Physicians and the NRA December 3, 2018 Gun violence, Leadership, membership, Monday RX, Public Health 1149 Hours after a gunman opened fire in the Borderline Bar & Grill in Thousand Oaks, killing 12 people before turning the gun on himself, the NRA told "anti-gun" doctors to "stay in their lane" after a series of research papers about firearm injuries and deaths was published in the Annals of Internal Medicine, including new recommendations to reduce gun violence. The NRA wrote in the tweet, "Someone should tell self-important anti-gun doctors to stay in their lane. Half of the articles in Annals of Internal Medicine are pushing for gun control. Most upsetting, however, the medical community seems to have consulted NO ONE but themselves." As president of the Los Angeles County Medical Association, a 147-year-old organization dedicated to serving the medical profession and as a mental health advocate, I agree with my colleagues that we indeed need rigorous research to better understand the crisis, test solutions, and learn how best to implement and sustain work that is being done. As physicians we have a responsibility to seek the answers to questions related to health and safety of the communities, we serve every day. At LACMA, we surveyed our members (approximately 6,000) and the feedback has been both consistent and sobering: Some believe that organized medicine should treat violence, including gun violence, as an epidemiological health issue. Firearm ownership should include getting an operator's license and requirements for safe storage and safe use. Requiring every gun owner to complete a training course at first purchase and a recertification every year or two would also be useful. The training should include gun safety, depression warning signs, and instruction about how to get help for those in need. This is similar to what is done with motor vehicles. A sales tax on all gun purchases and ammunition purchases could be used to fund shelters, mental health facilities, free gun lock programs, and sponsored gun buybacks. All of this is similar to what was done with tobacco. One physician member had a different view: "I feel safer in my house knowing that many doctors have guns in their house, deterring break-in robberies. There isn't research that says keeping guns away from law-abiding doctors deters criminals." Perhaps one step is to follow the lead of the American College of Surgeons as they have enlisted gun owners to help them dissect the dilemma and help develop workable solutions. In fact, the best solution may be a respectful dialogue between gun owners and physicians to seek solutions and get away from ideology and painful rhetoric. A compromise based on facts, not ideology or raw emotion. Next year, LACMA will be hosting a "conversation" with local stakeholders including the emergency room, trauma and mental health experts along with law enforcement and yes, gun advocates to seek dialogue and perhaps, just perhaps, the lane could be expanded to many, not some. C. Freeman, MD, MBA, FAPA President, Los Angeles County Medical Association Adult and Geriatric Psychiatrist