; it is simply assumed, with no evidence whatsoever, that behaving in a safe way with guns results in gun-violence rates going down.

When anyone puts their hand on a live gun (that’s a gun with ammunition ready to go) they have moved into a high-risk zone. And the only way to mitigate that risk is to make it impossible for anyone to put their hands on that gun. Now there happen to be many people (one of them me) who have decided for all sorts of reasons that they have no problem accepting that risk. There are also a lot of people who still like to ‘light up a Lucky’ or walk around with 40 extra pounds on their frame. And by the way, the Constitution gives every American the ‘right’ to do both.

Would any physician ever claim, in the interests of  ‘non-partisanship,’ that these patients should be advised to find a safer way to eat or smoke? Of course not. And that being the case, the physicians who think they can find some kind of neutral pathway to reducing gun violence are simply showing their ignorance about guns.

Want to get rid of gun violence? Get rid of the guns designed to cause gun violence. An approach which, by the way, doesn’t run counter to the 2nd Amendment at all.

Guess What? Gun Violence Has Become an Investment Opportunity.

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              Sooner or later I knew it would happen. Gun violence has become an investment opportunity. Or I should say, talking about gun violence has now become a way to bring investors together who can try to make a buck by putting dough into various new ventures and other schemes.

              Want to get in on the ground floor?  There’s a conference being held in New York City  on December 12 whose chief sponsor is an outfit called Northwell Health, which owns and operates more than 20 hospitals in New York State. Chief among these hospitals are Long Island Jewish Hospital and North Shore Hospital which, along with more than 700 outpatient clinics and other facilities, employs more than 68,000 and runs more than 50 of those cutsie, little ‘urgent care’ centers which keep popping up all over the place.

              I think it’s really interesting that a medical conglomerate which doesn’t operate a single health facility in any inner-city neighborhood would get interested in health issues related to guns. If I were to take the time to analyze gun-violence rates in the areas served by Northwell’s hospitals, outpatient clinics, rehab and dialysis centers, pharmacies, imaging and everything else, the baseline number for gun-violence injuries would be somewhere around zilch.  So how come a medical system which treats the patient population least likely to suffer gun injuries is all of a sudden so concerned about what their CEO refers to as ‘this public health crisis?’

              Maybe it’s because Northwell has teamed up for this big deal with a private investment firm, Landmark Ventures, which holds what they refer to as ‘carefully curated’ events connecting ‘thought leaders, C-level executives, innovators and entrepreneurs.’ The purpose is to ‘build strategic relationships and partnerships with top industry dealmakers.’ In other words, Davos Lite.

              So there you have it. Gun violence has now become a vehicle for talking about the latest and greatest investment opportunities that might just be relevant to the medical field. After all, the medical industry now cranks out more than $3.65 trillion every year. That’s not chopped liver even in my book.

              Coming up with new medical products happens as well to be a particular end-game for Northwell Health, which runs a medical-products lab that has gone heavily into a new medical technology, ‘bioelectronic medicine’ which promises to replace pain-killing drugs with electronic impulses that will control the nerves which create pain. These products, none of which are yet on the market, also are being developed to control bleeds. Is that the connection with injuries caused by guns? Maybe they are working on some kind of electronic impulse that will inhibit all those street thugs from taking out their Glocks because ‘he dissed me.’

              In any case, you may recall that back in February, the American College of Surgeons hosted a national, gun-violence ‘summit’ where representatives of more than 40 medical organizations showed up, spent a day blabbing back and forth and issued the usual laundry-list of recommendations for reducing gun violence through the application of various ‘sensible’ gun laws. Then everyone went home and that was the end of that.

              Funny, but the invitation sent out by Landmark Ventures for the ‘carefully curated’ New York event went to the same groups who showed up at Chicago, along with companies like Wal Mart and Dick’s Sporting Goods, who have stopped selling black guns. Oh well, you never know what will happen when you get a bunch of sporting-goods salesmen in a room with a high-level assortment of innovators and entrepreneurs.

              If you catch a slight bit of sarcasm in my text, it’s not by accident but by design. Five or six years ago, you could go to any number of conferences which bring ‘thought leaders’ together but you wouldn’t hear any discussions about guns. Now such conclaves seem to be breaking out all over the place.

              There’s only one little problem. Basically, these confabs don’t accomplish a friggin’ thing. Unless what you’re just trying to accomplish has really nothing to do with the violence caused by guns.

Should Doctors Base Their Response To Gun Violence On What Everyone Wants To Hear?

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              Yesterday the House Judiciary Committee held a hearing on an assault-rifle ban, and what made the headlines was the testimony of a former cop, Diane Muller, who told Jerry Nadler and the other Congressional gun-grabbers that she wouldn’t give up her gun. Muller says that she is the organizer of The DC Project, which describes itself as a ‘nonpartisan initiative to encourage women to establish relationships with their legislators, and reveal the faces and stories of real firearms owners and 2nd Amendment supporters.”

