How Doctors Can Make Gun Safety Part of Routine Care

Scrubs Addressing the Firearm Epidemic (SAFE) offers a free course for doctors to learn how to talk about gun safety with patients.

In the wake of the Half Moon Bay and Monterey Park mass shootings earlier this year, Dr. Eunice Chen wanted make a change in her medical practice. As a physician, she already had an intimate understanding of her patients’ most private health matters, but her goal was to introduce something new into her annual check-up questions: gun safety.

She found an online course offered by Scrubs Addressing the Firearm Epidemic (SAFE) and joined the over 400 physicians that have taken SAFE’s Clinicians and Firearms course since it launched in 2021.

SAFE is the brainchild of former Stanford medical student, Sarabeth Spitzer, who started the group with the help of retired Air Force Colonel and Stanford Professor of Medicine, Dean Winslow, and his wife, Julie Parsonnet, the George DeForest Barnett Professor of Medicine at Stanford.

“Our objective is to teach physicians that they need to consider when their patients have guns and to discuss it with them and try to make sure that they give the patients the general fund of knowledge they need to have safe gun ownership,” Parsonnet tells LAMag.

Though guns are a contentious political issue, Parsonnet believes that doctors are in a good position to have difficult conversations— including about gun safety—with their patients, given the smorgasbord of other sensitive topics often addressed during routine physicals.

“Patients talk to doctors about their sex lives—their lack of sex lives—their concerns about their children, their depression, their relationships,” she says. “It’s part of what happens when you see a physician.”

But talking to patients about gun safety in particular is a relatively new idea—and many doctors don’t yet know where or how to begin.

“Firearm safety is not something that is necessarily fluent in our conversations because we’re not comfortable with it,” Chen tells LAMag. “We don’t really have training on it, [but we need to realize] that this is part of our role to keep our community safe, that we can have a neutral conversation.”

By educating patients about guns and promoting safe gun ownership, Chen and SAFE believe doctors can help prevent and lower some of the country’s staggering gun death rate, and especially the rate of unintentional gun deaths.

In 2021, over 45,000 people were killed by firearms in the United States—more than those killed by motor vehicles. That number has been rising over the past decade, according to the PEW Research Center and the Gun Violence Archive.

Of the more than 45,000 gun deaths, 26,328 were suicides and another 2,027 were accidents. Some 1,065 children and 4,645 teenagers were killed or injured in gun incidents in 2021. And, there were a record 690 mass shootings in 2021.

“We’re dealing with a huge public health problem,” Safe co-founder Winslow told Stanford Medicine’s Scope earlier this month. “We’ve controlled tuberculosis and HIV as major causes of death. We’re not cutting it with guns—we’ve let it become the leading cause of death in children ages one to 18.”

Winslow is a Stanford University professor of medicine who was nominated to be the assistant secretary of defense for health affairs in September 2017 by then-President Trump. However, he withdrew his name from consideration in December after his Senate confirmation was put on hold by the Senate Armed Services Committee after he testified that he believed it was “insane” that civilians could purchase semiautomatic assault rifles, like AR-15s.

SAFE believes that the one of most effective interventions doctors can make to promote gun safety will likely come from focusing on potential suicides, particularly among young people.

“High school and college are where kids often have a lot of psychological stress and having a gun at home can be particularly challenging,” Parsonnet notes. “These are things that physicians can talk about, the same way they talk about hormones and sex education and condoms and all these other things that we talk about with the parents of teenagers.”

Another intervention point can be for doctors to focus on men, who are 3.88 times more likely to die by suicide than women.

Chen noted in particular her concern for elderly men—a demographic that has seen a record number of suicides in recent years. In 2020, however, men over the age of 85 made up the highest percentage (20.86) of all suicides in the U.S., according to the American Foundation for Suicide Prevention.

Doctors can also address risk factors for unintentional firearms deaths. A doctor, for instance, can walk parents through proper storage practices, including keeping ammunition in a separate safe, removing bolts from weapons and ensuring that a safe’s keys or codes are also kept securely.

“There are specific at-risk groups that we know are at high risk of gun violence or gun injury,” says Parsonnet. “Safe storage reduces those deaths and, just like having a car seat, we should be talking to families about it.”

Chen adds that, for parents, gun safety should extend to where their children play, including their neighbors.

“It’s also being brave enough to ask before you send your child over to a friend’s house,” she says. “The hard question is to ask ‘Do you guys have firearms within your home and are they secured?’”

“Culturally, it’s a tough question,” she admits. “Some people consider it a very private matter, a little bit intrusive, some might consider it a political matter.”

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