AMA tool helps doctors talk to patients about gun safety

In its stepped-up advocacy against gun violence, the American Medical Association on Thursday launched a tool to help physicians identify patients at risk of becoming victims of gun violence and offer ways to intervene before they're hurt.

The new online module will educate physicians on recognizing and counseling patients who are at high risk for committing suicide, which accounts for nearly two-thirds of all gun-related deaths, as well as patients dealing with domestic violence. Guns have been used to threaten an estimated 4.5 million U.S. women at some point in their lives, according to a 2017 study published in the Journal of Women's Health.

Physicians will be trained on counseling parents in pediatric settings about firearm safety, since 1 out of every 3 households with kids in the U.S. has a gun, according to figures from the Center for Injury Research and Prevention at Children's Hospital of Philadelphia's Research Institute; the research showed an emergency department visit for a non-fatal assault injury increased a child's risk for subsequent firearm injury by 40%.

"Injury and death from firearms is a major public health crisis. Yet, while we know there is a very real need for firearm injury prevention among patients, the majority of physicians are not taught how to screen and counsel their patients on firearm safety," AMA President Dr. Barbara McAneny said in a written statement. "We encourage all physicians to openly talk with high-risk patients about firearm safety—doing so will go a long way toward addressing this public health crisis, helping prevent unnecessary firearm-related injuries and saving lives."

Nearly 40,000 gun-related deaths occurred in the U.S. in 2017, according to the Centers for Disease Control and Prevention. From 1999 to 2017, more than 612,000 people were killed by firearms.

The rising death and injury toll has prompted several health systems to implement their own gun violence prevention initiatives.

In July, Salt Lake City-based Intermountain Healthcare launched its Zero Suicide initiative to expand behavioral healthcare services within its primary-care settings and to help clinicians address firearm safety with patients. Utah had the fifth-highest suicide rate in the country in 2016 at 21.8 deaths for every 100,000 people despite ranking 29th in total deaths at 620 that year, according to the CDC.

Addressing the public health effects of gun violence has been a growing priority among healthcare providers over the past few years. Firearm-related injuries accounted for an estimated 25 of every 100,000 patients visiting emergency departments from 2006 to 2014, according to a 2017 Health Affairs study. That resulted in more than 700,000 visits during that time period, $2.9 billion in ED charges and $22 billion for inpatient care.

Calls from the medical community to address gun violence grew even louder in 2018 as public sentiment for gun control hit a fever pitch in the aftermath of the Feb. 14 mass shooting that killed 17 people at Marjory Stoneman Douglas High School in Parkland, Fla.

In November, the medical community drew the ire of the National Rifle Association for its position calling for gun control, with the organization telling physicians in a tweet to "stay in their lane" in response to a paper published in the Annals of Internal Medicine that offered recommendations to reduce gun violence. The tweet sparked an immediate backlash by clinicians, culminating in a response published in the Annals of Internal Medicine titled, "Firearm Injury Prevention: AFFIRMing That Doctors Are in Our Lane."