gun control

AG Healey: Curbing Gun Violence Requires “Partnership” with Physicians

Posted in gun control, Public Health Leadership Forum on April 5th, 2016 by Erica Noonan – Comments Off on AG Healey: Curbing Gun Violence Requires “Partnership” with Physicians

Curbing the epidemic numbers of deaths and injuries from firearms in the United States  will require a “spirit of partnership” among law enforcement officials, health care providers and community leaders, said Massachusetts Attorney General Maura Healey.

“This is a public health issue, and we are not going to be able to prosecute our way out of this,” she said.  “We need to reframe the conversation and retake the issue for the good of our country.”

Healey was a featured speaker at 12th Annual MMS Public Health Leadership Forum – Firearm Violence: Policy, Prevention & Public Health on April 5 at MMS Headquarters in Waltham.

The forum was convened to discuss the latest information on firearms violence, including how physicians can reframe the debate about firearms in order to encourage strategies that support gun violence prevention policies, research and programs.

Expert faculty includes Georges Benjamin, MD, executive director of the American Public Health Association, David Rosmarin, MD, director of the Forensic Psychiatry Service at McLean Hospital, the Rev. Jeffrey Brown, longtime anti-violence activist and founder of RECAP, and many more distinguished speakers.

Healthy defended the right of physicians to speak to their patients about guns, noting that physicians in Florida were recently prohibited by an appeals court from doing so.

She also urged support for policies that would require gun manufacturers and dealers to be held more accountable for the estimated 33,000 deaths per year across the country.  “Guns are the only consumer products that enjoy full immunity (from lawsuits)” she said.

Healey drew parallels between the guns and the issue of opioid abuse, an issue on which the MMS and state officials have collaborated extensively.  “This crisis requires renewed focus and persistence,” she said. “I hope collectively we can work together and make an impact.”

–Erica Noonan

Public Health Keynote: 91 deaths a day, 33,000 a year

Posted in gun control, Public Health Leadership Forum on April 5th, 2016 by MMS Communications – Comments Off on Public Health Keynote: 91 deaths a day, 33,000 a year

The numbers represent a “true epidemic,” said Georges Benjamin, M.D., as he tallied the number of deaths per day and the number of deaths per year from gun violence in the United States in delivering the keynote address April 5 at the 12th Annual Public Health Leadership Forum, Firearm Violence: Policy, Prevention and Public Health.  The forum was attended by approximately 120 physicians, health care leaders and public health and government officials.

The numbers represent a public health crisis, and the grim statistics prove the point: on an average day, 91 Americans are killed by guns, with more than 33,000 dying every year.  In an average month, 51 women are shot to death by their intimate partners, and seven children and teens each day are killed by guns.

Dr. Benjamin, Executive Director of the American Public Health Association, had three objectives in his keynote: (1) to define the societal toll of firearm injury; (2) to articulate a public health approach to reducing injury and death from firearm violence; and (3) to offer a broad approach to reducing firearm-related injuries and deaths.

“Guns are part of our culture,” said Dr. Benjamin, noting that the U.S. has more guns than people, “and we have the fundamental belief that firearms protect us.” Yet, he said, far too often the result is death and injury. Mass shootings, like the one at Sandy Hook, Connecticut, remain a persistent issue, with the U.S. experiencing more days with mass shootings than without.

“The protective safety of guns is overestimated,” said Dr. Benjamin. “In homes with firearms, homicide is three times more likely and suicide is five times more likely.”

Dr. Benjamin argued that through technology and education we can make guns safer and make people safer with their guns.  And it is an issue, he says, that physicians should embrace.  “Why should physicians care about this?  If it hurts people, if it kills people,” he said, “physicians should care.”

— Richard P. Gulla

Dr. Benjamin’s slide presentation, A Public Health Approach to Reducing Firearm Injury, may be viewed here.

Mass. AG Maura Healey: Gun Violence is a Public Health Crisis

Posted in gun control, Public Health, Public Health Leadership Forum on March 31st, 2016 by Erica Noonan – Comments Off on Mass. AG Maura Healey: Gun Violence is a Public Health Crisis

Massachusetts Attorney General Maura Healey will speak to leaders in public health and medicine at MMS’s Public Health Leadership Forum on Firearm Violence on April 5.  MMS Public Health Manager Robyn Alie spoke with Attorney General Healey recently about firearm violence and how it affects physicians and the public.

