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A knock on the door interrupted my thoughts. I turned my head to the door and said, “Come on in.” Nurse N. opened the door, and pushed along a cart with a laptop on top. Nurse N. is a pleasant woman, ready to retire. She takes my blood pressure and pulse, then returns to the laptop and enters my vitals. She asks a few questions. Have you been feeling this, have you been feeling that. She clicks the mouse recording my answers. “Now I am going to ask you some mental health questions,” she says, moving the mouse around. “Have you been feeling any symptoms of depression?” . . .

It only takes me a moment to respond. “Respectfully, nurse, I am not going to answer that question.”

“Well,” she smiles, used to my being a bit of a curmudgeon, “I have to ask. I don’t seem to have a place where I can say ‘refused to answer’.”

“Is there a place where you can say I responded, ‘pound sand’?”

Later I tell my doctor. “Look, I refused to answer those mental health questions. I do not want an electronic record of my mental state floating around. In fact, I wish to hell your notes about my medical conditions were just on paper.”

“I completely understand.” she replied.

“What bothers me is that I ought to be able to talk to you about how I feel. I think of you as a friend, but given that the IRS will be running Obamacare, and the IRS has already released private, privileged information to friends of the Obama administration, I do not want to have my 2nd Amendment rights taken away because I told you I am feeling blue about something.”

My doctor nodded “I completely support you in that.” she said. In the past, I have crabbed at her about the ‘No Weapons’ sign in the window of her office. As it turns out, this is a policy of her medical partnership. She personally has no problems with me being armed during a visit, should I choose to be.

I care very much for my doctor. She’s a good egg, and has been my primary physician for over 20 years, poking and prodding me and my children, helping us stay healthy. It sucks that her partners have fallen into line with the leftist establishment over civilian disarmament and government management of medical records.

My wife and I will likely look for a concierge doctor who does not take insurance. I would rather pay cash money for an office visit and know that my medical records are not floating around in the ether. The cat may already be out of the bag for my other health conditions, but the mental health questions entered into a laptop were the last straw.

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    • My wife went to the doctor last week, and had some blood work done . The doctor said that the lab work would be done by a different lab from the one used in the past, because the new lab provides results in about 2 days instead of the longer week of the other lab. The doctor also said that she could get the lab results in 2 days by calling the lab.

      So after 2 days, she called the lab and asked for the results. They said that due to HIPPA restrictions, they could not give her the results–HER RESULTS! Since insurance is paying for the lab work, the results can only go to the doctor who in turn can give them to her. Had SHE paid for the lab work, they would gladly give her the results.

      So now she has to go back to the doctor and pay yet another copay for yet another visit.

      What a crock.

      • Laws are named to disguise their purpose. HIPAA might imply that it is for privacy, but in fact its purpose is to ensure that everyone gets your medical information if they work for the government or insurance companies.

        • Health Insurance Portability and Accountability Act

          I don’t see “privacy” in there anywhere. I think most people think there are two ‘P’s but it is actually two ‘A’s.

      • It’s nice to know that the lab isn’t in the business of providing personal and confidential medical information to whomever can pick up a telephone and provide some basic information to supposedly confirm an identity.

  1. Sorry to burst your bubble but after I Jan 2014 it will be a felony for Doctors to offer “concierge” type services. They are required to take Obamacare and are forbidden to offer their services outside of the system.

    • Wrong.

      I understand a lot of people are very unhappy about the Affordable Care Act, but lying about its provisions is neither productive nor appropriate. There’s enough unpleasant about its provisions that you should have ample fodder to attack it without making up nonsense.

        • Wait, you want someone to prove that a random internet claim is untrue? Do you believe random internet claims, generally?

      • Hey John Smith, ok so it is not complete nonsense, there are concierge practices that still accept insurance, that is where the no no will occur. If a doctor wants to be a true concierge practice then they will have to say goodbye to accepting any kind of insurance and be on a complete cash basis. I am betting this will be the least of our worries about the ACA.

