Of more than 500 adult patients who had regular checkups during a one-month period, about 56% bypassed a question about firearms on a questionnaire used in many clinic waiting rooms and online portals of Michigan Medicine, the University of Michigan’s academic medical center, where the study was done.
Nearly all answered the rest of the questions about other health and social topics.
A survey of 109 doctors and other providers at those clinics found 36% were uncomfortable discussing firearm-related risks with patients.
About 32% of providers said it was only slightly important, or not important, to discuss firearm safety during checkups with all adult patients.
That answer was different when the patient had a history of mental health conditions. In those cases, 77% of providers said such discussions are important. About half of providers felt the same way about patients with substance use disorders.
The authors said their findings suggest a need for improvement in how primary care clinics train providers on firearm-related topics, and screen patients for potential firearm-related risks.
“Our hypothesis is that patients are deliberately not answering because they don’t want to — maybe because they feel uncomfortable talking about firearms with their doctor or other health provider,” said lead author Dr. Joseph Ladines-Lim, a fourth-year resident in Michigan Medicine’s combined program for internal medicine and pediatrics.
“At the same time, our findings suggest there’s a lot of ambivalence from providers about asking their patients about firearms during the course of a routine visit,” he said in a university news release.
“A decent number want to address it, but an almost equal number don’t think it’s something for them to address. However, there is a consensus about addressing it with those at higher risk, but we also found a lot of providers did not feel well-trained to discuss this issue,” Ladines-Lim said. ..
“Studies have shown that many patients aren’t as resistant to discussing this topic as providers might suspect, especially in people with higher risks — but I suspect firearm use may be a sensitive topic such as obesity or substance abuse where asking permission of the patient to discuss it may be a helpful first step,” Meddings said in the release.