MMS:  You have called the epidemic of gun violence a public health problem. Why?

AG HEALEY: I think what’s really important is we talk about this as a public health crisis and as a moral issue for our country.   In far too many places, across this country, people are fearful of sitting outside on their porch, fearful of letting their kids walk to school. We have too many victims of domestic violence, subject to incredible mental anguish given that their abusers have guns and are able to wield all sorts of power.

Guns have a significant impact on the health and wellbeing of families and of the community at large. The fact of the matter is that having a gun in your home does not make it a safer place to be, and actually makes it more dangerous. It’s not that people aren’t entitled to exercise their second amendment rights and to keep a gun at their house, but the risk of suicide is five times as high. Death of a household member is three times more likely. With a gun in the home, a woman’s risk of intimate partner homicide is seven times as great.

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MMS: Last year, a physician at Brigham and Women’s Hospital was fatally shot by a patient’s family member. What are your thoughts about how to protect health professionals?

AG HEALEY: It was so tragic. He was shot to death in the hospital doing his job. In the wake of that event, we reached out to the hospitals to find out how we can be helpful, and we learned that hospitals need to find the right balance, between providing secure spaces for their workers and patients, and at the same time providing a place that’s welcoming and inviting for family members and for visitors, and it’s tough. It’s a delicate balance, and one that requires the use of best protocols and policies to ensure that no one’s in harm’s way.

But I still see instances where the availability of guns has made it far too easy for someone who’s set on doing harm to obtain guns and be able to go out and cause harm.

MMS:  We have seen that mental health is often implicated in gun violence events, but research has shown that the proportion of gun violence perpetrated by people with mental illness is actually quite small, and those with mental illness are actually more likely to be victims. What are your thoughts about policies related to mental health and gun violence?

AG HEALEY: I would never want our gun violence blamed on mental health problems. We shouldn’t use this issue to create greater stigma around mental health and behavioral health. But, I think it is an opportunity to recognize that those services need to be more robust. That’s why we need true mental health parity when it comes to coverage and access. We need to focus on the reality that 62% of gun deaths are suicides. Also, we do need to provide care and treatment to those folks. How are we looking to intersect with them so that we have an opportunity to intercede? Again, here’s where I think health care and medical professionals have that opportunity. And why their involvement and engagement are so important. Because we should be doing everything we can to make sure that people who are a danger to themselves or a danger to others, who might harm themselves are not able to access guns in a way that’s going to enable them to harm themselves or someone else.

MMS: What about issues of patient privacy?

AG HEALEY: It’s an issue where I know there has been some differences across the states. There’s a law in Florida that actually prohibits physicians from asking their patients about gun ownership. That law is now being challenged in the courts. And I think it should be challenged for all the reasons we just talked about. Gun violence is a public health issue and I don’t think that doctors should be restricted from asking their patients about an issue that could affect their health. The NRA has long pushed for these kinds of laws in part because they know how influential physicians can be. I think that’s where we need to have doctors more involved in addressing this question. I don’t think doctors should be in any way prohibited from asking patients about an issue that in any way could affect their health. This is one. Obviously there are appropriate ethics that apply when it comes to physicians becoming aware that someone may do immediate harm to themselves or others, and they should act appropriately there, according to their ethical obligations.

Learn more about the 12thAnnual MMS Public Health Leadership Forum, Firearm Violence: Policy, Prevention & Public Health, on April 5 from 1:00 to 5:00 p.m.

 

The President’s Podium: Physicians, Opioids, and Guns

Posted in gun control, opioids on January 15th, 2016 by MMS Communications – 1 Comment

by Dennis M. Dimitri, M.D., President, Massachusetts Medical Society

From Medicare to electronic medical records to telemedicine, physicians are facing a variety of issues this year. Here’s a look at three that our medical society will focus on in the months ahead.

A renewed spirit by physicians about our profession
In my inaugural address upon becoming president last May, I spoke about the declining satisfaction within our profession. While Dr.DimitriMMS (4)recognizing that physician stress and frustration have increased, and that the business of medicine has added roadblocks to our practice of medicine, I urged physicians to remember how we affect the lives of our patients, that they look to us to help them overcome their problems, and that it is our privilege to do so.