        • As a nurse practitioner, I “should” love the ACA because it will increase my “business”. However, docs who change their practice models to concierge will make more money, have more time to spend with their patients, and be able to provide better care than ever before under the existing insurance models. This is based on the published experiences of docs currently in practice who have changed their practice model.

      • So you, “John Smith” (and how is Pocahontas these days?), “debunk” Mike’s post (HINT: denying something is NOT “debunking” it!), but are too royal to offer your alternative truth.

        Are you still receiving a pension from the Queen, Captain?

        • I have read it carefully. I’m a bloody attorney. Cite the provision to which you refer.

        • That’s not how the internet works John; “I’m right- do your own research” is the extent of internet argumentation.

        • Mike Crognale,
          I pulled up the bill via the link posted by John Smith & searched the entire thing for any instance of the word “concierge” & all instances of the terms “mandatory” & “participation”. I have not come across any passage that supports your claim.

          At this point, burden of proof is on you. Saying he needs to just “read it carefully” when it would be much easier for you to just provide the relevant reference makes it seem like you’ve just taken someone else’s word that it’s in there somewhere.

        • @John smith:

          So I guess you found the “opt-out clause”?

          I did….

          Has anyone else?

          IMO, it is how the SCOTUS ruled the “non-partipant fee” as a fee, not a tax.

          But the “opt-out” clause is technicaly 2-parted, yet singly exercisable, as a single concept.

        • John Smith is correct as is the other fellow. I went back and searched the entire law as finally passed. There is no provision for felony charges against docs who stop taking insurance. My information came from the original bill which I had researched thoroughly because of all the “death panel” claims. My apologies to everyone for the clamor but especially to John.

        • Good on you, Mike. Most people would have just faded off rather than man up.

  2. Good for you and your doctor. Not sure who picked it but I love the pic at the top. Obamacare is seriously making me rethink continuing my career in “medicine.”

    • Most health care providers are already out of the business of providing medical services or health care as their principal business. They’re principally in the business of billing the payer (which ain’t the patient) and doing the bidding of the payer (again, ain’t the patient).

      • Yea no kidding. I currently work for an ambulance service providing non-emergent transport services. We spend more time on scene and at destination trying to round up billing information than caring for the patient. It makes me sick and miss my 9-1-1 days.

        I love going to the dialysis facilities and they refuse to provide us the information because of HIPAA. Which is total BS because it is legally required for turn over of patient care. I love to argue, maybe I should be a lawyer.

        Everything about a patients report is going computerized now. States are quickly requiring us to do our PCRs (patient care report) by computer. They have their advantages such as unlimited space for the report and spell check (depending on the software your employer uses) but are otherwise not practical for feild work. As I have always said, my clipboard has never crashed, froze or lost signal.

      • True, and we’ve cured our already excessive helping of government middleman-ness with a triple dip more of Obamacare. Then again, the ACA has very little to do with ‘health’ or ‘care’.

    • I believe if medicine is you passion, you should continue. As always, things change and there is no constant.

      That said, my PCP is packing up and closing his office in August before the October 1st mandates. That was the reason he gave that he sent to all patience in his practice.

  3. American gun owners will be seriously screwed by ObamaCare.

    Pres. Obama continues apace to “medicalize” firearm ownership via the CDC and HHS.

    As to “concierge care”: Great. But it won’t last for the most sophisticated care. It simply cannot.

    • “But it won’t last for the most sophisticated care.”

      This x1000!

      When you go to the doctor and need an MRI or labs done you will often get a seperate bill from a different company for thoes services because while they may occupy the same building are usually not a part of the practice. Blood is often sent to another location (hospitals being the acception) because they dont normally have their own lab.

      I dont see many concierge doctors with their own MRI machine despite some being portable via 18 wheeler. Often even in a hospital their MRI equipment is leased.

      • According to the few anecdotal reports I have found, lab fees, X-rays, even MRI and CT studies, can be negotiated down to very reasonable levels. Hospital fees and the whole myriad fees associated with more sophisticated care can be negotiated, too. And, I am led to believe when the patient offers cash, almost all facilities are quite willing to drop their fees greatly!

