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Unintended Consequences: Docs & Glocks Edition
Several years ago, the American Medical Association instituted a new policy of recommending that doctors enquire about their patients’ firearms. This was pitched as a matter of household and child safety and — while the policy stressed “education” — its language makes it pretty clear that this is not something Eddie Eagle would endorse. Despite not having kids, I’ve been asked about my guns at least twice at the doctor’s. The first time, I wasn’t expecting it and simply answered the nice nurse’s question. The second time, I said something to the effect of, “Thank you, but I don’t think that’s a medical question.” The nurse shrugged and the appointment proceeded as before.
Unsurprisingly, stories soon emerged about doctors dropping patients who refused to answer the question, as well as others who (chillingly) tried to talk to children about it behind their parents’ backs. In response, several states, including Florida, passed legislation that forbade doctors and other medical professionals to bring up the subject of guns under most circumstances.
Much has been written about this: I came across a discussion of it on Science-Based Medicine earlier this week, which made reference to a recent post on the Volokh Conspiracy that I’d missed. We’ve also talked about it on Ricochet. The most recent news is that the Florida law has again been found constitutional, this time on First Amendment grounds subject to strict scrutiny. That seems like a bad decision to me, but I’ll recommend you read others’ takes to form a legal opinion.
I do, however, have a political opinion on the matter: This sort of high-temper, confrontational situation is a direct consequence of progressive big government. The more entangled the medical profession becomes with the state, the more its practitioners will find themselves on the receiving end of the I’m-calling-my-lawyer and show-me-the-warrant attitude that Americans have long harbored toward their government. This is especially so when its executive praises the idea of abridging their natural rights while his party flirts with a candidate who advocates a single-payer system.
Doctors have long held a special place of trust in our culture, and doctor-patient confidentiality enjoys a respect exceeded only by that of spouses, clergy, and attorneys. If you want to damage that trust, you’d be hard-pressed to find a better way than to invite the government in.
Published in Domestic Policy, Guns, Healthcare
I have not had a lot of medical appointments over the last few years, but when I have seen a doctor I have never been asked about my ownership of guns by any of my physicians. I have been prepared to tell them that it is none of their business, if asked, but the opportunity has never arisen. I belong to a long standing HMO, Group Health Cooperative of Puget Sound, and it may be their policy to not ask that question.
The line of thinking for the progressives who enacted this type of legislation goes like this:
Funny how docs don’t ask about something that’s a greater danger than guns in the home, a swimming pool in the backyard…
I just lie and say no. It bothers me not. These questions are part of an Obamacare checklist to be entered into online medical records. The real goal is to eventually link gun ownership with certain types of medications whereby gun ownership can be denied or restricted. You have already seen the VA try to pull this on Vets taking depression medicine. Lord knows what would happen if you admit you have more than 3 drinks a week, other than wine and pot of course.
Hmm, I wonder if Doc Jay is taking new patients?
I’m curious. What is the doctor supposed to do if you tell him that you do have guns? Is he supposed to talk to you about how to keep them safe? Is he supposed to report you if you don’t?
This is my rifle. This is my gun.
It’s ambiguous, with some of language sounding unobjectionable and others sounding spooky:
I mean, if the doctor said “Oh, cool. Hey, it’s really important to make sure you store your weapons safely” and handed me an NRA pamphlet on the matter, I wouldn’t find that too offensive. But that’s obviously not what’s going to happen in a great many cases.
I live in Florida and own several handguns. My Doctor has never asked me the gun question and if he had I would have told him it is none of his business. Thanks to Florida law it appears that now they can’t ask me.
By the way, both of my teenage kids have taken NRA safety training and both have spent time at the range with me learning how to shoot. I want them to be able to protect themselves if someone breaks into my home when I am not there. I have absolutely no concern about them accidentally shooting someone because they have been properly trained and they know guns are not toys.
Come and take it.
We have instructed our children about this. If someone asks, the answer is “No.” Next question.
My neighbor buys cigarettes and liquor with cash only. No records for doctors or insurance companies to scan.
What a country! I cannot for the life of me recall anytime in history when people were asked to spy on their neighbor’s, patients and customers – well, not that many times – so they could turn them in, give them advice or help them make better decisions for the good of the state.
Can you Kommrade?
Kevin!!!
Darn you!
Now I have to add this to our instructions for the children: “If someone asks you, does your family own a swimming pool, the answer is, ‘NO'”
Which is a good outcome — because doctors don’t have any business or expertise in the matter — but I also think it’s unsettling for the legislature to be in the business of forbidding doctors from asking them questions and for federal courts to say that that’s consistent with a strict scrutiny reading of the 1st Amendment.
It’s a lousy precedent.
