With three resolutions, House supports right to talk about guns with patients

Last year’s Sandy Hook elementary school shooting sparked a heated national conversation about gun control, gun violence and mental health. A year earlier, physicians’ role in gun safety landed in the spotlight when Florida passed a law prohibiting physicians from asking their patients about gun ownership. And earlier this year, the Obama administration clarified that the Affordable Care Act doesn’t bar physicians from speaking with patients about gun safety.

Yesterday, the AOA House of Delegates passed a resolution supporting this clarification and encouraging research on firearm violence and, noting the link between mental illness and firearm violence, increasing access to mental health services.

“We felt that it was an appropriate time to develop a new policy statement on firearm violence,” says Ohio delegate George Thomas, DO, the chair of the AOA Bureau of Federal Health Programs, which submitted the resolution. “Basically we’d like to preserve the rights of physicians and health care professionals to counsel patients on prevention, rather than have any federal law interfere with a doctor-patient relationship.”

Concern about the patient-physician relationship also led Andrew P. Eilerman, DO, to draft a resolution clarifying that the AOA opposes any policy mandating physicians to report information about their patients’ gun ownership status, except in cases when physicians deem reporting necessary for safety reasons. The AOA House approved this resolution yesterday as well.

Dr. Eilerman says the Obama administration’s clarification made him nervous about laws going too far in the other direction—that physicians might be required to ask patients about guns and even keep a record of or report them.

“The president brought physicians to the table when it comes to discussion about gun control,” he says. “As a consequence, I was concerned because I believe that the most important thing that we have with our patients is our patient-doctor confidential relationship. And patients put their trust in us to maintain that.”

Dr. Eilerman says it is important for physicians speak to certain patients about gun use—he just doesn’t think the government should be involved.

“It’s not something that I typically bring up,” he says. “And maybe the Sandy Hook tragedy does bring light into needing to talk about it more. … But I certainly am not going to be taking inventory of people who do and do not use guns. That’s none of my business, and I don’t think it’s anyone else’s business either.”

A third resolution passed Saturday also seeks to protect physicians’ relationships with their patients from interference laws, which include those dictating how physicians can speak with patients about gun use. The AOA House of Delegates approved a policy paper drafted by its Bureau of State Government Affairs to help the AOA express opposition to state and federal proposals to adopt interference laws.

“Interference laws can heavily impact the ability of physicians to continue to have the trust of their patients,” says Florida delegate Joseph A. Giaimo, DO, who chairs the bureau. “The vast majority of patients come to see physicians and trust them with their health. If things are put in the way of that relationship, it will fracture it, and the patients will really be at a loss in knowing whom they are able to trust.”

Interference laws vary and include those that prevent physicians from asking patients certain questions, require physicians to provide tests or treatment not supported by evidence, require physicians to speak to patients about specific treatments and place restrictions on the information physicians can share with patients.

Examples of these laws, the policy paper cited, include those requiring physicians who perform abortions to first give the patient a fetal ultrasound and those restricting physicians from speaking with patients about the dangers of chemicals used in the fracking process. Fracking is a technique used to extract oil and gas from rock by injecting water, sand or chemicals.

“Interference laws were starting to become very prominent in a lot of state legislatures,” Dr. Giaimo says. “And frequently, if it starts out in one or two states in one legislative session, then it starts to snowball and gain momentum in other states. We felt that these laws were going to become more and more prominent over the upcoming legislative cycles. And therefore, we wanted to prepare a position paper.”

The policy paper can be used as a template by the osteopathic state societies when they work with their state legislatures, Dr. Giaimo says.

“We’re hoping that the policy will help fortify our physicians, our practitioners, and our representatives and state legislatures to be able to move forward and continue to protect the citizens that they’re responsible for,” he says.