What can a pediatrician do to prevent gun violence?

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sliceofbread136

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Like many I’ve started paying more attention to this issue given recent news.

Has screening for guns and giving anticipatory guidance for gun safety actually been shown to help? Have anything been shown to have a preventative effect?

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Nothing. Encourage gun safes around toddlers. Otherwise, nothing a pediatrician can do. Lobby I guess, but it’s not really effective.

In fact, it was temporarily illegal in Florida (for 6 years or so, until 2017) for pediatricians to ask about firearms around children in a household.
Court Strikes Down Florida Law Barring Doctors From Discussing Guns With Patients

You’re talking about a legal issue. Doctors don’t directly write laws, they just abide by them like everyone else.
 
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I think it’s appropriate to mention gun safes/storage within the context of child proofing discussions
 
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I would discuss that the safest thing is to remove the guns from the house entirely. I would also add that if there is going to be a gun in the house, to keep it locked up and unloaded. This is consistent with the APP policy statement on the issue (the first line is "The absence of guns from children’s homes and communities is the most reliable and effective measure to prevent firearm-related injuries in children and adolescents.")

Clearly there are bigger, global things you can do to lobby and advocate for children on gun safety. The people who were plugged in to the AAP in my residency said that sometimes lobbying at the state level may be more effective in making a difference for your patients.
 
When I am at continuity clinic I start mentioning in at about 4 years of age by saying “if you haven’t started having the good touch bad touch talks, you should, pay attention around pools, and if you have guns in the home, they will look for them so they need to be locked up.” As they get older it is a different version of this.

But I am not interested in clinic so maybe what i am saying isn’t nearly enough. Guess I will make a terrible general OP pediatrician.
 
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When I am at continuity clinic I start mentioning in at about 4 years of age by saying “if you haven’t started having the good touch bad touch talks, you should, pay attention around pools, and if you have guns in the home, they will look for them so they need to be locked up.” As they get older it is a different version of this.

But I am not interested in clinic so maybe what i am saying isn’t nearly enough. Guess I will make a terrible general OP pediatrician.

I hate clinic as well but I’ll be stuck in it a few more years so might as well do a good job. I’m gonna steal your spiel if you don’t mind

Thanks to other who responded as well
 
I think this is a tough question. The AAP routinely speaks out about the threat the guns pose to children in society, and I do think on a community level we should feel comfortable speaking out. Just having an MD after your name (and the AAP association) carries weight. In terms of what is possible in an office visit, I agree there's not much. You just don't have the time except to encourage safety and make risks known in a non judgemental way. But there are practices that regularly post to social media and get involved in local community safety themes, from trampolines to vaccine outreach to firearm awareness. If you're part of a larger university or academic system, I would encourage outreach on that level as these institutions often carry a lot of weight in their communities.

Maintaining your AAP membership and becoming a part of their process is also an option. The do have some influence on legislation and access to larger, more powerful audiences.
 
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