    • I really don’t understand the problem with gun questions from your doctor. JUST LIE and say you HATE guns and wouldn’t have one of the demonic devices in your home!

      It’s not a lie if you’re protecting your life, well-being or family. It’s SELF-DEFENSE!! Stop being squeamish about lying to traitors and tools!!

    • “Medicalize firearm ownership”

      Commit that phrase to memory, 2A people. And we thought the backdoor approach to gun control is ammo shortage. Again, Obamacare will “medicalize firearm ownership”. Attempt to, anyway. Mental health `issues’ will be the weapon of ownership forfeiture. Watch for it.

  4. Prudence, indeed, will dictate that Governments long established should not be changed for light and transient causes; and accordingly all experience hath shewn, that mankind are more disposed to suffer, while evils are sufferable, than to right themselves by abolishing the forms to which they are accustomed. But when a long train of abuses and usurpations, pursuing invariably the same Object evinces a design to reduce them under absolute Despotism, it is their right, it is their duty, to throw off such Government, and to provide new Guards for their future security.

  5. Just because your information is on a computer does not mean its “out there” in the ether. HIPAA privacy laws still apply; and physicians have a legal obligation to protect your medical records from disclosure without a court order or your consent. Further, if there were a reporting requirement (which there isn’t at present except to the extent the patient presents an immediate risk of harm to himself or others), sending a fax isn’t a whole lot more difficult that pushing the “send” button on a computer.

    But I do share your general concern. I got into a “discussion” with a dentist one time about his questionnaire’s broad mental health questions, questions that I declined to answer as irrelevant and invasive of my right to privacy. He declined to serve me, which was fine, but he also dumped my wife who had been seeing him for some time.

    • Pardon me for noting a bit of credulous naivete in your response, but offering up “HIPAA privacy laws still apply” is counting upon the government to operate within the bounds of law.

      There seems to be a lot of evidence to suggest that such faith is misplaced, to the extent that calling it a “wild fantasy” is not out of bounds.

      • “HIPAA privacy laws still apply” is counting upon the government to operate within the bounds of law.”

        Needless to say that is also dependant on if the healthcare provider understands HIPAA (see my response to BLAMMO, the second paragraph). HC providers are so paranoid about it that many do not understand it. It is hard enough as a result for me to get information they are legally obligated to provide. Personally I can care less if we get a SS# and insurance info, thats why we have a billing department.

        Some of my best sleep has been during HIPAA classes. Its pretty fv@king simple really. Give it to persons assuming care of the patient and the patient themself if needed, all others need a supeana. Including the police, even if the patient comited a crime.

      • Case-in-point. Local municipalities that receive health related data protected under HIPPA law usually don’t have staff that give a sh!t about the law, or who are completely oblivious to it. I’ve seen a man with a PhD in a quasi-medical field store HIPPA information on a non-encrypted, non-secured laptop with no password. I cringed and made mental note never to visit that local facility for *anything*.

    • “HIPAA privacy laws still apply; and physicians have a legal obligation to protect your medical records from disclosure without a court order or your consent. ”

      Good god; so physicians are collecting their patients’ information as to ownership, their attitudes about guns and government – TO WHAT PURPOSE? To light tinder in their huge fireplaces?

      The patient information is being collected, ultimately, on request of the government; do you imagine they are just trying to keep doctors BUSY?

      The government is collecting data on citizens, their attitudes towards government, oppression, guns, and prying for specific data on what and what kind of guns, if they are lucky enough to get that out of a patient.

      For which non-nefarious purposes would one imagine this is being done? To keep statisticians busy?

  6. Download the health care law .pdf here:

    Right click in the .pdf and click search the type in Gun Rights.

    This takes you to page 766 and towards the bottom you will read this:

    health promotion activity implemented under subsection
    (a)(1)(D) may not require the disclosure or collection of any
    information relating to—
    ‘‘(A) the presence or storage of a lawfully-possessed
    firearm or ammunition in the residence or on the property
    of an individual; or

    And continue to page 767 you will read this:

    ‘‘(B) the lawful use, possession, or storage of a firearm
    or ammunition by an individual.

