Doctor’s gingerly posed Q: 'Are there guns in your home?'

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Doctor’s gingerly posed Q: 'Are there guns in your home?'

Primary care physician Pamela Pentin has broached firearm safety with patients for more than a decade. Most, she says, are grateful.
Brian Donohue

If your primary care physician asked whether there’s a gun in your home, how would you feel? Astounded? Spitting mad? Freshly aware of the potential risk? Unsure?
Pam Pentin, a family physician at UW’s Northgate Clinic, says she has broached gun safety with patients since 1996, in the same way she has asked parents about toddlers’ access to household toxins.
Pentin knows she’s in the minority, in terms of primary-care physicians who discuss gun safety. The checklist of questions to cover in a 20-minute preventive checkup is already long. And some gun owners will consider the question, however gingerly posed, as an affront or provocation. It can be easier to choose not to go there.
“It can feel dangerous to ask,” Pentin said. “Some people interpret gun safety as purely a constitutional issue, but we have no intention of challenging the Second Amendment.”

Brian Donohue
Dr. Pamela Pentin is a UW assistant professor of family medicine. At her request, her face is obscured because she is also a U.S. Navy Reserve senior officer, a role that might make her a target during international travel.
Pamela Pentin at her desk

She cited a court case, too, that has physicians nationwide watching: The 11th U.S. Circuit Court of Appeals is hearing a case, nicknamed “Docs vs. Glocks,” to decide whether Florida doctors may legally ask patients about gun ownership during medical consults. The appellate court is ruling on a federal judge’s 2012 decision to block Florida from enforcing its law that would subject healthcare providers to sanctions for broaching the topic. The district judge ruled that Florida’s law violated physicians’ First Amendment right to free speech, and Florida appealed.
So Pentin phrases the question delicately and advances it gently, just as she might ask a patient about erectile dysfunction, she said.
“I usually preface it with something like, ‘I want to talk about some things that might be safety or health issues in your home. Is it OK if I ask whether there are guns in your home?’ And if a patient says they don’t want to talk about it, I’m OK with backing off.”
Some patients bristle, wary at Pentin’s intent – akin to parents warding off a physician’s discussion of birth control with their adolescent child.
If the answer is, “Yes, we have a gun,” Pentin asks permission, again, gently, to inquire about how the gun is stored. “Most gun owners are open to talking. Often they will have protective measures in place, just like parents will have protective covers over the power outlets.”
Others, she said, have expressed uncertainty and concern.
“I’ve had women tell me that their husbands or boyfriends own weapons, and they’re not sure how to approach that person about it,” Pentin said. “My job is to raise consciousness, not to educate about the theoretical safety of weapons. I would be more interested to talk about how the gun is secured. Is it loaded? Does it have a lock? Is it kept in a safe? Who has access?
“I would invite that woman to open a discussion with her significant other about how to make sure the gun is secure. I can refer people to several excellent websites. … It’s especially important when there are vulnerable people – children, individuals with developmental delays, the elderly – in the house We’re simply seeking to introduce the issue of safety.”
Pentin can’t look back over the years of these conversations and point to a confirmed life-saving outcome. Yet she knows that large studies have shown that guns kept locked and unloaded reduce the risk of unintentional injury.
She’s happy that her patients, newly mindful of the risk, say they’re going home to address it.