              This ‘organization’ is nothing more than an online shopping cart selling the usual retail crap (clothing, concealed-carry purses, etc.) with some exhortations about personal safety, getting involved, protecting civil rights, the whole nine yards.  Websites which focus on female self-protection as a vehicle for selling gun-related junk keep popping up, but no matter how they slice it or dice it, the gun industry has never been able to persuade women to buy guns.

              Diane Muller’s claim to be running a ‘non-partisan’ advocacy organization is about as truthful as my claim that the 45th President is smarter than Leonard Mermelstein, who  happens to be my cat.

              I don’t really care if hucksters like Diane Muller pretend to be committed to views from both sides. The fact that someone with so little real presence in the gun world would be representing the 2nd-Amendment bunch in front of a Congressional committee says an awful lot about the gun ‘rights’ movement during the waning days of Donald Trump. On the other hand, when physicians get together to talk about gun violence and also claim to be ‘non-partisan’ in their approach, this doesn’t just rankle me, it really gets me pissed off.

              Physicians aren’t supposed to be dealing with a medical crisis like gun violence by finding a ‘non-partisan’ cure. But it has now become fashionable in medical circles to talk about a ‘consensus’ approach to gun violence, which is how the ‘historic’ Chicago summit meeting in February of 43  medical organizations promoted their Magna Carta for reducing gun violence.  In fact, what they produced was nothing more than the same load of recommendations which the medical community has been using to chase after its gun-violence-prevention tail for the last twenty years: expanded background checks, safe storage, red flag laws, blah, blah, blah and blah. Oh, and let’s not forget the all-important research money from the CDC.

              Now we have a new medical group on the scene, courtesy of a $5 million grant from the National Institutes of Health, which calls itself FACTS, a.k.a., Firearms Safety Among Children and Teens Consortium. Most of its members are the same research crew which show up everywhere else, and they also promise to take a consensus-based approach to understanding violence caused by guns. The consensus in this instance is provided by a single individual representing gun owners who runs something called Gun Owners for Responsible Gun Ownership, which like the DC Project, is just a website but doesn’t yet have anything for you to buy.  I’m sure a shopping cart will appear in time. The odds that what this guy references as ‘responsible’ gun behavior could ever remotely pass muster with most people who own guns is about a great as the odds that #45 is smarter than Seymour Sliperman, who happens to be another one of my cats.

              Doctors who promote the idea that their research represents some kind of consensus are doing nothing more than hoping that if the CDC starts giving out research monies on guns, they can pretend that their work is not intended to be used for gun-control advocacy because, after all, what they will say reflects the views of both sides.

              The day that physicians all agree that treating disease should be based on remedies which meet everyone’s interests and concerns, is the day I stop going to the doctor and hope for the best. This is nothing more than cynical pandering at its worst and physicians should know better than to engage in such nonsensical crap.

Why Do Physicians Continue To Support The NRA?

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              In 1927 a Belgian medievalist, Henri Pirenne, created an academic firestorm with the publication of an article which argued that the shift of Western Civilization away from the Mediterranean (Greece – Rome) to its modern locus in Northern Europe was due to the 7th-Century invasion by Islam into North Africa and Spain. His study provoked the publication of endless responses, revisions and refutations that probably accounted for an unknown number of academic promotions, tenures and teaching careers. When the whole controversy finally died down fifty years after it began, the center of Western Civilization was still located alongside the Île de France.

              I am reminded of Pirenne’s thesis whenever yet another pronouncement is issued calling for more research into the violence caused by guns, even though the formative research by Art Kellerman and Fred Rivara linking higher rates of suicide and homicide to guns in the home was published more than twenty-five years ago.

              The demand for more research has grown exponentially since Sandy Hook, just as the whole gun-control movement has spread outward following that terrible event. In April, 2015 eight national medical organizations published a ‘Call for Action,’ which demanded more “research to support strategies for reducing firearm-related injuries and deaths.” You can download this paper right here.

              Pursuant to that manifesto, three of the organizational signatories have produced their own calls for more research, agendas which allegedly reflect the various specialties which they bring to the issue of guns. I refer to pronouncements made by the American College of Emergency Physicians (ACEP) in 2016, the American College of Physicians (ACP) in 2018 and the American College of Surgeons (ACS), also in 2018.  You can download all three papers right here: ACEPACPACS.  Feel free to download the Kellerman-Rivara articles here and here.

