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Medicine and Public Policy |

Internists' and Surgeons' Attitudes toward Guns and Firearm Injury Prevention

Christine K. Cassel, MD; Elizabeth A. Nelson, RN; Tom W. Smith, PhD; C. William Schwab, MD; Barbara Barlow, MD; and Nancy E. Gary, MD
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For author affiliations and current author addresses, see end of text. Disclaimer: The views presented here are those of the authors alone. They are not official and do not reflect the views of the Educational Commission foreign Medical Graduates; the U.S. Department of Defense; The Joyce Foundation; the National Head Injury Foundation, Inc.; or the directors, officers, or staff of these organizations. Acknowledgments: The authors thank the following advisors to the project: Whitney W. Addington, MD; Katherine Kaufer Christoffel, MD, MPII; David J. Gullen, MD; Ronald Maier, MD; James A. Mercy, PhD; Stephen P. Teret, JD; Franklin Zimring, JD; and Charles E. Lewis, MD. The authors also thank Catherine Haggert, Robert Johnson, and Phillip Panczuk of the National Opinion Research Center for execution of the survey and technical and analytical support and Linda Harris of the Research Center of the American College of Physicians for technical and administrative support. Grant Support: By The Joyce Foundation and the National Head Injury Foundation, Inc. Requests for Reprints: Elizabeth A. Nelson, RN, Research Center, American College of Physicians, Sixth Street at Race, Philadelphia, PA 19106. Current Author Addresses: Dr. Cassel: The Henry L. Schwartz Department of Geriatrics and Adult Development, Mount Sinai Medical Center, One Gustave Levy Place, Box 1070, New York, NY 10029.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1998;128(3):224-230. doi:10.7326/0003-4819-128-3-199802010-00009
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Background: The high rates of death, injury, and long-term disability related to firearms in the United States have led to growing concern in the health care community. Medical organizations and journals are devoting increasing attention to firearm violence as a public health problem; however, few reports discuss physician attitudes toward guns and prevention of firearm-related injury.

Objective: To determine internists' and surgeons' attitudes toward guns and firearm injury prevention.

Design: Analysis of results of a structured telephone interview.

Setting: Internal medicine and surgical offices.

Participants: 457 internists and 458 surgeons.

Measures: 55 questions that covered six domains: experience with firearms, knowledge about clinical sequelae of firearm injury, knowledge about public policies on firearm violence, attitudes toward public policies on firearm violence, clinical practice behavior, and education and training.

Results: The interview response rate was 45.3%, with a compliance rate of 82.5% and a 95% probability (error rate, ± 5%). Ninety-four percent of internists and 87% of surgeons believe firearm violence is a major public health issue. A majority of internists and surgeons also support community efforts to enact legislation to restrict the possession or sale of handguns (84% and 64%, respectively). Furthermore, although 84% of internists and 72% of surgeons believe that physicians should be involved with firearm injury prevention, less than 20% of respondents usually engage in some form of firearm injury prevention practice in patient care.

Conclusion: Many internists and surgeons think that firearm injuries are a public health issue of growing importance, that physicians should incorporate firearm safety screening and counseling into their practice, that physicians should join community efforts to regulate handguns, and that specific gun regulation measures should be adopted as public policy.





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