(from: freerepublic.com)
Most doctors don’t care whether you own guns and won’t bother asking because they don’t have the time, although some may enjoy chatting about them as shared interests. But occasionally one will raise the question as if it has something to do with routine medical (“preventive”) care.
Here are some examples:
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Scene: A physician’s exam room, complete with chair, small desk, exam table, cabinets full of mystery items—and a computer.
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Version 1 (how it ought to go, if the doctor even asks):
Doctor: “Well, what seems to be the trouble?”
Patient: “It’s my ________ [fill in preferred physical complaint].”
Doctor (after a quick exam): “All right, take this prescription and come back in 2 weeks for a re-check. By the way, my specialty organization recommends that we ask and counsel patients about guns.”
Patient: “Why in the world, doc?”
Doctor: “Uh, because they’re dangerous. So do you own any?”
Patient: “You mean dangerous like driving, swimming, and using power tools and ladders? Since that’s not why I came to you, it’s not relevant, is it?”
Doctor: “I’ll just put that down as ‘Not Applicable’ then.”
Patient: “Fine with me, doc. Thanks.”
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Version 2 (how it might go, if the doctor is more persistent):
Doctor: “Well, what seems to be the trouble?”
Patient: “It’s my ________ [fill in preferred complaint].”
Doctor (after a quick exam): “All right, take this prescription and come back in 2 weeks for a re-check. By the way, my specialty organization recommends that we ask and counsel patients about guns.”
Patient: “Why in the world, doc?”
Doctor: “Because they’re really dangerous. So do you own any?”
Patient: “Well, my family has always had guns. I’m comfortable with them.”
Doctor: “I’m sure you know that guns kill over 30,000 Americans every year, and when they are present make firearms injury and death more of a risk.”
Patient: “I suppose. But no one in my family or anyone I know who follow safety rules has ever even had an unintended discharge. As I recall, less than 0.1% of gun owners are ever involved in shootings, even though most even have more than one gun. And what do you mean by ‘guns kill’, doc? I never saw a gun do anything without someone making it.”
Doctor: “Maybe so. But did you know that they should always be kept locked up with the ammunition locked separately in another room?”
Patient: “I’ve heard that. It’d be really tough to do in our one-room camp cabin. And wouldn’t it get confusing if you have to go all over the house unlocking multiple storage units just to work on your gun, reload or actually shoot the things?”
Doctor: “I wouldn’t know, but that’s what they say. You want to know about gun safety, don’t you?”
Patient: “Oh, do you mean Cooper’s Four Rules, NRA’s Three Rules, NSSF’s 10 Rules of Safe Gun Handling?, or maybe Revee’s Three Accident-Proof Rules?”
Doctor: “That’s a lot of rules—what, 20 rules to remember how to use a gun?”
Patient: “Well, there’s some overlap. What do you mean by ‘gun safety’, anyway, Doc?”
Doctor: “All I know is about locking up guns and ammunition in separate rooms, and that for your and your family’s safety I’m supposed to advise you to get rid of them, because so many people get hurt by them.”
Patient: “Gee, I always thought that ‘gun safety’ was about using guns safely, like we always do. But if everyone got rid of them, how safe would that be? How would people be able to protect themselves against violence—especially women, the elderly and the disabled?”
Doctor: “Well, I don’t have all the answers.”
Patient: “Sounds like you just have one or two, no matter what the question is. . .”
Doctor: “I can’t cover every hazard in detail. Life is full of them.”
Patient: “People die in traffic accidents, drownings and poisonings, lots more than in shootings. So do you mean we shouldn’t drive, swim or use any chemical unless it can be swallowed?”
Doctor: “No, I that would be going too far. There’s good in all of those, just be careful not to get hurt.”
Patient: “Now that sounds like good advice, doc. Hope you understand that’s what smart people do with guns, too.”
Doctor: “Well, that does make sense. You might know best how to handle your own guns depending on how you use them and who else might be around.”
Patient: “Yeah, I think so, doc.”
Doctor: “So do you own any guns? You never answered that question.”
Patient: “No, I didn’t. Why do you want to know again?”
Doctor: “It was in order to tell you how to be safe with them, but I’ve got this electronic medical record form to fill in the information, too.”
Patient: “Well, I know what your advice was now. What happens to information about guns in that record?”
Doctor: “Oh, all your information is confidential and can’t be shared without your permission. Unless, as you’ve already signed for, it has anything to do with coordinating treatment, quality reporting required by insurers or the government, or communicating for any business purposes with other organizations.”
Patient: “That doesn’t sound too private, doc. Has patient information ever gotten stolen from electronic records? I never heard of information from locked up paper charts getting out.”
Doctor: “Um, well, a few times—but electronic records are supposed to increase the quality of care.”
Patient: “So how much has been stolen?”
Doctor: “Uh, to be honest, millions of patient records, including clinical, financial and personal information, have been hacked from electronic databases.”
Patient: “Sounds like more good reason not to go into anything that’s not about the medical care I need, then. You know, I just wonder why the medical world gets so focused on guns when we hear that hundreds of thousands of patients die from medical mistakes every year.”
Doctor: “Tell you what, let’s just skip this stuff about guns—and I’ll try not to make any mistakes on you.”
Patient: “OK, doc.”
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Versions 3+: These are the scenarios that shouldn’t happen, such as the doctor getting upset if you decline to tell about your guns or your finding out your children are being asked about it without your permission. In these cases, see What to Do When Your Doctor Asks About Guns.
— DRGO editor Robert B. Young, MD is a psychiatrist practicing in Pittsford, NY, an associate clinical professor at the University of Rochester School of Medicine, and a Distinguished Life Fellow of the American Psychiatric Association.