    Looks pretty self-explanatory unless I am missing something.

    • Wow. I wonder who managed to get that stuck in. You can bet it wasn’t Feinstein. Is that the version that was signed into law?

    • Last I heard, Obama was pushing an executive order to emphasize to doctors that although people are not required to answer, that doesn’t mean that doctors can’t ask. So, your doc asks if you have any guns, you say “I choose not to answer,” provided you know you don’t have to answer and don’t just naively give them the info. Then the doc records that you have opted not to answer the question, at which point anyone reading those records would assume that you do in fact have a firearm, or else you would have just said “no.” And zoom, off that goes to the central data clearinghouse.

        • Ultimately, do you believe they will follow the law? That would be a novelty.

        • Exactly! A non-answer, you can bet your hide, in a “yes” or “no” question, defaults to a “yes” answer.

          Give ’em the LILAC TREATMENT. Like lack hell!

    • That means they can’t force a doctor to ask if you own guns.

      It doesn’t mean they can’t ask you about your mental state; if a Bad Thing makes it into the NICS database, you’ll have problems buying a gun.

    • “… health promotion activity implemented under subsection (a)(1)(D) [b]may[/b] not require the disclosure or collection of any..”

      Im not sure exactly how it is interprited but it says MAY not rather than WILL not.

  7. I don’t talk to my doctors about anything other than what I’m there for and general physical health concerns.

    I also have no problem lying to them about stuff they have no business knowing in the first place.

    In the present and even moreso in the future, honestly answering questions about your mental state and firearms ownership will only get you further scrutinized by leviathan.

    Objecting to the questions themselves will be seen as a de facto admission that something really is wrong with you and that you do own guns.

    So tell them whatever will attract the least amount of attention.

    Welcome to the new America.

      • Alternatively – and I certainly don’t recommend this – you can, instead of answering, start asking the doctor the same questions he’s asked you.

    • Amen!

      The only time I ever ask a patient if they have a weapon is if it I am called for a psychiatric emergency and they are not already in a medical facility or police station where they would have been searched. Hopefully the police are already on scene and have done that. That said, we dont usually go in a situation like that without the police and there is nothing in my paperwork requiring me to ask and doccument if the patient owns firearms.

        • No worries there. I started in a proffesion that was about quality of care with an emphasis of, “if its not written then it didnt happen.” In my eleven years that important emphasis is now more focused to quality of paperwork and an overwhelming quantity of patients. That is to be specific, let your patients stack up and get through as many as you can but take your time and get the paperwork done the way the insurance companies want it.

          Frankly, Im sick of the insurance companies ruling over me and am disghusted with having to tell patients that the insurance likley will not pay.

    • @ Michael B
      Best analysis in this string. Besides, for security purposes, no firearm owner wants that information out there in ANY form for others to see; that information is essentially PII. Anyone who reveals such information runs the risk of being targeted by oportunistic theives who may learn of it through an employee who has access to the information or database.

      Kind’a like putting clearly marked ammo boxes out with the trash.

    • Approx 2000g in the Obumacare bill. Who knows how many pages of enabling regulations (so far). You can bet the lie you tell to a Medical Professional, who is now a conduit to the feds, is a crime just like lieing to a cop.

      • I doubt it. But even if it was, I don’t care. I’ll do it anyway.

        None of their damned business.

  8. My previous Doctor in DC/NOVA area has went to the cash only concierge system. Even though I do not live in that area anymore and only visit my sister (that does), I am still on their mailing list. Over a year ago, I received his notice in change of service and asked if I wanted to join his practice by paying a monthly or yearly service fee. Once paid, this fee would cover me for any and all services provided by this physician. I opted out of course, but it was quite expensive.

  9. I’m sure not to be the only one disappointed to see George Zimmerman’s primary care provider testifying in court that he was seeing a psychologist, and being questioned about his martial arts activity. I work in a hospital and we take health care information privacy very seriously, but if that information can be subpoenaed in court, apparently the patient is out of luck. It’s unfortunate that what you say in private to your doctor could become a matter of public record simply for being charged with a crime.

