The vast majority of adults who live in homes with guns say they have never discussed firearm safety with a clinician, a new study finds.

Analysis of data from more than 4,000 adults who responded to a nationally representative survey revealed that that fewer than 10 percent of those living in homes with firearms have ever discussed safety with a clinician, according to the report published in the Annals of Internal Medicine.

“This shows that as clinicians and physicians we could do better at counseling patients on the risks of household firearms, given that many medical organizations, including the American Medical Association, the American College of Emergency Physicians and the American College of Physicians all advocate for clinicians and physicians to counsel patients on the risks,” said the study’s lead author, Andrew Conner, a medical student at the Frank H. Netter MD School of Medicine at Quinnipiac University in North Haven Connecticut.

Conner says he and his colleagues weren’t surprised by the findings.

“They’re pretty much in line with previous studies,” he said. “But ours is the first to look at the issue on a national level. Others have looked at specific subgroups, such as parents of children.”

In the last decade, more than a dozen states have introduced legislation aiming to prohibit physicians from asking their patients about gun ownership or gun safety precautions. Florida’s “gag law,” the most restrictive, was eventually found to violate physicians’ 1st Amendment rights.

“I think there are a lot of physicians who may not feel comfortable counseling patients on sensitive topics, especially given the political nature of the firearms debate” Conner said. “Lack of training is another commonly cited reason why physicians and clinicians don’t counsel their patients on this subject.”

To take a closer look at how often clinicians and physicians are talking to patients about gun safety, Conner and his colleagues turned to data from the second National Firearms Survey, conducted online from July 30 to August 11, 2019, by the survey firm Ipsos. All of those participating in the survey were adults living in homes with firearms, both owners and people who lived with them.

The participants were sampled from the Ipsos Knowledge Panel, a probability based web panel of approximately 55,000 noninstitutionalized, English-speaking adults designed to represent the U.S. population, with the exception of active military personnel.

Respondents were asked: “Has a physician or other health care provider ever spoken to you about firearm safety?” Those who answered yes were asked a series of other questions: where did the discussions occur (outpatient medical visit, outpatient mental health visit, emergency department or other setting); who the patient was (the respondent, another adult or a child); and what was discussed in the most recent encounter. The survey data included information on socio-demographics and whether there were children in the home.

Included in the analysis were data from 4,030 respondents, 7.5 percent of whom said they had ever discussed firearm safety with a provider. The proportion was slightly higher, 12. 0 percent, among those who were living children, as compared to 5 percent of those in homes without children.

Of those who had discussed firearms with a provider, 48 percent said that locking all firearms was discussed at their most recent visit, 31.8 percent said that storing ammunition separately from firearms was discussed and 15.9 percent said that removing firearms from the home as covered. When the patient was a child just 4.1 percent reported discussing removing firearms.

Dr. Paul Nestadt welcomed the new study.

“This is such an important paper,” said Dr. Nestadt, an assistant professor of psychiatry at the Johns Hopkins School of Medicine. “It’s a big deal that it’s in the Annals.”

“It’s particularly important right now in the context of the 2020 pandemic and everything else that has happened this year,” Dr. Nestadt said. “There has been a dramatic run on guns. There are more new gun owners this year than there have been since people have been keeping track. There was a huge spike in March that has continued month after month with a new record in June.”

This big increase in gun ownership is different from the ones that preceded it, Dr. Nestadt said. “For the first time ever, there have been more new gun buyers in Democratic states,” he added. “One new survey found that about half of gun buyers during the pandemic are new gun buyers. And they are at a high risk for problems. About half never had safety training and 42 percent had a gun unlocked with kids in the house.”

That makes it even more important for physicians to talk to patients about guns, Dr. Nestadt said. “Especially in areas where they are not used to having the conversation,” he added. “Now there are new owners in blue states and urban areas. These are not traditional gun buyers.”