I don’t understand why those of you who have guns and have been, or might be asked, would say “no.” I don’t own a gun, don’t want a gun but appreciate your right to have one. If the doctor asked me (and now I’m prepared for that possibility), I’d tell him it’s none of his business. Where does it say he has the right to that information?? And if I gave him an answer he didn’t like, he can kick me out. Doctors are already denying service to some because they have Medicare. If that happens (and I know it might be hard to find a new doctor), I’ll tough it out!
I am increasingly coming to despise the medical profession. Not as much as I despise my own (academia), but close.
If asked whether I had guns, I would probably ask if they liked kinky sex.
The rest of the conversation is easy to predict.
I pay my doctor directly. He’s a concierge doctor who doesn’t take insurance. But he still asked me that once. I don’t remember what I said but I remember thinking concierge docs especially shouldn’t ask questions like that.
Just an FYI, you’ll become “Kaiser-ized” very soon, see here. And then you will be asked, your response will be documented in the electronic medical record and visible to all your Kaiser staff. Kaiser does some things well, but they are all-in on these types of standards.
That’s part of it. Here’s the other part: lying about things that go on your medical record, particularly questions that are asked as part of the “standard of care,” might affect your insurability or premiums.
Owning a gun is a health risk, you see. Sure, you have a right under the Second Amendment. It’s just that, like smokers, you need special
reeducationindoctrinationattention to make sure your lifestyle complies with Federal or AMA guidelines. Or financial incentives to do so. That can all be done administratively without actually banning the filthy things.The correlation with electronic purchases of medically inappropriate items comes later.
The intermediate step is to require retail establishments not just to ask for ID from all purchasers of problematic items (in much the same way as is now done for cough syrup and alcohol) but to enter the ID number it into a field on the register screen (which I think is starting to happen for cough syrup; I haven’t been carded for alcohol in decades.)
I’ve answered that question with “that’s none of your business;” but then gotten progressively more angry as they kept asking nosy questions that went well beyond what I felt was appropriate for a well-child check.
After paying the bill, having received literally nothing useful, I told my wife that our kids don’t need to go to any more “well-child” checks unless they need shots.
That’s understating it. Guns, in this context, are a safety issue, not a medical issue. They’re not the same thing. My doctor doesn’t ask me if someone holds a ladder for me or if I wear a seltbelt, and he shouldn’t. That would leave the realm of medicine, and enter the realm of the busybody.
Is it? Cause I could see that conversation ending in several different ways..
Yeah, we’re with Group Health (out of Seattle) as well, and also about to become Kaiser-ized. Starting to look at other options, actually.
I think there’s a case to be made that some safety issues might be close-enough to medicine to count. I don’t think the clears that bar at all.
But, generally, I agree: You’re a doctor; stick to doctor stuff.
I work with a guy that has a standard response when cold-call salesmen or political types ring him up at home or on his cell…. “Does your wife *you can probably guess the last part*?”; When they protest with something like “Sir, I don’t think that’s appropriate”, he replies with “Well, you invade my privacy, I figure I’ll return the favor. Does your wife *blank* or not?”. They usually hang up by then.
All of them work for me.
If the answer is some variation of “none of your business,” you reply, “yes, that makes sense.” Silence.
If the answer is in the affirmative or negative, then thank them for the data. Silence.
I find that keeping my mouth shut at just the right moment can be amazingly effective at making people feel awkward.
Keep in mind that, while HIPAA purports to protect your personal health information, you ought to be prepared for the government to exempt itself whenever it wishes. The proposed Toomey/Manchin bill, for example, specifically exempted the NICS (national instant check system) from HIPAA protections. That means what you answer as to ownership of guns will at some point be available to the feds whenever they wish. Even worse, your prescription medications will also become known to them. I would bet the farm that the next big “mental health” push for more gun control will include going after anyone who has ever been prescribed any psychiatric medication. This is low hanging fruit and about half the population has taken it at one time or another. New York state has already tried it on a gun owner who was prescribed a sedative on a single occasion – the death of his mother. It was still in litigation last I heard.
I suspect that if the question does arise, my prepared answer, None of your business, will be the one the asker will get. I have been a member of GHC for more than 40 years. I have been very satisfied with the quality of care I have received over the years. I doubt the Kaiser will change the culture of the organization as it has existed., at least within my lifetime.
A very good reason why the AMA’s days are numbered.
I have been asked the question a couple times. I’ve answered somewhat thusly: “I understand you’re supposed to ask that question, but I decline to answer. It’s none of their business.” Without exception, the questioner smiled and moved on, in a manner that suggested to me that she was hoping for that answer.
Once my dentist mentioned that, you know, I’m supposed to ask those questions, too. Never has. But some years ago I did advise him on the process to obtain a CCW.
I advised my Rabbi on what I learned here on Ricochet about finishing receivers…