    • Oath or no, it’s not in your best interest to answer in the affirmative. You DO care about your best interest, don’t you?

      LIE. It’s not in a court of law. Unless you were referring to a direct question posed under oath in a court of law. It doesn’t real like you were.

  10. TO: All
    RE: THIS….

    …..sort of stuff has been going on in the VA for quite some time.

    And it’s always the nurse who asks such questions.


    Because there is no such thing as Nurse-Patient confidentiality.

    So the nurse can blab all they want without breaking professional ethics or the law.


    [The Truth will out….nurses can’t be trusted….]

    • Not true, confidentiality applies to all healthcare providers. I am but a lowley EMT and could easily lose my license over a HIPAA violation.

      Every service I have ever worked for requires us to provide our patients with an NPP (Notice of Privacey Practices) which informs them how their information will be used and may not be used. The patient or authorized respresentative is in turn required to sign our paperwork stating they have been given a copy of the NPP.

      • Show me the documentation…..

        And does it apply to the VA? A federal agency under the control of Obama?

        As if Obama gave a flying flip about legalities.

        Doubt this? Look at the IRS and NSA scandals.

        • Look at any number of privacy act laws posted at any healthcare facility, usually in the lobby. And they are supposed to give you a copy after they have finished caring for you. Just because doctors take an oath does not mean they are the only ones bound to confidentiality.

          As far as what Obama, the IRS and NSA think about legalities is not relevant to my previous statement or yours. If it were then your previous point would be meaningless because they could/would just bypass the hypocratic oath.

        • TO: In Memphis & Paul53
          RE: Try Not to Miss the Point

          The VA has had nurses asking veterans these sorts of questions for some time now.

          And, if the vet answers in the affirmative about some mental issue, e.g., depression, anger, suicidal thoughts, there have been reports that if the vet has a concealed carry permit, that permit is revoked.

          I don’t have documentation supporting that, but I know several veterans that attest to being asked those sorts of questions.

          I’ll have to do more research on whether or not CCW permits are revoked.

          Again, with the computer loading of such information…..what makes you think the NSA can’t hack a doctor’s office computer?

          You medical field professionals put a lot of ‘faith’ in the Law. But Obama violates the Law every day.


          [If you’re not paranoid, it’s because you aren’t paying attention.]

        • Chuck, that has nothing to do with it not being a doctor. Privacy laws apply to ALL HC providers, right on down to QA, billing and coding. Your original point was why does a nurse ask this question not if anyone beyond facility can access it.

          At the end of the day the doctor, PA or nurse practitioner (not to be confused with RN) is the one signing the documents and giving the orders. Thoes of us below them do not have the final say in it, myself included. Yes even as an EMT I am under the orders of an MD.

          I cant answer to the VAs practices, they are a whole different world. But you also said yourself you dont have doccumentation to prove it. While I do believe it happens, that dosnt mean its right. But I can assure you we are all bound by the same privacy laws.

      • I am an IT professional in a hospital environment. EVERYONE signs the HIPAA confidentiality contract. Students, Docs, Nurses, Groundskeepers, Parking staff, Finance Admins, Custodians, etc. You will be prosecuted, fined, and/or jailed for any unauthorized access. I’ve seen people fired for leaving a workstation and not logging off/locking their session. “Indispensable” people fired for using risky file transfer services (Dropbox, etc). Same for leaving paperwork in the open, face up, with patient or financial info present. The Psyc areas are even more locked down. Only Docs have access to the data, and anyone but them requires a court order, and only for specific information. No blanket requests. Hospitals don’t f’k around with personal info.

    • Chuck, you are wrong. Don’t worry, I can’t tell anybody my real opinion of your statements because, as a Registered Nurse for over 25 years (stopped counting at 25) my opinion is confidential. I do suggest you research before you make such statements, and if you are offended by my constructive criticism, I urge you to get professional help. Paul, RN, Board Certified Emergency Nurse.

      • Please, virtually any piece of digital information contained within a device connected to the Internet is stored within the digital bowels of the NSA within nanoseconds of being typed.

