A man in Florida who thought his fiancée was an intruder in his house shot and killed her the day before they were to be married.1 John Tabutt, 62, told investigators he fired his gun at a figure in the hallway who he thought had broken into his home. Unfortunately, the figure was Tabutt's fiancée, 62-year-old Nancy Dinsmore. Tabutt told authorities he thought she was next to him in bed as the incident took place. “Right now, everything points to a tragic accident,” said the police chief investigating the case.

Similar scenarios involving guns can have chillingly tragic outcomes. Consider the child who plays with a loaded handgun that he found unsecured in his home; the intruder who wrests a loaded gun from a panicked homeowner's grasp in the middle of the night; a gun-owning college student who is despondent over both a breakup with a girlfriend and his plummeting grades; and the single mom who answers her doorbell, only to find her estranged husband standing there with a rifle—despite a restraining order that is supposed to keep him away.

You probably think that this editorial is about gun control —a sensitive issue that  evokes strong emotions in everyone, whether for or against. But it isn't. I have found that conversations about gun ownership usually boil down to either a battle of statistics or a heated discussion about the Second Amendment and individual rights. In either case, opinions about gun control seem impervious to being changed. There just isn't much grey area here.

Where I think most of us can agree is that we have an obligation as health professionals to discuss gun safety with patients. And to do that effectively, we need to know the facts about guns.

How pervasive is gun ownership, and how adequately are we prepared to provide information and counseling about firearm safety? Overall, one-third of Americans— 42% of men and 25% of women—say they have a gun, rifle, or pistol in their home.2 University of Washington third-year family practice residents conducted a study to learn whether gun safety was a health issue for their patients.3 They found that 1 in 7 patients had a gun in their house. About half the patients with guns reported storing them unlocked, and more than half had not talked to their children about gun safety. Interestingly, half the patients said that doctors should counsel about gun safety, while only 5% said their doctors had done so. Two-thirds of the doctors said that they were not trained in or com fortable with counseling on gun safety. Another study had similar findings.4 In this case, 84% of respondents (a random sample of 600 members of the American Academy of Family Physicians) never or rarely counseled patients on firearm safety and believed that such counseling was a low priority; 78% lacked formal training on how to counsel patients about firearm safety, and 49% believed more time should be spent in residency programs on firearm safety counseling.

Firearm safety courses are available to educate people on the safe handling, use, and storage of firearms. It stands to reason that these courses are attended by citizens who own or plan to own guns. Unless you're a gun owner yourself, however, you may have no experience with or training on this topic, either as part of the PA program curriculum or since graduation.

When we talk to our patients about their health and choices they can make to stay healthy, we usually speak about behaviors such as quitting smoking, losing weight, exercising more, and limiting alcohol intake. Counseling about firearm safety should be on our list of topics. A gun in the wrong hands at the wrong time or handled improperly can kill instantly. There aren't many behavioral issues we discuss with patients that have such tragic outcomes right away.

Asking patients about gun ownership and safety should be as automatic as asking them about whether they smoke or how much alcohol they drink. You don't need special training to ask, “Do you own a gun?” At the very least, counseling on firearm safety can begin with these gun safety pointers. (1) Remove guns from your home, or keep them unloaded and locked up, with ammunition stored separately. (2) Treat guns as if they were loaded and ready to fire. (3) Do not allow children access to guns.

There are a lot of guns out there. It's part of our job to teach patients how to keep themselves and their loved ones safe. JAAPA

Sarah Zarbock, PA-C, is the editor in chief of JAAPA.

REFERENCES

1. Police: Fla. man kills fiancée on eve of wedding. ABC News. http://abcnews.go.com/US/%20wireStory?id=8796646. October 10, 2009. Accessed November 11, 2009.

2. Public takes conservative turn on gun control, abortion. The Pew Research Center for the People and the Press. http://people-press.org/report/513/. April 30, 2009. Accessed November 11, 2009.

3. UW family practice residents research gun ownership, gun safety practices and gun safety counseling. University of Washington News. http://uwnews.org/article.asp?articleid=1911. May 10, 2000. Accessed November 11, 2009.

4. Everett SA, Price JH, Bedell AW, Telljohann SJ. Family practice physicians' firearm safety counseling beliefs and behaviors. J Community Health. 1997;22(5):313-324.