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

              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.

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

              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?