        • Also, don’t be surprised when we hear the next big leak is that the NSA is recording our everyday lives through our smart phones.

  11. Just lie.
    Seriously, it’s no big deal. You’re literally just lying to the Obama administration. They should have absolutely no problem with this – lying is just their way of exhaling a drawn breath, and comes just as naturally. So why would they have a problem with you lying about something like that?

  12. All healthcare workers are required to maintain the highest level of confidentiality within the law. Once we get to the legal part, all bets are off. My discussions with my doctor are confidential. My answers to medical and mental health questions on my state license are public records. My doctor and I discuss firearms. Since none of our discussions lead to any medical concerns, her and my firearms conversations are never documented.

    • Prove it.

      If and personal info goes in an electronic database the Feds certainly have access to ALL the info if they have such a whim. And if not the NSA then private hacker can get it. There is no such thing as a “secure” computer system if there is any connection to an outside phone lines.

  13. The most amusing moment at my Dentist office is they asking me
    to read and sign their “privacy policy” …there is none. I appreciate
    how some medical folks might still hold to the illusions of HIPAA
    but fewer and fewer of us will take the risk. This is the back door
    gun control effort. See an psychiatrist…lose your guns. This WILL
    be broadened in the future. The NIC’s check the NRA foolishly
    supported was the 1st step…now we get to see the 2nd step to
    restricting ownership. Once you have to ask permission (NIC’s)
    then its child’s play to start making “mommy may I ?” more

  14. Tim? C’mon, man…. you’ve REALLY had the same doctor for 20 years? My mind is approximately blown.

    During my (admittedly occasionally erratic) working years, employers would drop HMOs every 1 1/2 to 2 years, and each time, I was forced to choose a PCP from a new laundry list. Usually a short one. I must have had, what, fifteen or more different PCPs. We would barely begin to get to know one another, and PPFFFFT! He were gone.

    A more recent employer made an HMO change before I ever had a chance to select a doc from the original list. I think it had like, 4 doctors on it! This change meant my closest choices were only 19 miles away… I choose to drink instead of drive, but even if that were different, imagine driving NINETEEN MILES when you’re throwing up from flu, or whatever! Then drive 19 miles home, and take a nap before you have to clean the puke from the interior of your car. Or something far worse.

    So I figure Obushacare is going to be, oh, three times worse than that, and four times as expensive. “Why don’t you just give up and DIE?”, is the motto of Obushacare.

    And the pity of it all is, I’ll probably be too sick to get to some cool mountains where I can die a good death, waiting for a cougar or bear to eat me….

    • Yes, I have had the same doctor since I was married – my wife and I have the same doc. We will be celebrating our 25th anniversary next month. As to your other points – this is why I am not a fan of what passes for “insurance” these days. I think we would all be better off paying for the first 1000 in medical care per year rather than expecting insurance companies to cover it for us.

    • And some still think that “employer provided medical care” is a “fringe benefit”

      No thank you. The contract is – I work for you and you give me money. End of contract/story.

  15. One of my children was already asked by a doctor about how are firearms are stored at home. I believe he told the doctor that they were looked up in safes. Despite that being true (aside from my home carry), I had a family meeting. No doctor needs to know about my gun and ammo storage in order to treat a medical condition. No information is to be given whatsoever. Of course, doctors will ask children, who are particularly vulnerable. I’m sure that anti-gun healthcare providers are already aware of this.

    Thanks again to all the Obama voters out there who made this additional attack on the 2A possible. Perhaps some day folks will wake up that big government doesn’t care about the Bill of Rights, particularly the 2A. Or maybe not. I’m sure the IRS and NSA will treat privacy issues very seriously while they are reading your emails, text messages, and health care documents. Not.

  16. From what I have seen, a pretty good percentage of gun owners are better off answering no to the stupid questions and spending their time with their PCP discussing weight loss, cholesterol control, hypertension control, diabetes control, etc, instead of arguing about the unrelated questions.

