UConn researchers want to know why gun safety isn’t on every doctor’s checklist – Hartford Courant
Dr. Stacy J. Taylor regularly asks her patients about the safe storage of firearms at home.
“Someone said they put it in their bedside table and it was loaded,” said Taylor, a family physician at Trinity Health New England. “So I said, ‘Maybe that’s not a good idea. If you don’t have a safe, at least keep the gun in one place and the bullets in another. His patient promised to consider a change.
Questions about the safe storage of firearms do not arise at every annual physical or well visit. Studies suggest that only a quarter of family physicians regularly discuss gun safety with their patients.
Despite some of the toughest gun control laws in the nation, Connecticut experiences high levels of gun violence, with more than 60 deaths in the first six months of 2022.
Nationwide, with more than 300 mass shootings this year, gun deaths remain one of the leading causes of premature death. In 2020, 45,222 people in the United States died from gun-related injuries, with suicides accounting for more than half of those deaths, the Centers for Disease Control and Prevention reports.
A new study by two researchers from the University of Connecticut aims to find out why doctors are not systematically addressing this serious public health problem.
“We looked at why they weren’t including conversations about safety or gun safety as part of what we call anticipatory guidance,” said Jennifer Necci Dineen, associate professor-in-residence at the School. of Public Policy from the University of Connecticut, referring to when doctors ask about things like cancer screenings and whether a patient uses a seat belt.
Dineen and co-researcher Kerri Raissian, associate professor, conducted a qualitative survey of 18 family physicians in 18 states, including Connecticut. Most of the physicians surveyed did not ask about gun safety as a primary question, but were likely to raise it if another response prompted the request.
“If I get screened for depression, for example, they might ask me if we have guns in our house,” Dineen said. “If I express concerns about my partner or, say, one of my children being violent, and I tell my doctor, he may ask me if I have weapons at home. But they will rarely talk about it proactively.
The research is part of UConn’s ARMS Center, or Advancing Research, Methods, and Scholarship for Gun Injury Prevention, which connects scholars, advocates, and policymakers in the search for ways to reduce all forms of gun violence.
The researchers selected nine states that have laws regarding home gun storage and nine that do not, in an effort to determine whether the state’s legal and policy framework influenced doctors’ decisions. . In Connecticut, Ethan’s Safe Gun Storage Act passed in 2019. The legislation is named after Ethan Song, 15, of Guilford, who died in an accidental shooting at the home from a neighbor where there were unsecured firearms.
Bringing up the subject of firearms by doctors has been a political minefield in the past. In 2011, Florida passed a law banning doctors from asking questions about gun ownership. After a series of appeals, a 2017 ruling found the law violated doctors’ First Amendment rights.
Florida isn’t the only state to attempt so-called “gag laws.” Similar laws, although less restrictive, have been passed in Minnesota, Montana and Missouri.
But to the researchers’ surprise, the political climate of the doctors’ home state does not appear to be the deciding factor. And the doctors’ comfort level with the subject was only part of the picture. Instead, the biggest hurdle turned out to be time.
“While we had suspected a lot of it had to do with comfort or political context,” Dineen said, “what we hear is that it has more to do with time pressure and the fact that there is more to talk about now than there ever was before.
Add to this time pressure the fact that many conversations during wellness appointments are guided by a form provided by the physician’s electronic medical record system.
“These electronic medical records are pre-packaged and purchased,” Dineen said. “They tend to come with a standard set of items. Some of those items are driven by what’s covered by insurance in many cases.
Dineen and Raissian are in the early stages of their research. They are writing about their survey in 18 states and hope to get funds to expand their research to include pediatricians and OB-GYNs.
They hope their research will shed light on how electronic medical records are compiled so that gun safety issues become a routine part of wellness appointments.
Dr. Adam Weinstein, associate professor of medical sciences and pediatrics at Netter School of Medicine in Quinnipiac, says all medical students should be introduced to the idea of asking questions about the safe storage of firearms in the part of their training.
“We introduce this in September of the first year of medical school in a session where we introduce them to health maintenance visits for children and adults,” he said. “Gun safety is presented as one part of this more comprehensive whole when it comes to health promotion and disease prevention.”
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Most students will also see the principle in practice when they observe health maintenance visits with a preceptor who is a family medicine practitioner, and then again in their third year when they participate in the care team.
“It’s real experiential learning,” he said, “even if the experience isn’t specific to gun safety and storage tips. Rather, it is done in the context and as part of the comprehensive health maintenance visit. »
Taylor, who in addition to being a family physician is a board member of the Connecticut State Medical Society, agrees the issue is also one of training.
“I have students in my practice, and I teach them to ask this question before they go in and ask it for the very first time,” she said. “If you just say to someone, ‘Do you have any weapons?’ which appears to be conflicting.
Taylor said the better question is: If you own a gun, is it stored safely? “You’re implying you care about storage, not gun ownership,” she said.
“It’s a fine line between the patient perceiving you are challenging them and helping them.”
This story was reported through a partnership with the Connecticut Health I-Team (c-hit.org), a nonprofit news organization dedicated to health reporting.