Thursday, April 28, 2011

The NRA takes aim at the physician-patient relationship

Should the government be able to dictate to a doctor what he or she is allowed to discuss with a patient? Yes, says the National Rifle Association (NRA), which is pushing state legislation to prohibit physicians from asking patients about firearms in their homes.

An NRA-supported bill in Florida originally would have made it a criminal offense—punishable by fines and/or jail—if physicians asked a patient about firearms. The Florida Medical Association (FMA) fiercely opposed the bill as an intrusion on the physician-patient relationship. Now, a compromise has been reached between the NRA and the FMA that “allow doctors to ask questions about gun ownership, as long as the physician doesn’t ‘harass’ the patient, and doesn’t enter the information into the patient’s record without a good reason.” Violations would be policed by the state licensing board instead of being subject to criminal prosecution.

A long-standing ACP policy encourages physicians “to inform patients about the dangers of keeping firearms, particularly handguns, in the home and to advise them on ways to reduce the risk of injury.” But this issue is much bigger than guns, it is about whether the government should be allowed to tell physicians what they can and can’t say to patients.

Bob Centor of DB’s Medical Rants calls the NRA bill an “outrageous” attack on the doctor-patient relationship. He links to a must-read blog from a gun owing ER physician from Texas who explains why no physician should support the NRA bill—including the compromise.

I am not going to second-guess the difficult decisions made by the Florida Medical Association. But I agree with Dr. Centor that it is “outrageous” that the government would even consider dictating to a doctor what he or she can say to a patient. If this isn’t big government at its worst, tell me what is?

If the government can ban physicians from asking patients about firearms, what’s next? Will legislators sympathetic to the cattle industry try to prohibit physicians from asking patients about their consumption of steaks? Will advocates for legalized marijuana try to prohibit physicians from asking patients about their use of drugs? Where does it stop?

And where are all of the “constitutional conservatives” who carry copies of the U.S. constitution in their pockets? Are they raising their voices against the NRA and its state legislature sycophants over this egregious attack on the first amendment right to free speech? If the NRA succeeds in Florida and other states in getting physicians thrown in jail if they violate a government-dictated speech, then how can I as a patient trust anything that my doctor tells me in the examination room?

Today’s question: What do you think about the NRA’s effort to pass laws to dictate to doctors what they can and can’t say to their patients?


Jay Larson MD said...

Heck, the tobacco and alcohol industry should jump on the band wagon so physicians can't ask about tobacco or alcohol use.
What insanity.

ryanjo said...

As a resident of Florida, I am embarrassed that this bill is even being considered. But the deeper story is that the Florida Medical Association (FMA) is skillfully doing some serious horse-trading with the legislature on a number of issues that seriously affect physicians and patients. FMA leadership of the compromise on the gun ownership bill, which watered it down to meaningless drivel, garnered support for a tort reform bill regulating expert witnesses that is also moving through committee. Maybe our national medical leadership could learn about working the political system to meet our goals instead of rubber-stamping the ACA while accepting no meaningful action on SCR repeal, serious tort reform or bureaucratic burdens on physicians.