  17. How many of you whingy complainers were for single payer universal health care? None of you? Well, then enjoy the milquetoast reform you helped create with your unthinking, reactionary conservatism. On the plus side, the PPACA prevents denial of insurance or claims for preexisting conditions, so at least your debilitating paranoia will be covered.

    • Hey everybody! Look! Our favorite troll is back. How are you RTempleton? Out on holiday from the liberal home for the Hopelessly Silly?

        • The difference between us? I was prompted by John Smith to go back and verify what I -thought- I knew. I was wrong. I manned up and apologized for my mistake. It’s what conservative MEN do.

  18. If you are not voting for gun in 2014 & 2016, you should be voting against the sham that is Obamacare. That should give two good reasons to vote the antigun bums out because most likely than not, if they voted antigun, they probably voted for Obamacare too.

  19. Good for you. I wasn’t bother about my private medical records with my doctor before, but when I heard that in some states they were merging CCL records with medical records, that put a cold chill down my spine. I may go the same thing and get a concierge doctor. I may still keep my insurance for when I may need any expensive surgeries. I demand that the federal government stay out of my medical records.

  20. Leave it to the government to make something “free” while simultaneously making people avoid it like the plague.

  21. HERE.

    Let’s say you think this is full of shit. Are you willing to take that risk? Or maybe you believe the pharmaceutical companies are keen on your privacy…

  22. Long time reader, first time poster-

    I ask my patients about owning firearms in the home because I am concerned about their safety. As someone who is knowledgeable about guns, I feel that I can advise them about the safety issues of carrying a pre-1983/series 80 1911, or a 1911 clone that doesn’t have a drop safety, etc.. I can also inform parents about the NRA’s Eddie the Eagle.

    The fact is, the questions I ask about gun ownership aren’t meant for the people of the gun who read this site regularly. I ask them so that I can find and counsel the brand new gun-owners out there who were never taught by their parents anything about gun safety: like the new mom who buys a cheap handgun for protection but is too embarrassed to talk to her kid about it (she has trouble racking the slide back in a hurry, so she leaves it with a round chambered, no safety, and unlocked in a drawer where that boy or girl can find it before long).

    I don’t record it in the medical record (its actually illegal to record that kind of information in the health record, courtesy of the ACA). But, it is certainly my business to ask about things that can threaten my patients’ health.

    In terms of mental health questions- keep in mind that we are far, far away from the days of big government pulling patients’ mental health records. The AMA and many state medical associations are fighting hard against laws that mandate reporting of anything to firearms registries, and save in New York (where doctors are suing, last I heard) we’re won so far.

    We record the information because we want to research and discover ways to better help our patients. If you’re between 35 and 65, you’re more likely to die of suicide than any other cause. If we can find away using big (anonymous!) data to figure out who’s most at risk, and reach them before they hurt themselves, we can save over 30,000 people a year- including many veterans, whose deepest scars are often invisible.

    • Do tell. You ask about proper installation, location, maintenance of residentialsmoke detectors. residential sprinker system, swimming pool/hot tub? Condion of the sidewalks, safe grab rails in the tub? All furniture anchored to the wall? Drive unsafe tiny algore mobiles (with high voltage batteries).

      None of your business and neither is anything about firearms. I’d can your ass and report you to the licensing board (who likely would give you an award.

      • Neiowa:
        I do, actually. I have a long checklist that I’m happy to use- it’s one of the (few) good parts of modern Electronic Health Records.

        On first visits and some yearly physicals, I ask about swimming pools, smoke detectors, grab rails in the tub and non slip surfaces if the patient is elderly, etc. It is entirely my business to educate my patients on healthy life choices.

        Freedom is only real if one has the information to make the right choice. If you know what it means to have an unlocked gun in the same house (not on your person) as a 5-year-old child who doesn’t know anything about guns besides what they see in the movies, then that’s your choice. But, it is my duty as a doctor to try and educate you on what that choice means if you don’t know. Again, this isn’t targeted at readers of this site- the problem is, I don’t know which of my first-time patients read TTAG/know about gun safety without asking them.

