This year I have written several times about violence and its impact on the public’s health, and last week I shared our N.H. physician survey results indicating that addressing gun violence was a priority for many of you.

Tomorrow night a group of our members will meet as part of the NHMS Medicine and Public Health task force to talk about what we can do to address violence in our communities. In preparation for this meeting I reviewed our current policy (I wrote about that previously here). I also looked externally to see what other physicians are doing on this important issue and found a report from the National Physicians Alliance entitled "Gun Safety & Public Health: Policy Recommendations for a More Secure America." Read report The report has science-based information that led to some practical recommendations:

 Report Background Information

  • 89% of unintentional shooting deaths of children occur in the home, and most of these deaths occur when children are playing with a loaded gun in their parents' absence;
  • 64% of individuals who received verbal firearm storage safety counseling from their doctors improved their gun safety practices;
  • Mass shooting incidents in which assault weapons or large-capacity ammunition magazines were used resulted in 135% more people shot and 57% more people killed;
  • The federal Consumer Product Safety Commission, which regulates the safety of consumer products from baby cribs to clothing and office chairs, has no authority to require firearm manufacturers to consider the safety of the products they make; and
  • 10 states have introduced Medical Gag-Rule Legislation to limit what we can say to our patients about firearms, and two states have enacted them.

Report Recommendations

  • Extending gun purchase and possession prohibitions to people known to be at a high risk of committing firearms-related or violent crimes, such as violent misdemeanants, alcohol abusers, and serious juvenile offenders;
  • Banning assault weapons and high-capacity ammunition magazines;
  • Establishing a universal system of background checks for anyone buying a firearm or ammunition;
  • Regulating guns and gun safety devices as consumer products by requiring the inclusion of product safety features, such as loading indicators and magazine disconnect mechanisms, and testing these products for safety prior to sale;
  • Encouraging the development of new technologies that will increase gun safety, such as personalized guns;
  • Removing all gag rules that apply to clinical encounters, because patients and providers must be free to discuss any issue, including gun safety;
  • Building an evidence-based approach to gun violence prevention, which includes the restoration of robust funding and training for epidemiological research in this area (e.g. through the National Institutes of Health and the Centers for Disease Control and Prevention) and gathering data that tracks gun-related deaths and injuries, safety interventions and the impact of measures to reduce the incidence of gun violence over time;
  • Requiring law enforcement oversight of gun dealerships and ammunition sellers, who should be held accountable for negligence in the marketing or sale of these products; and
  • Ensuring that violence prevention, including gun safety, is a core part of the training and continuing professional education of doctors, nurses, social workers, chaplains, teachers and other professionals.

All of these recommendations may not be pertinent for New Hampshire, but I strongly believe we should look broadly and consider all information available to us as we start our work. This NHMS task force will look to this report and others to develop science-based, practical policies and activities to reduce the risk of violence in New Hampshire. To do this well, we need your help. I hope to see you tomorrow night. RSVP


Please send your questions or comments to or post a comment below.




WOW! I don't know where to begin. It goes beyond "we will have to agree to disagree." The death of any innocent person is a tragedy be it from a firearm, rope, accident of any nature and obviously from a result of crime. Can't argue that. Sometimes the devil is in the details especially when it comes to statistics. The 89% of children involved in shooting deaths in the home is a statistic often used when in fact many of these "children" are under 18 years of age gang members and not the innocent "children" the statistic implies. There is no distinction made between a 5 year old finding a gun at home and several 17 year old gang bangers having a shoot-out at someones home over a girl or drug deal gone bad. Children. 64% of counciled patients improve their home gun safety? How is that statistic generated? Is a home inspection performed or is it a verbal answer to a follow-up question at another appointment? One could assume that the patient (possibly from fear of reprisal) might....lie? I suspect alot of folks tell their dentist that they floss every night when questioned. A mass killing is defined as 4 or more dead not including the perp. "assault" weapons (an arbitrarily assigned name) accounts for less than 2% of all incidents of mass killings. Large capacity magazines are again arbitrarily assigned descriptor. There is no definition of large capacity recognized by the ATFBE or FBI. How was this statistic generated? 135% more people than what? small capacity or normal capacity firearms? What are they? You are correct in that the consumer product safety commission has no authority to regulate firearms and for good reason. No one is trying to take away peoples access to cribs, clothing and office chairs. The firearms industry lobbied hard and successfully to get that exemption so that the use of the CPSC would not be the tool that Daniel Patrick Moynahan and Diane Fienstien and their like would use to prohibit fireams ownership and use by law abiding citizens. The gag rule I am not so sure about. I can see no problems from asking ADULTS about firearms in their possession or home etc. I just don't think anyone should answer that question in todays EHR world where your government and a whole bevy of other onlookers can take a peak in a retrievable data field. It's up to that particular patient to share that information as long as they know that they can decide not to answer it. Recommendations... Violent misdemenanants? Alcohol abusers? Serious juvenile offenders? There is too much room for abuse of these nebulous criterea for any serious citizen interested in protecting their 2nd ammendment rights from gun grabbers...I mean well intending gun safety advocates. Universal background checks....are you serious? Listen to Joe Biden on the subject. He has been on record saying that the reason only 44 cases of lying on form ##44 for the NICS (a felony!)have been prosecuted of the 77,000 NICS denials on grounds of criminal prohibitions done this past year is because of lack of resources for enforcement...yet the gun control folks want to feed more folks into this broken system. Prosecute these people. Then we can talk. Negligence in the marketing and sales of guns and law enforcement....What is the negligence? There are laws that govern these issues. Negligence in marketing is a fluff term of an obtuse nature that leaves too much discretion to unelected enforcement personel to deprive law abiding citizens their constitutional right to keep and bear arms. You can't legislate better behavior of people and still as of tonight, 10/16/2013 there is no cure for stupid. Of the people that I know and have known, legal gun owners are by far the most honest and law abiding folks and we don't like our rights trampled upon or carefully disected by people that feel they know what's best. See U.S. Constitution, Bill of Rights Amendment #2. Check it out. Have a nice day. :o)

Paul, Thanks for reading my post. All the statistics I used are well thoroughly cited in the document. I encourage you to read it with an open mind. As a physician and as a human being I believe we all have something to learn even about areas of our expertise and that is why I talk with my patients about gun safety. I don't do it in a paternalistic way, but rather through inquiry I explore what they know and look to add to their knowledge just as I do when I address someone's hypertension. My experience differs slightly from yours, I have found most gun owns have something they could learn and welcome it. Some know how to safely store their weapons, but simply haven't done so because they haven't gotten around to it. I hope you can see that this issue is not black and white and that learning is possible for everyone. Thanks for your careful consideration Travis

Full disclosure. The report mentioned above by the National Physician Alliance was generated in partnership with The Law Center to Prevent Gun Violence, a San Francisco based legal foundation working with such other groups as MAIGs (Michael Bloomberg's Mayors Against Illegal Guns), George Soros's Joyce Foundation and the Brady Foundation as an organization that is a proponent of increasing legislation banning citizens access to firearms. It is important to know sources and thier potential for bias and agenda.