Guns should not be allowed in private physicians' office

Employees in any sized healthcare facility should not be allowed to carry guns inside their place of employment.

Pro Gun: You can't keep guns out of medical practices

I am not a gun owner and never have been. I’m not inclined to own a gun in the future. I never lived in a neighborhood where guns were commonplace. Luckily, I have never been in fear for my life, either as part of growing up in small-town America’s “safe” suburbs nor during urban medical school or residency training. I never acquired the taste for hunting live animals but I am not offended with the culling of wild animals humanely to allow for the safe expansion of their populations. 

I am a carnivore and I understand “where the meat comes from.” I enjoy “shoot-‘em up” movies as much as the next guy and whenever I see a LivingSocial offer for practicing shooting guns in a shooting range, I always imagine myself as 007. One day, I will buy one of those offers. It looks a fun way to blow off steam regarding my frustrations with the U.S. healthcare system: insurance pre-authorizations, “meaningful” use, alternate payment schemes, unreasonable patients, etc. 

I am an internist in a solo private practice in the heart of Washington, D.C., once the murder capital of the United States. My practice is close enough to Pennsylvania Avenue that the motorcades often affect my commute home. Everyone in the D.C. area seemingly believes “when” and not “if” in regards to terrorism-particularly whenever you hear loud noises unexpectedly. 

In D.C., private businesses can prohibit the carrying of guns as long as proper signage is posted at the entrance to the business or private property. District law also allows a business owner to carry a firearm on his person as long as it is hidden from public view and mandates that the firearm be stored securely in a device that is attached to the property. This only applies to businesses where the business owner reasonably knows that minors cannot access the firearms. 

So, what is my policy regarding guns? I don’t carry or store them in my office. I don’t allow employees to bring guns into the office- but in 15 years, no one has ever asked to do so. I allow law enforcement personnel (city/state police officers, FBI agents, Secret Service agents, and foreign embassy security details) on active duty to carry weapons into my office. Even so, they always ask me if they can carry while on active duty and I always say “yes.” Off-duty law enforcement personnel have never asked me if they can carry when coming to my practice.

Next: Our offices are safe havens

So far not one patient (non-law enforcement) has asked if he or she can carry a firearm in the office and as far as I can tell, no one has so far. If a patient who is not in law enforcement asks me if he or she can carry firearms into my office, I would tell them “no.” I don’t have an official posting at my office entrance but I doubt this is a question that I will be asked much in the future. Why? 

My patients who live in the D.C. area are generally liberal-to-moderate Democrats or Republicans. As such, based on our conversations, they are probably in favor of gun control. I doubt they carry concealed weapons although some enjoy hunting. I’ve had conversations with quite a few patients who absolutely favor gun control. 

Blog: Gun ownership is a civil right

The more interesting question is whether I believe that any non-law enforcement patient should be allowed to carry firearms into his or her doctor’s office in DC or anywhere else in the U.S. Again, my answer is “no.” 

Gun control advocates cite studies showing that households with guns have higher gun-related morbidity and mortality than households without guns. This may be cause-and-effect or it may be a correlation, but that point is moot. The higher morbidity and mortality rates still remain.

By extension, one can say that any space where guns are present will have higher gun-related morbidity and mortality than any space where guns are not present. Gun-rights advocates say that removing guns from the public space will not reduce gun-related violence and death. They are partially correct. It will not reduce intentional and/or rage-related gun-related violence and death. However, removing guns from the public space will reduce accidental, non-rage-related, gun-related morbidity and mortality. 

There is already a ban on bringing guns into federal and state government buildings and institutions, including schools and universities. This is done as a service to the people, keeping those spaces as safe havens for citizens to obtain government services. Will that policy prevent a person who intends to kill people from doing so in those settings? Of course not. However no policy, even one that allows every person to carry a concealed weapon anywhere, can guarantee that no one will be killed by someone intending to kill.

With regards to guns, the purpose of a safe haven is to eliminate preventable morbidity and mortality, such as accidents, and not the unpreventable such as intentional murder.

Next: We should be allowed to ban guns

If public schools and universities can ban carrying guns, then why can’t private ones? Well, most already do, citing protection of students, i.e. a safe haven. What about churches? Yes, many already ban guns for protection of parishioners-again, safe haven. 

Therefore, private doctors’ offices, hospitals and other healthcare facilities should be allowed to ban guns from being carried into those places by providing a safe haven for the protection of their patients-protection from accidental gun-related morbidity and mortality. Many states with right-to-carry laws already allow for exceptions for private businesses-specifically, schools, churches and healthcare facilities. 

Blog: Obtaining an assault rifle should be as difficult as becoming a doctor

Besides providing a safe haven for patients, what other reason should doctors use to ban concealed weapons in their offices? As stated previously, gun-related morbidity and mortality is higher in households with guns than in those without guns. The American Academy of Pediatrics, the American College of Physicians and the American Medical Association believe that to protect patients’ health, doctors should be allowed to ask patients whether they allow guns in their households. This is not to report those patients to “the authorities” or to encourage them to get rid of their guns. The purpose would be simply to encourage safe use of guns in the household if guns are present. 

The final question concerning this matter is whether doctors should be allowed to carry guns in their offices, or at least be able to store them there. Just as households with guns have higher gun-related morbidity and mortality, theoretically, doctors who carry guns in their offices may have higher gun-related morbidity and mortality in their offices. 

Even if I ask a patient about guns, I’m not telling him to get rid of their guns. Likewise, even though I may not want to keep a gun in my office, I cannot tell another doctor that he cannot keep a gun in his medical practice. This question becomes harder regarding employers in a larger medical office, healthcare facility or hospital because of the higher risk of accidental gun-related morbidity and mortality due to increased numbers of persons who are inside such places.