        And RE: your theories on suicide- that would be true, if suicide is a freely arrived at choice. The problem is, depression isn’t “all in your head”, it’s a biochemical disorder that we frequently have to treat with medications. And if it’s that biochemical disorder that’s making you kill yourself: it’s not a person’s free choice.

        Many patients who would be dead by their own hand are now alive, healthy, and loving their long and healthy lives- because of the drugs we now have to treat severe depression. Would you advocate leaving your fellow men and women to the tender mercies of their own minds, when we can help them? I believe in freedom as much as the next man- when someone is facing Alzheimer or some other disease for which medicine can do nothing, or when someone elderly has no one who loves them left in the world- suicide is a rational choice. But, if that person is irrational- if they can not make a free decision- it is our duty to help them get their mind back.

        Every time I go to the range, I am reminded that us gun owners are a good bunch of people. Any problems, I know I can ask it aloud and get 10 people over wanting to help. Why can’t we help each other when we need it the most?

  23. The main problem with such a mental health check is it is too open for abuse for personal means or to push a personal political viewpoint that would serve well in academic circles, but have little to do with the real world.

    A radical example could be person A is found free and clear of mental problems and is a fit person to own a firearm… Until he wants to own a firearm, then he obviously has a mental health problem because he wants to own a firearm!

  24. VKA, so you also ask them if they wear their seat belt…drive the speed limit, look both ways before crossing the street, txt while they drive and so forth, correct?

    • Of course not, he is too busy counseling patients on the evils of morbid obesity, hypertension, hyperlipidemia, diabetes mellitus II, alcoholism, drug abuse and on and on. You know, what primary care physicians are supposed to do. Oh he’s not? He’s talking about firearms? What a drop in the bucket compared to what is really killing so many American people way before their time.

      • My patients who have diabetes, I counsel about diabetes. My patients who are obese, I counsel to lose weight (or refer them to surgery/other therapies if I have to- obesity is a disease as much as a willpower problem). New parents who are driving their kids around without appropriate car seats, I counsel about how dangerous that can be.

        And new gun owners, who don’t read the Irresponsible Gun Owner of Day posts, I counsel about gun ownership.

        Also, I didn’t talk about this above but this needs to be brought up:
        Most gun control research is bullshit. I was out there before TTAG’s post, shooting down Kellerman’s NEJM studies in 1986. But, we do know this: suicide is impulsive. Many people who survive suicide attempts tell us that the feeling was transient- they regretted jumping/swallowing/whatever. In a famous observation, it was noted that a country banned a certain type of stove which one could use to easily commit suicide- this resulted in an actual drop in the number of suicides in that country, independent of many other effects.

        If someone is suicidal, and has access to a firearm, they are more likely to kill themselves than if they don’t. That IS NOT an argument for creating a registry to take away their 2nd Amendment rights. And I am NOT implying that owning guns is in any way a mental health problem. But, if someone owns a gun and they are having suicidal thoughts, doctors have to act differently. More aggressive with our medications, less “let’s see if this passes naturally”, and ultimately perhaps more aggressive with temporary commitments while we stabilize them. It is important to us to know if someone who may be suicidal owns a gun- because they are more likely to kill themselves than someone with the same problem who doesn’t own a gun. Especially our troops- many of whom both own weapons and suffer from TBI and PTSD induced depression.

        • Suicide isn’t a subclause of a “womans right to chose”?

          Offing oneself is to make a major bet on the existance (or not) of hell. If the Catholic Church is correct on concept of mortal sin then the whining that leads to suicide is a minor problem. Some one wants to suicide not really your problem.

  25. My doc and I have been through some sh*t. Kids, deaths in the family, so on and so forth. I ought to be able to talk to her about things that affect my heart and spirit. There are effective treatments for depression that can break a dangerous cycle giving cognitive approaches a chance to work. Should I ever need that, I am sure my doc wil keep the talk off the books, but not the prescription. Nice job, Obama.

  26. Someone explain to me the moral superiority of granting certain people the right of suicide V interfering with same w/o sanction?

    Personally all modality of SA should be eliminated from statistical reviews of the subject.


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