As we continue to deal with the changing aspects of our profession, let’s remind ourselves that we enjoy enormous public respect and prestige, and that we make a difference, every day, to our patients and to our communities. I believe this topic to be so important, in fact, that our Educational Program at the annual meeting in May will be built upon the theme of Sustaining Joy in the Practice of Medicine.

Reducing opioid and prescription drug abuse
The MMS has taken a leadership role in the Commonwealth in combatting opioid abuse, and our efforts in this area are a prime example of how physicians can make a difference. We have developed prescribing guidelines for physicians that address pain management and addiction and have educated patients about safe storage and disposal of opioids. We have sponsored forums and summits related to opioids, and worked with public health and elected officials in improving prescription monitoring and creating strategies to reduce prescription drug abuse.

Despite those efforts, along with those of law enforcement, state officials, legislators, and many others, the numbers of overdoses and deaths continue to rise. Further, a recent study by Boston Medical Center, showing that more than 90 percent of people who survived a prescription overdose were able to get another prescription for the drug that almost killed them, demonstrates just how hard this problem is to solve. Though many of us understand the complexities that drive continued prescribing in some of these situations, studies like this can cause physicians to close what the study authors suggest are “major gaps in communication, education, and oversight” despite our deep concern about opioid abuse.

I told MMS delegates at our Interim Meeting in December that the opioid crisis is our medical society’s top issue. It remains so, and we will continue our efforts to curb opioid misuse, while at the same time ensuring that those patients who truly need help for chronic pain will be able to get it.

A new focus on physicians and gun violence
Gun violence has continued to be one of the major issues in public health. Last March, MMS took the occasion of Doctor’s Day to raise awareness about this issue, and specifically, preservation of the right of physicians to discuss the subject with their patients. Unfortunately, the 2011 Florida law making it illegal for physicians to ask patients if they own a firearm or record information about gun ownership in their medical record was upheld in December for a third time in a decision by a three-judge panel of the U.S. Court of Appeals for the Eleventh Circuit.

According to reports, the panel’s opinion was that “the law fits well within the traditional authority of the states to define and regulate the practice of medicine.” Not to be deterred, physicians will appeal for a third time to have a full court review. This remains a critical case for physicians, as it has national implications and directly affects the physician-patient relationship.

MMS physicians have addressed violence intervention and prevention in many forms, and gun violence is as appropriate for physicians to study as youth violence, partner violence, or human trafficking. To that end, our 2016 Public Health Leadership Forum, Firearm Violence: Policy, Prevention & Public Health, will seek to provide practical information for physicians on gun violence and what we can do to protect patients from harming themselves or others.

Physician satisfaction, opioids, and gun violence certainly will not be the only subjects commanding the attention of our medical society in 2016. But each of these three is a major issue growing in importance with critical implications for both physicians and patients. Each also speaks to the mission of our medical society: to “advocate for the shared interests of patients and our profession.”

The President’s Podium appears periodically on the MMS Blog, offering Dr. Dimitri’s commentary on a range of issues in health and medicine.

July Physician Focus: Guns and Public Health

Posted in gun control, Physician Focus, Public Health on July 2nd, 2015 by MMS Communications – Comments Off on July Physician Focus: Guns and Public Health

Deaths and injuries from firearms continue to shine a spotlight on gun violence as a public health issue. The latest mass shooting at a church in South Carolina joins a list that includes tragedies in Newtown, Connecticut, at Virginia Tech, and in the Colorado communities of Columbine and Aurora. These shocking incidents receive great attention because of the numbers of people killed and injured, the young ages of the shooters, and where they take place (schools, a church, a movie theater).

Those incidents, however, are just a few of  the total number, with many of them taking place at schools. Since the Newtown, Connecticut tragedy in 2012 that resulted in the deaths of 20 children and 6 adults, an additional 127 school shootings have occurred in the U.S., 73 of them in grades K-12, according to Everytown for Gun Safety, which tracks such data.

Physicians have since become some of the most vocal advocates for gun safety. In April, seven physician organizations, the American Public Health Association, and the American Bar Association issued a call to action, saying “Deaths and injuries related to firearms constitute a major public health problem in the United States.”

To continue to highlight this important topic, the July episode of Physician Focus features a discussion with Michael Hirsh, M.D., (photo, right) Surgeon-in-Chief of UMass Memorial Children’s Medical Center and Medical Director of the Public Health Department in Worcester, Mass., and Robert Sege, M.D., (center) Vice President of Health Resources in Action in Boston and a member of the American Academy of Pediatrics Committee on Child Abuse and Neglect. Hosting this edition is primary care physician Bruce Karlin, M.D. (left).

