Just released: Proceedings from inaugural Medical Summit on Firearm Injury Prevention

CHICAGO (May 20, 2019): Proceedings from the first-ever Medical Summit on Firearm Injury Prevention have been released and published on the Journal of the American College of Surgeons website as an “article in press” in advance of print publication.

Leaders from the 43 national medical organizations and the American Bar Association attended the historic meeting on February 10-11 in Chicago, which was hosted by the American College of Surgeons Committee on Trauma (ACS COT). Organizations represented lawyers, physicians, nurses, public health professionals, and emergency medical service providers, with attendees providing perspectives from the front lines of caring for seriously injured patients as well as dealing with the aftermath of violence in communities.

“We’ve reached a point where tens of thousands of Americans are seriously injured, permanently disabled, or die annually from firearm incidents,” said David B. Hoyt, MD, FACS, ACS Executive Director. “By working together with other stakeholder organizations seeking to remedy this crisis, we can collectively find and put forth viable solutions to this epidemic that continues to inflict tragedy on Americans’ lives.”

Throughout the Summit, attendees expressed their compelling interest in reducing deaths, injuries, and disabilities from firearms in the U.S. The collegial environment of the meeting set the scene for fostering an inclusive dialogue on how to work together to identify opportunities for the medical community to reach a consensus-based, apolitical approach to firearm injury prevention focused on understanding and addressing the root causes of firearm violence while making firearm ownership as safe as possible.

Summit attendees identified opportunities to collaborate in the areas of research, education, and targeted injury prevention initiatives. Using a public health framework, attendees engaged in collegial discussions to build consensus on actionable items for firearm injury prevention that the group could support as a unified voice.

Following the meeting, consensus statements were compiled by the planning committee and brought to the attention of attendees for further internal consideration by their organizations.

The just-released Summit proceedings article identifies a comprehensive public health approach to addressing this problem that 42 of the participating organizations have formally agreed to support and provides a road map that can be implemented through collaboration among medical, legal, and community organizations.

Briefly summarized below, these consensus-based points for potential action address the need to:

• Recognize firearm injury as a U.S. public health crisis, and take a comprehensive public health and medical approach to address it
• Research this public health crisis using a disease model, and call for research funding at federal and philanthropic levels commensurate with the burden of the disease on society
• Engage firearm owners and communities at risk as stakeholders to develop firearm injury programs
• Empower the medical community across all health care settings to act in the best interests of their patients in a variety of palpable ways: counsel patients on safe firearm storage; screen patients at risk for firearm injury or death; and engage the community in addressing the social determinants of disease through hospitals and healthcare systems
• Commit professional stakeholder organizations to ensure that these statements lead to constructive actions for improving the health and well-being of our nation
  (Read the complete Executive Summary of the Summit proceedings. Addendum follows.)

“A key driver for this movement is to take a systems-based approach toward addressing the problem and base it on the public health model,” explained Ronald M. Stewart, MD, FACS, article coauthor, who is Medical Director of ACS Trauma Programs. “This approach involves not only engaging firearms owners as part of the solution–not the problem–but also engaging people who live in communities at risk as part of the solution, and not the problem. We must identify our society’s structural factors and social determinants that create or perpetuate the cycle of firearm violence and call for a commitment for research funding that matches the burden of this disease in America.”

“Despite the fact that many organizations have been leading efforts for years to address the dire consequences of firearm violence, a national collaborative effort led by the medical profession as a whole has yet to take flight,” said Eileen M. Bulger, MD, FACS, Summit moderator, coauthor, Chair of the ACS Committee on Trauma, and professor of surgery, University of Washington, Seattle. “And yet–while the medical community has successfully worked together to reduce death rates from traffic injuries, HIV, and cancer–U.S. death rates from firearm violence have risen. The precedent is already there: by taking a public health approach to addressing this problem, we can work more effectively as a whole to reduce death, disability, and injury from firearms.”

As the authors write, “coming together as a professional community and approaching this epidemic as a disease and a public health problem promises to make our neighborhoods and our country safer, stronger, and more resilient. We believe this can be done in a manner which preserves (or even enhances) freedom. This professional approach requires freedom with responsibility.”

