“The Conversation is Easier than We Think” – Physician Interviews on Firearm Safety Counseling

Abstract

Purpose

Clinical firearm safety counseling can help prevent firearm injuries, yet many clinicians have not adopted this practice. We collected practical tips from physicians who do such counseling to help others interested in conducting such counseling while perhaps feeling insecure about how to implement it.

Design

Qualitative interview study.

Setting/Participants

Sixteen physicians who had made clinical firearm safety counseling part of their practice.

Methods

An interview guide included questions about how, when, and with whom participants were undertaking firearm safety counseling, motivations, experiences with the counseling, patient reactions, and barriers and facilitators. The interviews were analyzed using inductive thematic analysis.

Results

Most (11 out of 16) physicians were in primary care/family medicine or pediatrics; 54% worked in urban, 27% in rural/small town, and 20% in suburban settings. Three takeaways were reported by virtually every participant: firearm safety counseling is not difficult; almost all patients react positively, and occasional skeptical reactions are easily defused; and this counseling does not take much time. Participants kept conversations nonjudgmental and focused on safety, not on firearm ownership itself. Participants’ strong convictions that it was their responsibility to address firearm safety helped them overcome barriers such as lack of time, training, and guidelines.

Conclusion

Participants shared actionable ideas on how to facilitate firearm safety counseling, exemplifying ways to encourage firearm safety behaviors.