Gun Violence Archives - Page 2 of 2 - Screening for Better Health

Obamacare and Gun Screening

May 12, 2016 by drjaffer

The Affordable Care Act, more commonly known as Obamacare, was originally planned to contain a provision regarding gun violence screening and reporting by doctors. This was dropped, under pressure, from the act that was ultimately passed. In fact, language was specifically added, in a section called Title X, that specifically outlines restrictions on doctors to prevent them from recording and tracking gun violence statistics and the results of gun violence screening. Title X also states that healthcare programs may not require gun violence screening questions, and that patients may not be forced to answer gun violence screening questions.

Nevertheless, since the passage of the act, there have been a number of attention-grabbing headlines and chain e-mails of doctors demanding patients answer gun screening questions. Never mind the fact that your doctor cannot force you to answer anything, or that insurance companies cannot restrict their policies based on gun ownership or the likelihood of gun violence (it’s right there in the Affordable Care Act!).

Are these doctors overstepping their bounds? Are they breaking the law?

In a word: No. None of the provisions in Title X can stop a physician or a patient wanting to discuss firearms violence or ask questions about threats of gun violence. Doctors are doing so because they believe it can save lives. We can’t write it down, and we can’t share the data, but we can work with an individual patient to determine if they are at risk and what steps they could take to protect themselves and the people they love.

Everyone seems to agree that mental health is an issue with regards to gun violence. We are trying to directly address this problem. We are not violating your rights, and anyone that tells you we are doing so is lying to you to fulfill their own agendas. When you go to a medical professional, our job is to determine the risks – ALL of the risks – that you might be facing to your life and well-being. For years, patients have been speaking to their doctors about their fear of gun violence in their homes – doctors have simply started asking in advance, because many patients are not aware this is something we can help them with.

When guns are present, people are more likely to die as a result of violence. Simply having a gun in the home makes homicide or suicide more likely. Americans have always owned guns, and likely will continue to do so. The only way for us to reduce gun violence is to look to the source: people who are at risk.

New Gun Violence measures taken by the White House

May 6, 2016 by drjaffer

With a number of stories in the news lately about toddlers and young children accidentally shooting, and sometimes killing, themselves and their family members with unlocked guns, President Obama has made a priority of putting new protections in place to help curb the gun violence epidemic that has infected our country. These new protections focus primarily on the practical safety measures and better screening and reporting for mental illness, and are aimed to be less controversial than past attempts to reduce gun violence. We’ll take a look at the current measures being pursued and what they might mean.

Smarter Handguns

The first and most well-known idea the administration is pushing is the use of smart-gun technology, designed to prevent people either than the gun owner from firing a handgun. The goal of this technology is to keep guns out of the wrong hands, prevent children from firing unlocked guns, and curb the illegal sale of firearms.

The current challenges facing this technology are largely practical: Are these guns equally effective in the hands of police and military personnel as current firearms? And can manufacturers be convinced to produce these new smart guns efficiently?

The administration hopes to answer these questions by running military tests and incentivizing both manufacturers and local governments from adopting smart gun technology. A fully report on the processes being implemented can be found here.

While responsible gun owners have long touted the policy of “lock up your guns”, the government has now chosen to have a hand in making this more of a mandatory process than a friendly suggestion. While it may not solve the issue of legal gun owners committing violent crimes, it does provide a welcome safeguard against accidental violence and some amount of black market gun sales.

Focus on Mental Illness

Currently, laws do not allow doctors to collect or share data on gun violence, despite the fact that many doctors now choose to screen for gun violence with their patients. As a result, the president has focused on the background checks system as the current most important stage of screening. The proposed rule the administration is publishing is designed to ensure that mental health information is appropriately reported during background checks while attempting to obtain a firearm. It also seeks to provide an exemption policy from people with mental health issues that nevertheless seek to be cleared to own a firearm.

This policy change would still not fix the knowledge gap we have artificially created which prevents doctors from compiling gun violence records for study. Only by changing the laws in a significant manner could we do that, but heavy lobbying from the NRA has thus far been successful in preventing this from happening. Hopefully, myself and fellow medical professionals will one day be permitted to gather real, concrete data to better understand the gun violence problem we have as a nation, but for now steps like this may help staunch the bleeding.

State and Local Collaboration

This is the least concrete of the initiatives, as it simply announces a 50-state initiative to combat gun violence on the state and local level. The 50-State Gun Violence Prevention Convening will focus on legislative and executive actions to fight gun violence, as well as a forum to discuss the current background system and reporting tools available to the states.

While it’s difficult to see significant change arising from this initiative, the current issues with reporting on gun violence and the background check system make things like this necessary to better understand the challenges faced at the state and local level.

There’s little doubt that the Obama administration has been frustrated by past attempts to fight gun violence in this country. This recent announcement reflects some of those frustrations, focusing instead on practical, less-controversial measures to fix what can be fixed. Let’s hope these small measures result in real change, and that this is the first step toward a country free of the fear of day-to-day gun violence.

When gun violence is a medical problem

February 17, 2016 by drjaffer

With the rise in high-profile shootings across the country, the potential for gun violence is becoming an integral part of the patient’s healthcare in both screening and prevention. The White House has recently issued a statement requesting doctors to protect patients and communities from gun violence. Physicians have traditionally addressed socio-personal issues relating to illicit drugs and alcohol use, seat belt use, depression, sexual history, domestic violence, and mental health in the clinic. Now, many doctors are coming around to the belief that discussing gun ownership habits and certain red flags are correct to discuss with willing patients as well.

While there are no mandates requiring doctors to talk with you about gun ownership, many doctors have begun doing so of their own volition. This screening process typically involves a set of short questions which are designed to asses common risk factors regarding gun ownership. These risk factors include availability of unlocked firearms, past threats made involving firearms, and the mental health of people with easy access to firearms.

These questions were designed to be uncontroversial while still helping identify potentially dangerous situations involving guns. For example, there is near-universal agreement that firearms are dangerous in the hands of people with certain mental illnesses, or those who regularly abuse drugs. Likewise, most responsible gun owners understand the need to keep firearms locked up in the presence of children.

Obviously, you are under no obligation to answer these questions. But your doctor is asking them for a reason. Many gun-related deaths are preventable. Many happen after a long history of threats or other red flags. Still others happen because of untreated mental illness coupled with easy access to firearms. While doctors cannot prevent all these tragedies, they can in many cases help identify dangerous or life-threatening scenarios before they happen.

There is no easy solution to gun violence, and certainly clinical screening is not going to fix it entirely. But the hope is that by asking the right questions and helping patients better understand potential risk factors in a household with guns, doctors will be able to prevent deaths and help patients lead longer lives – which is, after all, their business.