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In addition to Dr. Bulger and Dr. Stewart, other article coauthors are Deborah A. Kuhls, MD, FACS; Brendan T. Campbell, MD, FACS; Stephanie Bonne, MD, FACS; Rebecca M. Cunningham, MD, FACEP; Marian Betz, MD, FACEP; Rochelle Dicker, MD, FACS; Megan L. Ranney, MD, MPH, FACEP; Chris Barsotti, MD, FACEP; Stephen Hargarten, MD, FACEP; Joseph V. Sakran, MD, MPH, FACS; Frederick P. Rivara, MD, MPH, FAAP; Thea James, MD, FACEP; Dorian Lamis, PhD; Gary Timmerman, MD, FACS; Selwyn O. Rogers, MD, FACS; and Bechara Choucair, MD.

“FACS” designates that a surgeon is a Fellow of the American College of Surgeons.

Citation: Proceedings from the Medical Summit on Firearm Injury Prevention: A Public Health Approach to Reduce Death and Disability in the U.S. Journal of the American College of Surgeons. DOI: https://doi.org/10.1016/j.jamcollsurg.2019.05.018.

Note: The Journal article contains a list of the participating organizations and resources that these groups have already publicly put forth on firearm injury prevention.

Medical and Injury Prevention Organizations that Support the Consensus Statements from the Medical Summit on Firearm Injury Prevention – Listed online
Addendum: Executive Summary, Proceedings from the Medical Summit on Firearm Injury Prevention

About the American College of Surgeons

The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for surgical patients. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 82,000 members and is the largest organization of surgeons in the world. For more information, visit http://www.facs.org.

Executive Summary

Proceedings from the Medical Summit on Firearm Injury Prevention

Chicago, IL

In collaboration with 43 leading professional organizations in the United States, the American College of Surgeons hosted a historic Medical Summit on Firearm Injury Prevention in February 2019. The leadership of these organizations came together around developing a public health approach to minimize death and disability related to firearm injuries in the U.S. The publication of the proceedings from this conference demonstrates the extremely strong commitment of the professional medical and legal communities in eliminating needless death and suffering related to firearm injury. The report provides a road map for a comprehensive public health approach that can be implemented through these medical, legal, and community organizations. The document also provides a summary of the current activities by each of the participating organizations. The publication concludes with the following consensus statements supported by 42 of the participating organizations:

1. Firearm injury in the United States is a public health crisis.
2. A comprehensive public health and medical approach is required to reduce death and disability from firearm injury.
3. Research is needed to better understand the root causes of violence, identify people at risk, and determine the most effective strategies for firearm injury prevention.
4. Federal and philanthropic research funding must be provided to match the burden of disease.
5. Engaging firearm owners and populations at risk is critical in developing programs and policies for firearm injury prevention.
6. Health care providers should be encouraged to counsel patients and families regarding firearm safety and safe storage. Educational and research efforts are needed to support appropriate culturally competent messaging.
7. Screening for the risk of depression, suicide, intimate partner violence, and interpersonal violence should be conducted across all health care settings and in certain high-risk populations (such as those with dementia). Comprehensive resources and interventions are needed to support patients and families identified as high risk for firearm injury, who have access to a firearm.
8. Hospitals and health care systems must genuinely engage the community in addressing the social determinants of disease, which contribute to structural violence in underserved communities.
9. Our professional organizations commit to working together and continuing to meet in order to ensure these statements lead to constructive actions which improve the health and well-being of our fellow Americans.

A comprehensive public health approach requires an in-depth understanding of the epidemiology of violence and culturally competent, evidence-based interventions. This approach requires a significant investment in firearm injury prevention research and collective effort to address the social determinants of health and structural violence in our communities.

The report outlines the current evidence for specific interventions to address suicide, unintentional injury, and intentional interpersonal violence such as: counseling patients and families regarding safe storage of firearms; lethal means safety for suicide prevention; hospital-based violence intervention programs; identifying patients at risk for violence; the relationship between mental health and firearm injury; and issues of public policy.

Many of these practical interventions can be implemented without the need for political debate. We believe that by investing in research and empowering the professional community to address this issue we can improve the health and well-being of all Americans.