Robert M. McLean, MD; Patrice Harris, MD; John Cullen, MD; Ronald V. Maier, MD; Kyle E. Yasuda, MD; Bruce J. Schwartz, MD; Georges C. Benjamin, MD
Acknowledgment: The authors thank Renee Butkus for her invaluable role in developing the document. They also thank the persons who reviewed and provided input about the document for their professional organization, including Robert Doherty; Debra Cohn, JD; Andrea Garcia, JD; Julie Wood, MD; Shawn Martin; Mike Munger, MD; Douglas Henley, MD; Kristin Kroeger; Colleen Coyle; Alison Crane; Eileen M. Bulger, MD; Deborah A. Kuhls, MD; Christian Shalgian; David B. Hoyt, MD; and Ronald M. Stewart, MD.
Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-2441.
Corresponding Author: Robert M. McLean, MD, American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106; e-mail, firstname.lastname@example.org.
Current Author Addresses: Dr. Harris: American Medical Association, 330 North Wabash Avenue, Suite 39300, Chicago, IL 60611-5885.
Dr. Cullen: American Academy of Family Physicians, 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2680.
Dr. Maier: American College of Surgeons, 633 North Saint Clair Street, Chicago, IL 60611-3295.
Dr. Yasuda: American Academy of Pediatrics, 345 Park Boulevard, Itasca, IL 60143.
Dr. Schwartz: American Psychiatric Association, 800 Maine Avenue SW, Suite 900, Washington, DC 20024.
Dr. Benjamin: American Public Health Association, 800 I Street NW, Washington, DC 20001.
Author Contributions: Conception and design: R.M. McLean.
Analysis and interpretation of the data: J. Cullen.
Critical revision for important intellectual content: J. Cullen, R.M. McLean.
Final approval of the article: G.C. Benjamin, R. Butkus, J. Cullen, P. Harris, J.E. Jackson, R.V. Maier, R.M. McLean, B.J. Schwartz, K.E. Yasuda.
Administrative, technical, or logistic support: R.M. McLean, B.J. Schwartz.
Someone should tell self-important anti-gun doctors to stay in their lane. Half of the articles in Annals of Internal Medicine are pushing for gun control. Most upsetting, however, the medical community seems to have consulted NO ONE but themselves.
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Gilbert A Handal, MD
Texas Tech University
August 8, 2019
The issue of shootings is not just guns!! Certainly appropriate registration and background checks and elimination of high power war instruments have no place in civilian life, but I believe the problem is a more deep issue and I do not believe it is related to mental health as such, people are looking for simple solutions to complex problems and that never works!
I believe is a societal problem as we forget about God, as family is redefined and frequently absent in its real role and as our educational systems prepare the students to take tests and not real life issues education. I believe if we are serious about this issue we have to look at all these issues which have profound implications well beyond the shootings
August 10, 2019
Inconsistency on respect for life in the medical profession?
While the medical profession is speaking out against gun violence, and it should, while there have been 1,196 people killed since 1966 in mass shootings in America, there have been >50 Million babies killed in abortions since just 1973, at a rate of >600K per year. What puzzles me is the lack of outrage and outcry re the latter, in contrast to the former.
October 16, 2019
Call to Action Sign-On: Organizations added
TO THE EDITOR:
In August 2019, the American College of Physicians joined with 6 other physician and public health professional organizations, in publishing a “Call to Action” regarding firearm injury and death as a major public health problem in the U.S. We advocated for measures and impactful legislation that would reduce firearms-related injuries and deaths and protect patients and the communities physicians serve.
We have subsequently invited a wide variety of organizations to endorse the article. In addition to the organizations represented by the authors of the article, the following organizations are officially endorsing the article and its recommendations:
Alliance for Academic Internal Medicine
American Academy of Allergy, Asthma, and Immunology
American Academy of Neurology
American Academy of Ophthalmology
American Academy of Physical Medicine and Rehab
American Association of Clinical Endocrinologists
American College of Cardiology
American College of Chest Physicians
American College of Obstetricians & Gynecologists
American College of Preventive Medicine
American Geriatrics Society
American Medical Group Association
American Medical Women's Association
American Psychological Association
American Society of Hematology
American Thoracic Society
Association of American Medical Colleges
C. Everett Koop Institute at Dartmouth
Doctors for America
Everytown for Gun Safety
Institute for Patient- and Family-Centered Care
Manhattan District Attorney’s Office
National Council of Asian Pacific Islander Physicians
National Hispanic Medical Association
National Partnership for Women & Families
Renal Physicians Association
Scrubs Addressing the Firearms Epidemic
Society for Adolescent Health and Medicine
Society of Critical Care Medicine
Society of General Internal Medicine
Society of Interventional Radiology
States United to Prevent Gun Violence
Robert McLean, M.D., MACP
President, American College of Physicians
James R Webster MD,MS, MACP
Emeritus Prof. of Medicine, Feinberg School, of Medicine of Northwestern Univ. estern
November 4, 2019
Reducing Gun Violence in the U.S.
