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Firearms are a leading cause of death. Why don't more doctors talk to their patients about gun safety?

A white mail doctor presumably asking his seated bearded, white male patient about access to guns.
Why there's a push for more doctors to ask patients about their access to firearms. (Getty Images)

More than half of suicides in the United States involve a firearm, and suicides make up over half of all firearm deaths. Guns are also a leading cause of unintentional injury — and death — in American children ages 17 and under.

But despite this deadly link, many primary care doctors still don't bring up gun safety with patients. Several recent studies have flagged this fact, along with how more lives might be saved if gun safety were a regular topic in doctor's offices. "Only about a quarter of those who die by suicide go to a mental health provider, but they go to the primary care provider," Allison Bond, firearm safety researcher at ​Rutgers University, tells Yahoo Life. "We're missing the opportunity to talk about things like suicide risk and gun safety."

Why aren't more doctors talking about this, and how much does it really matter? Experts break it down.

Why aren't more doctors talking about gun safety?

Right now there are no federal regulations around doctors talking to their patients about gun safety, but several medical organizations recommend the practice. The American Academy of Pediatrics (AAP) suggests that pediatricians "routinely" talk about firearm safety with patients and families, and the American Medical Association (AMA) recommends that health care providers ask whether patients have firearms in their home and counsel them about risks and safe storage.

But it's ultimately up to the doctor and medical practice to actually do this, Dr. Joseph Ladines-Lim, a researcher and resident at Michigan Medicine, tells Yahoo Life — and many don't.

Ladines-Lim conducted a study published earlier this year that surveyed 109 health care providers across 10 sites, asking whether they provided gun safety counseling during new patient visits. He found that only 36% of health care providers said they felt comfortable talking to patients about gun safety.

"A lot of us tend to be a little reluctant to bring up the topic because it can be really politicized and touchy," Ladines-Lim says. "We don't want to do anything to offend or turn the patient away." His research also found that doctors are often pressed for time and may not think this is as important a topic to discuss as others.

Talking about firearms can also feel very personal — and it's just one more intimate question to add to the list that doctors already ask about, Bond says. "But that then perpetuates this notion that we can't talk about firearms in a health setting, which isn't true," she says.

Many doctors also don't bring up the topic because they don't know what to say, Dr. Amy Barnhorst, an expert on firearms law and mental illness and director of the BulletPoints project at UC Davis Health, tells Yahoo Life. "Some are also afraid that if they find out that a patient with a risk of suicide has a gun in their home, there's nothing they can do — that's not true," she says. (Red flag laws in some states allow law enforcement to temporarily remove firearms from people who have been identified as dangerous to themselves or others, she points out.)

What can talking about firearm safety by doctors do?

These conversations can help lower the risk of accidental shootings and suicide, Lauren Khazem, a research assistant professor and clinical psychologist in the Department of Psychiatry and Behavioral Health at the Ohio State University Wexner Medical Center, tells Yahoo Life. People who die by suicide with guns tend to act impulsively and usually haven't attempted suicide in the past, she says. "If we're not asking about firearms, we're missing opportunities for suicide prevention efforts for these individuals," Khazem says.

Some patients may simply not know about safe firearm storage, Barnhorst says. "Patients rely on us for a lot of health and safety information for themselves and their family," she says. "They often have risks brought to their attention that they otherwise may not have known. Firearms is no different."

Research has found that counseling people on safe gun storage can lead to consistent changes. One study of members of the Mississippi National Guard who owned firearms found that 55% of those who were counseled on safe gun storage were still following the recommendations three months later, compared with just 39% of those who weren't counseled.

This also may help lessen the risk of intentional gun violence. Easy access to a firearm creates a five-times greater risk that a woman will be killed by a domestic abuser, according to Everytown for Gun Safety.

Finally, Bond says the conversations can also just remind people about safe gun storage. "If a patient has children or grandchildren coming to visit, maybe the patients will be reminded to unload the guns and store them in a gun safe," she says.

What do these conversations look like?

Ladines-Lim says it varies by practice and provider. "There is no set, uniform way of doing this," he says. Many will have a general questionnaire that patients fill out in advance that includes a question about guns, although Ladines-Lim says his research has found some people will purposefully skip the gun question.

If the patient answers that they have guns in the home or fills it out in a questionnaire, Ladines-Lim says he'll usually follow up to ask if it's locked or loaded and where it's stored before going into gun safety. That largely means talking to patients about having the guns unloaded, locked and stored separately from ammunition, he says.

"When I bring up gun safety with a patient, most will entertain it," he says. "But I've heard from some colleagues who say their patients are not interested in discussing it at all. It varies a lot."

Bond says there needs to be more research around this. "We don't know what this should look like and how a gun owner wants this to be brought up," she says. "We need more research."

Barnhorst says that medical training programs across the country are now focusing more on gun safety. "There's a large movement to incorporate this teaching in the classroom and clinical settings so clinicians know interventions that can help," she says.

Ultimately, Barnhorst says it's important for doctors to try to work with patients. "The people most at risk of firearm injury are firearm owners," she says. "It's important to engage them in a thoughtful conversation and work with them on solutions rather than taking an absolute approach that guns are bad and we shouldn't have them."