When the Patient is Packing

Subject: handguns in the clinical setting

 

As discussed in this morning’s Risk Management presentation following the M and M reports there have been several issues related to patients carrying handguns into the exam rooms during regular doctor/patient visits. The specific case discussed involved a patient who is a federal agent who is fully authorized ( and expected) to carry her weapons at all times and therefore expects to keep them with her during medical visits. A variety of responses to such a scenario were discussed including a reasonable resolution to the initial encounter ( a substitute physician provided care to the patient that day and the clinic manager is looking into providing a lock box for safe storage behind the counter.)

Following today’s meeting I visited the Security office at the UMHS for clarity on policy. I learned the following:

Federal agents are indeed exempt from the restrictions regarding carrying of firearms into the Health System facilities. Traditional law enforcement personnel are expected to report at the front desk that they have weapons and are only allowed to carry if doing so in the performance of security enforcement. Otherwise they check their weapons in a safe location i.e. a lockbox at the hospital.

 

In no case are patients or their visitors/ family members allowed to carry weapons into the UMHS facilities with the exception of federal agents as described above. If you discover such a breach has occurred you are encouraged to alert Security of the presence of a weapon/s in a manner that respectfully informs the carrier of the hospital policy but hopefully does not inflame emotions.

 

A patient such as this federal agent should have anticipated the concern her weapons would cause and explained in advance to the staff and her physician that she can and will carry handguns with her at all times.

 

FYI, in my retirement I have become more active in an organization called Physicians for Prevention of Gun Violence ( PPGV ) which is locally based but whose membership rolls number over 400 physicians across the state.  We have made presentations to various groups of physicians in a Grand Rounds format at over a dozen hospitals and residency programs ( Fam Med, Peds, Int Med) with a focus on recognizing our patients who may be at greatest risk of gun violence. These include CHILDREN, DEPRESSED INDIVIDUALS, PATIENTS EXPOSED TO INTIMATE PARTNER VIOLENCE.

Our message :

  1. Ask about guns in the home and safe storage plans
  2. Provide safe storage info ( UM Injury Center has a great 2-sided handout)
  3. Consider any gun in the home of a depressed patient as dangerous and urge removal.
  4. Be alert to signs of intimate partner abuse (e.g. a set of routine risk questions in our current UMHS health maintenance q’airre) and inform of the greater risk of gun violence in this setting/ direct toward counseling.)
  5. PPGV has decals for your office/home preventing guns. $1.

Thanks, Jim Peggs

www.PPGV.org

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