It is wonderful and so appropriate to see the ACP President continuing to lead our profession proposing evidence based interventions to reduce gun violence (GV) in the U.S. (1). Clearly the current collaborative, multi-organizational approach is a great strategy to achieve results. As further recommendations, I would suggest serious consideration of:• A nationally enforced waiting period for gun ownership. Currently available evidence (2) is that this significantly reduces gun suicides, which are currently the cause of the majority of gun deaths in the U.S. (1).This intervention may even reduce gun homicide rates as well (3). Hopefully more such data will be obtained, soon!• A national gun registry for semiautomatic handguns and rifles (AR-15’s, AK-47’s etc.). It could exempt hunting rifles, antique guns and such non-automatic handguns such as revolvers, to blunt any second amendment critics. The evidence from Australia suggests that this approach alone significantly reduces the total number of gun related deaths (4).• More physician education about guns and GV nationally and locally. A pressing need (5)! Knowledgeable physicians, especially former military members and gun owners are a great untapped resource. A speaker’s roster could be developed for presentations to medical students, house staff, grand rounds, national and hospital staff meetings.Unfortunately eliminating this epidemic is a marathon, not a one and done sprint. Fortunately, the ACP is clearly up to the challenge. BIBLIOGRAPHY1. McLean RM, Harris P, Cullen J, et al. Firearm-related injury and death in the United States: A call to action from the nation’s leading physician and public health professional organizations. Ann Intern Med. 2019; 171:573-5792. Anestis MD, Anestis JC. Suicide rates and state laws regulating access and exposure to handguns. Amer J Pub Health. 2015;105:2048-20583. Luca M, Deepak M, Poliguim C. Handgun waiting periods reduce gun deaths. Proc of the Nat Acad of Science 2017;114:262-2654. Chapman S, Alpers P. Gun related deaths: How Australia stepped off the American path. Ann intern med 2013;158:770-7715. Webster JR. Wanted: Local medical experts/champions to reduce gun violence. Amer J Med, 2019;132;376-77
November 1, 2019
Common Sense Firearms Policies Proposed
This article has not done a thorough job of understanding firearms ownership in the United States. How can you defend your home, family and self if your firearm is locked up? What about a persons right to bear arms? Most shootings occur with handguns and many are owned illegally. I favor uniform state firearm education and training including the law of self defense as well as background checks. Many people have protected themselves legally with guns. When seconds count we see again and again police are only minutes away.
November 3, 2019
"It seems pretty clear to me we have emotionally and/or (worse) politically entered into this arena under the guise of bringing in some kind of well meaning professionalism to the debate. We should be able to do so, but I think we need to be careful. We have enough liabilities regarding wrongful death to volunteer for more. As physicians it appears we have taken the emotional bait, allowing ourselves to be sucked into this arena merely because the NRA made a statement for us to mind our own business. If not but for the recent mass shootings to draw us in emotionally like everyone else, things would not be much different than they have been for years: years of criminals shooting each other, and suicides. Should we set ourselves up for this potential liability if we do not sound an alarm?If we somehow do not do our due diligence as the patient's physician to have prevented a death, are we not foolish for volunteering to do so. We also should not volunteer thinking we are going to be some sort of hero by heading off a mass shooting. This merely allows us to get potentially sucked into social media's false "5 minutes of fame game"; something even we are not immune!.
McLean RM, Harris P, Cullen J, et al. Firearm-Related Injury and Death in the United States: A Call to Action From the Nation's Leading Physician and Public Health Professional Organizations. Ann Intern Med. 2019;171:573–577. [Epub ahead of print 7 August 2019]. doi: https://doi.org/10.7326/M19-2441
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Published: Ann Intern Med. 2019;171(8):573-577.
Published at www.annals.org on 7 August 2019
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