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The Health Care Professional's Pledge: Protecting Our Patients From Firearm Injury

Access the Comments on Wintemute's article to see who has committed to talk to their at-risk patients about firearm safety. Make your commitment now. Too many of our patients suffer when bullets maim or kill them or their loved ones. And those not yet personally harmed by guns worry about the potential for future harm presented by the ubiquity of guns in America. Regardless of whether one believes guns hurt people or that people hurt people with guns, we have a public health crisis and health care professionals have an obligation to do what we can to combat it. Annals of Internal Medicine has raised the alarm about guns since at least 1998 (13). More recently, we have published strong recommendations to reduce firearm injury from the American College of Physicians (ACP) (4) and another from the ACP with 7 other health organizations together with the American Bar Association (5). Improvements in public health require careful study. We've published rigorous reviews to help synthesize what is and is not known (6). The dearth of evidence to inform sensible gun regulation led us to solicit original research and work hard to help authors report it accurately to disseminate as much truthful information as possible for others seeking to learn from and build upon the findings (717). Firearms have also been the subject of On Being a Doctor essays (18, 19). We've repeatedly called on ourselves and our colleagues to examine the evidence, take action, and raise our voices (2034). We've cried out that we must use our voices. Nowhere are our voices more important than in the privacy of the examination room. This is where our work is done, where all the research and learning come together. Of all the times and places where we might speak, this is where our voices can do the most immediate good. We must commit to using that time and place to help protect our patients from firearm-related harm. In this issue, Wintemute calls on each of us to make a commitment to ask our patients about firearms when, in our judgment, it is appropriate and to follow through (35). We know the factors that should alert us to the risk for alcohol, tobacco, and other substance use disorders; sexually transmitted disease; intimate partner abuse; suicidality; and other preventable harms to our patients. We ask about these risks and counsel accordingly. The risks for harming oneself or exposing others to harm from a firearm are also known. And we know we should speak up (34). While changes in U.S. gun regulations are sorely needed to address population-level threats presented by the availability of military-style firearms and unlimited ammunition, physicians and other health professionals at the frontline of patient care can help prevent firearm-related harm one patient at a time. Go to http://go.annals.org/commit-now and make the commitment to start doing this right now. By making a public commitment to ask our patients about firearms and counsel them to reduce this risk, we show our patients and their communities that we are committed to their safety and health. Feeling uncomfortable about how to talk with patients about guns is not a reason to shy away. Read when and how to do it (36). Let's start now. Too many of our patients are in danger. This simply cannot wait.