              According to the ACEP, “high-quality firearm injury prevention research is needed.” Says the ACP, “More research is needed on firearm violence and on intervention and prevention strategies to reduce injuries caused by firearms.” Announces the ACS, “We recommend that research for firearm injury and firearm injury prevention must be federally funded at a level commensurate with the burden of the disease without restriction.”

              So there appears to be a consensus emerging within the medical community that a behavior which results in injuries to more than 125,000 Americans each year is a serious problem and that more research will help develop effective interventions to bring that number down.

              With all due respect to the 39 signatories of these pronouncements who hold MD degrees, what they have published are road maps to help them design and produce more studies to enhance their research careers. Thank you very much.

              The behavior which creates gun injuries is well known – pick up a loaded gun, aim it at yourself or someone else, pull the trigger and an injury occurs. It’s guaranteed to work every, single time. If any one of the 39 medical researchers believes this research to be inadequate, come to my gun shop, we’ll go downstairs to my range, I’ll give you a loaded gun, then you pull the trigger and let’s test the result. Sorry folks, this outcome is validated at least 350 times in America every, single day.

              Incidentally, these three medical groups – ACEP, ACS, ACP – donated nearly $250,000 to the 2016-2018 Congressional campaigns of the worst, most aggressive members of the House GOP caucus whose votes have been primarily responsible for the lack of gun-research funding which these organizations all claim to be their most worrisome concern. Have any of these researchers who are so committed to saving lives said one word about this egregious state of affairs? Not one peep. And these researchers want their concerns about gun violence to be taken seriously by anyone other than themselves? Are they serious? You can download this wall of shame right here. You can also read a new JAMA article which goes in greater detail about medical support for the NRA.

               The research on gun violence is clear: get rid of the guns. I say this as a bone-fide gun nut, not just as some doctor who happens to own or not own a few guns.

The Big Scam Known as Gun-Safety Training.

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              Yesterday I began to write a series of columns in which I stated some strong opinions about the strategies being promoted by Gun-controlNation to reduce the violence caused by guns. Let me repeat again what I said yesterday, namely, that I have never (read:never) been opposed to any public policy that will reduce gun violence; my role,as I see it, is to raise questions about the research and information used tocraft and justify these policies when/if I see gaps in the research or theinformation which need to be filled.

              That being said, today’s topic covers one of the truly great scams both within and without the gun world, namely, the idea that an activity referred to as ‘safety training’ does anything to reduce gun violence at all. Which groups and organizations support training in the use of guns?  Every group on both sides of the debate. The NRA of course is in favor of training, that’s why America’s ‘first civil rights organization’ was formed. As for the other side, the latest bromide can be found in a recent policy statement from the American College of Physicians: Sales of firearms should be subject to satisfactory completion of a criminal background check and proof of satisfactory completion of an appropriate educational program on firearms safety.”

              The difference between Gun-nut Nation and Gun-control Nation as regards safety training is that the latter groups want such training to be mandated (i.e., required) as a requirement for gun ownership; as far as the former coalition is concerned, nothing involving 2nd-Amendment ‘rights’ should be mandated at all. Okay, so the NRA gave in on background checks back inn 1994, but in fact the requirement that gun owners be law-abiding has been in statute since 1968.  If anything, the ability of the NRA to portray its members as the most law-abiding citizens has been a master-stroke in terms of promoting the value and benefit of guns. Back to the issue of training.

              I may have a rather weird view of things, but I always thought that ‘training’ is a process whereby someone learns how to do some kind of activity correctly every single time. And it doesn’t matter whether what you are doing involves driving a car, or working on a computer, or cutting into someone’s chest, either you can always do it the same way, or you can’t. And the way we go about validating someone’s training experience is to test their performance to make sure that when actually engaged in the process for which they have been trained, they won’t make a mistake.

              Now if someone makes a small mistake, like not putting on a turn signal at the intersection or not shutting down the computer while an app is still running, it’s usually no big deal. But if someone makes a mistake with a gun, the result not only can be horrendous, but the odds that one can mitigate the effects of the mistake will often be zero to none.

              There is not one, single jurisdiction anywhere in the United States, even jurisdictions which mandate gun-safety training, where the proficiency validation even remotely begins to show that the person who has received training can be expected to safely use a gun. Sorry, but standing in front of a stationery target and shooting a few rounds downrange doesn’t prove anything at all. A study of live-fire requirements in all 50 states found that some states required a smattering of live-fire for a concealed-carry license, but rarely do any jurisdictions require live fire for simply owning a gun.

              If medical organizations like the American College of Physicians want to announce their support for gun safety education, the least they could do is take the trouble to learn what they are talking about. Ditto Gun-control Nation, which seems to assume that anything which smacks of mandated (government) gun regulations is a good thing. Sorry, government mandates are basically useless if they require activities that have no value at all. Which happens to be the case with gun training today.

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