Firearms Safety: The Role of the Physician

When it comes to firearms, the United States is not the most violent country in the world—that unfortunate distinction belongs to such countries as El Salvador, Venezuela, Guatemala, and Columbia. However, the United States is the clear outlier among our high-income peers, boasting not only the highest number of civilian firearms ownership per capita but also a gun violence death rate that is two and a half times that of the next most deadly country. Some 40,000 Americans die by a firearm annually, and that number is growing.

“The understanding and prevention of disease and injury should be the first strategy of medicine and that treatment, no matter how necessary, is not the logical first line of attack.” These words, from public health official William Haddon MD MPH, were meant to serve as the underpinning of a decades-long campaign to reduce death from automobile accidents.¹ However, the statement applies equally, if not more strongly, to our nation’s current firearms death and injury epidemic.

Under the umbrella of public health, medical organizations, such as the American College of Physicians (ACP), have long advocated for sensible firearms safety. When ACP published updated guidelines on this topic in 2018, the National Rifle Association (NRA) tweeted “Someone should tell self-important anti-gun doctors to stay in their lane.” The backlash was both swift and damning. “Where are you when I’m having to tell all those families their loved-one has died,” responded one trauma surgeon.

The medical community is well positioned through both its training and its unique role in patients’ lives to reduce firearms-related injury and death, and it has a rich tradition of advocating to improve the health of the public. Physicians have spoken in a unified voice: the gun violence epidemic is indeed “in their lane.”