Among the topics of conversation: what parents can and should do to make a home with guns safer for children, how guns in the home can lead to homicide or suicide, how technology can help to make firearms safer, the physician perspective on ‘gag laws’ preventing doctors from discussing gun safety with their patients, and gun buyback programs as a way to reduce the violence.

Physician Focus, now in its 11th consecutive year of production, is available for viewing on public access television stations throughout Massachusetts. It is also available online at www.physicianfocus.org,www.massmed.org/physicianfocus, and on YouTube.

March Physician Focus: Youth Violence and Child Abuse

Posted in gun control, mental health, Physician Focus, Public Health, violence on March 1st, 2013 by MMS Communications – Comments Off on March Physician Focus: Youth Violence and Child Abuse

As spectators, perpetrators, or victims, violence and abuse take a huge toll on our nation’s youth.  The numbers are stark and telling.

Homicide and suicide are the second and third leading causes of death of American children.  More than 707,000 youth ages 10-24 receive  emergency treatment for injuries from physical assaults, and more than three million reports of child abuse are filed each year – an average of nearly six every minute.

While the numbers show the size of the problem, news reports depict the tragedy.  The pictures and reports of such places as Columbine, Newtown, and Virginia Tech, and widespread abuse by clergy and coaches are now vivid and sad chapters in our nation’s history.  And they continue to make headlines.

The March edition of Physician Focus attempts to put some perspective on the topic of youth violence and abuse with Robert Sege, M.D. (center, photo) and Elliot Pittel, M.D. (right)  joining program host Bruce Karlin, M.D. (left) for discussion.

Dr. Sege is Director of the Division of Family and Child Advocacy at Boston Medical Center, a member of the American Academy of Pediatrics’ Committee on Child Abuse and Neglect, and co-author of the AAP’s policy on guns.  Dr. Pittel is a child and adolescent psychiatrist at The Home for Little Wanderers in Boston and chair of the MMS Committee on Violence Intervention and Prevention.

Among the topics of conversation are the causes of youth violence, the influence of media on children, the importance of ‘being connected’ for both parents and children, and the role physicians can play in helping to prevent and reduce the violence.

Physician Focus is available for viewing on public access television stations throughout Massachusetts and also available online at www.physicianfocus.org. and on iTunes at www.massmed.org/itunes.

 

The Newtown School Shooting: A Call to Action

Posted in gun control, mental health, violence on December 21st, 2012 by MMS – Comments Off on The Newtown School Shooting: A Call to Action

By Richard V. Aghababian, MD
MMS President

As we all try to sort out our thoughts and emotions over the school shootings in Newtown, Conn., I believe that it’s imperative that physicians and the Massachusetts Medical Society take action.

As always, we must focus on the safety of our patients, children and communities. But we need to do more than that; it’s time for us to speak out. As part of our action, I have asked that the MMS focus on three areas:

  • Gun control  – We need to emphasize that this is a public health issue, not just a matter of civil liberty
  • Mental health – What should we do to ensure that those who need care get it?
  • Education – How do we educate medical personnel to respond to such incidents?

On Wednesday, President Obama announced the formation of a task force on gun violence, led by Vice President Biden. The task force has been charged with developing proposals on gun control. At MMS, we will begin a review of our gun policies to see where the gaps are, and we will support reforms that will limit access to guns and ammunition that are so often used in mass shooting scenarios.

At the same time, advocates are pushing for meaningful changes in the mental health care system. Meaningful change means that society as a whole must give the same attention to mental illness as we do to physical illness.  We stand in strong support of mental health parity laws and comprehensive access to mental health services, including screening and prevention.

Our annual Public Health Leadership Forum this coming April, which will focus on mental health, will address some of the successes and failures in the mental health system and how to work together to address patients’ needs.

Further, do we need additional education programs to prepare responders who must deal with mass casualty situations perpetrated on innocent, unsuspecting victims?

As always, we will be communicating with our health care partners across the state as we move forward with an advocacy and education plan in order to best protect our patients and our communities.

I urge you to stay connected on this issue. If you have suggestions on directions we should pursue, please contact me at president@massmed.org with your ideas and comments.